Different Patterns of Progression in Nonproliferative Diabetic Retinopathy: Findings From a 10-Year Cohort Study

Characterization of the 10-year progression of diabetic retinopathy in type 2 diabetes was sought. We evaluated whether noninvasive optical coherence tomography angiography (OCTA) can identify eyes that progress and may develop vision loss. Of 222 participants, 62% completed the study, with 115 reaching the 10-year visit: 27% of eyes worsened, 50% remained stable, and 21% improved, based on Early Treatment Diabetic Retinopathy Study severity grading (2% unclassified); microvascular nonperfusion, measured using noninvasive OCTA, distinguished the eyes that worsened or remained stable from those eyes that improved. Progression of microvascular nonperfusion identified by OCTA enables identification of patients at higher risk for disease progression.