Potential Imaging Biomarkers in the Development and Progression of Diabetic Retinopathy

Abstract

Diabetic retinopathy (DR) is the most prevalent microvascular complication of diabetes and a leading cause of preventable blindness in the working-age population. However, due to a lack of suitable biomarkers, its prediction in asymptomatic patients is insufficient. Currently, DR is diagnosed at a stage when typical morphologic lesions become fundoscopically visible. Yet, chronically elevated blood glucose levels lead to characteristic alterations in retinal vessel caliber, blood flow, oxygen saturation, and the capillary network, which precede DR lesions. Furthermore, emerging evidence suggests that retinal neurodegenerative changes occur early in diabetes, initiating a disintegration of the retinal neurovascular unit prior to the appearance of microvasculopathy in DR. This chapter will discuss recent research achievements toward understanding the complexities of DR pathophysiology. It will focus on the nomination of potential imaging biomarkers for the prediction of DR development and progression using innovative structural, functional, and metabolic imaging techniques, including optical coherence tomography angiography (OCTA), retinal oximetry, ultra-wide field FA, and corneal confocal microscopy (CCM). Validation of these biomarkers would allow the identification of patients at high risk of developing DR and might initiate a swift move to early diagnosis and individualized care.

Microperimetry and mfERG as functional measurements in diabetic macular oedema undergoing intravitreal ranibizumab treatment

“…1), MP and mfERG values appear to have a good discriminative power to separate patients that will be good or poor responders, after treatment (ROC AUC = 0.65 and 0.68, respectively, Table 3). These results may indicate that different levels of visual dysfunction could occur in parallel with, or even before, BCVA impairment [31], and are worthwhile to be evaluated for a better characterization of DMO patients.…”

Automated analysis of retinal microcirculation in type 1 diabetes mellitus

“…Среди лабораторных биомаркеров информативным является определение уровня цитокинов в сыворотке, стекловидном теле, водянистой влаге и слезной жидкости, однако данный метод является инвазивным. Преимуществом оценки визуализируемых биомаркеров является неинвазивная оценка состояния сетчатки и сосудистой оболочки глаза in vivo, сопоставимого с гистологической картиной, при этом возможна оценка как структурных изменений ткани сетчатки, так и параметров микроциркулярного русла [3,4]. В настоящее время подробная оценка визуализируемых биомаркеров микрососудистого русла сетчатки доступна с помощью метода оптической когерентной томографии-ангиографии (ОКТ-А).…”