Retinal Vascular Calibre, Geometry and Progression of Diabetic Retinopathy in Type 2 Diabetes Mellitus

Abstract

Purpose: To determine whether changes in retinal vascular calibre and geometry are associated with progression of diabetic retinopathy in type 2 diabetes (T2D). Procedures: The retinal vascular calibre and geometry of 30 subjects with more than 20 years of diagnosed T2D with no retinopathy (NR) were compared to 30 subjects that progressed to proliferative diabetic retinopathy (PDR). The images of PDR subjects included in this study were those obtained before the onset of retinopathy. The diameter of retinal arterioles (CRAE), retinal venules (CRVE), tortuosity of retinal vessels, junctional exponent deviation (JE_a) and fractal dimension (D_f) were measured using Singapore I Vessel Assessment (SIVA 3.0) software and compared using Mann-Whitney U test. Results: The median CRAE and the median CRVE were significantly wider in PDR subjects compared to NR subjects (p = 0.014 and 0.016), respectively. Curvature tortuosity of the retinal arteries and veins and D_f were significantly decreased in the PDR subjects compared to NR subjects (p = 0.015, 0.016 and 0.03, respectively). The JE_a was significantly increased in PDR subjects (p = 0.01). Conclusions: Retinal vessel calibre and geometry of the retinal vasculature may be important risk factors for the progression to PDR. More longitudinal prospective studies will be needed to further explore the findings of this study.

Retinal Vascular Fractals Correlate With Early Neurodegeneration in Patients With Type 2 Diabetes Mellitus

“…21 Most clinical studies measuring Fd have included patients with type 1 diabetes mellitus, 12,13,22À24 patients with increased levels of HbA1c, 25,26 or examined data from patients with diabetes who developed DR over time. 27À29 In a cross-sectional study, Grauslund et al 12 found an independent correlation between lower Fd and the presence of inactive PDR as well as neuropathy.…”

Racial Differences in Retinal Vessel Geometric Characteristics: A Multiethnic Study in Healthy Asians

“…[39][40][41][42][43] BC was calculated to measure the changes in the total cross-sectional area across the bifurcation. An increased BC represented wider branch vessels, and a decreased branching coefficient indicated narrower branch compared with the trunk vessel.…”

The progress in understanding and treatment of diabetic retinopathy

“…The intra-retinal vasculature lacks autonomic innervation and close-regulation of blood flow through the inner retina is dependent on cell-cell signalling mechanisms(Delaey et al, 2000). Abnormalities of retinal blood flow in diabetic patients were reported by Wagener in the 1930's(Wagener et al, 1934) and as technology for assessing vascular function improved there were further indications that vessel calibre changed during diabetic retinopathy(Ballantyne and Loewenstein, 1943;Skovborg et al, 1969) with some predictive value(Crosby- Nwaobi et al, 2012) . In the 70's, seminal work by Kohner described hemodynamic changes in the diabetic retinal vasculature with a strong assertion that these abnormalities were connected to pathology and could form the basis of an early-stage indicator for diabetic retinopathy progression(Kohner, 1993; Kohner et al, 1975).…”