Retinal vascular imaging technology to monitor disease severity and complications in type 1 diabetes mellitus: A systematic review

“…In the intragrader measurements, the differences were < 10 μm in relation to 71 and 69 subjects, respectively, with ICCs of 0.67 and 0.91, but also without indicating the microvascular measurement of the retina to which these related. 26 [31][32] the prevalence of complications in type 1 diabetes, 33 the internal carotid artery pulsation index 34 and changes to adiponectin levels. 35…”

Section: Discussionmentioning

confidence: 99%

Validity and reproducibility of retinal arteriole and venule diameter measurements: ELSA-Brasil study. A cross-sectional study

et al. 2018

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Metabolic and vascular changes are inherent to the pathophysiology of diabetes and cardiovascular diseases, and their complications may cause damage to the microvasculature. This is reflected in changes to the diameters of retinal microvessels. 1-10 In this regard, the microvasculature of the retina is considered to be a non-invasive window to the microvascular system, which thus allows inferences to be made in relation to its involvement in the etiology of chronic diseases. 11 Furthermore, changes to retinal vessel caliber have been correlated with incident hypertension, diabetes and cerebral vascular disease. 12-14 To be useful, microvascular measurements of the retina need to be accurate and precise. The approaches towards making such measurements on the retina are still not well described in the literature, most probably because some studies have not defined well which tools (software and mathematical calculations) are used to measure these data. In this regard, the aim of the present study was to evaluate the validity and reproducibility of retinal microvascular measurements that were made within the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

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“…Optical coherence tomography (OCT) has evolved to inform on microvasculature by detecting changes in signal intensity due to microcirculation-induced speckle variations 22,23 . The technique has been employed to assess retinal vasculature in relation to diabetic retinopathy 24,25 or measure the epidermal thickness in patients with type I diabetes mellitus 26 . However, OCT has not been so far shown useful for assessing dermal microvasculature in diabetic skin, possibly due to the highly scattering nature of the epidermis, which limits the imaging sensitivity at dermal layers.…”

Section: Figmentioning

confidence: 99%

Optoacoustic skin mesoscopy opens a window to systemic effects of diabetes

Fasoula

Karlas³

et al. 2020

Preprint

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Diabetes mellitus affects the microvasculature of several organs, including the eyes, heart, brain, kidneys and skin. The skin is the most accessible organ and could offer a window for detecting diabetes-related systemic effects on the microvasculature. However, assessment of skin microvasculature is typically performed based on invasive histological analysis, which is a method that is not well suited for disease monitoring and application to large populations. We introduce ultra-wide band raster-scan optoacoustic mesoscopy (RSOM) for precise, non-invasive assessment of diabetes-related changes in the dermal microvasculature and skin micro-anatomy, resolved with unprecedented sensitivity and detail without the need of contrast agents. Based on this novel contrast, we investigated whether RSOM could impart a new concept in diabetes healthcare, offering characterization of systemic effects of the disease. We applied pretibial RSOM to 72 patients with diabetes, grouped according to disease complications, and 20 age-matched healthy volunteers. We extracted six label-free optoacoustic biomarkers, including dermal microvasculature density, total dermal blood volume and epidermal parameters. We study the effects of diabetes on these parameters as a function of disease severity and find strong statistically significant differences between microvasculature parameters and diabetes progression. We discuss how RSOM label-free biomarkers can lead to a quantitative assessment of the systemic effects of diabetes, complementing the qualitative assessment allowed by current clinical metrics and possibly, in the future, enable a more precise scoring system capturing the gradual evolution of disease.

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Retinal vascular imaging technology to monitor disease severity and complications in type 1 diabetes mellitus: A systematic review

Abstract: Our findings suggest that retinal microvasculature is associated with both disease severity and complications in young patients with T1DM.

Cited by 14 publications

References 51 publications

The Relationship of Retinal Vessel Geometric Characteristics to the Incidence and Progression of Diabetic Retinopathy

The Relationship of Retinal Vessel Geometric Characteristics to the Incidence and Progression of Diabetic Retinopathy

Validity and reproducibility of retinal arteriole and venule diameter measurements: ELSA-Brasil study. A cross-sectional study

Optoacoustic skin mesoscopy opens a window to systemic effects of diabetes

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