Three-Year Follow-up Study of Blood-Retinal Barrier and Retinal ThicknessAlterations in Patients With Type 2 Diabetes Mellitus and Mild NonproliferativeDiabetic Retinopathy

Lobo, Conceição; Bernardes, Rui; Figueira, João; Abreu, J. R. Faria de; Cunha-Vaz, Josè

doi:10.1001/archopht.122.2.211

Cited by 44 publications

(17 citation statements)

References 15 publications

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“…The results described herein may have a major impact on the management of diabetic retinopathy, particularly if the studies of Klein et al [4], using simple microaneurysm counts, and Lobo et al [23], using determination of microaneurysm turnover, are confirmed in a larger number of patients for a longer follow-up period. The results of this study showed that by using the method described it is possible to reliably identify microaneurysm turnover by calculating microaneurysm formation and disappearance rates and, therefore, activity of the retinopathy in its early stages.…”

Section: Discussionmentioning

confidence: 61%

“…In contrast, computer-assisted determination of microaneurysm turnover in these same eyes and at the same intervals clearly showed a progressive increase in the number of new microaneurysms. This increase was different in different eyes with the same level of retinopathy, potentially identifying eyes in which the retinal disease is more active and possibly progressing more rapidly [23]. …”

Section: Discussionmentioning

confidence: 99%

“…Lobo et al [23] have shown that in mild nonproliferative diabetic retinopathy some patients exhibit rapidly progressive retinopathy, while others show very slow progression to more advanced stages of the disease and visual loss.…”

Section: Discussionmentioning

confidence: 99%

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Computer-Assisted Microaneurysm Turnover in the Early Stages of Diabetic Retinopathy

Bernardes¹,

Nunes²,

Pereira³

et al. 2009

Ophthalmologica

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Purpose: To assess the reliability of microaneurysm turnover, computed from color fundus photographs, in evaluating diabetic retinopathy in patients with type 2 diabetes and nonproliferative retinopathy. Methods: A new method (MA-Tracker) was developed to count microaneurysms by mapping their locations through image co-registration. To compute the reliability of microaneurysm turnover, 3 different graders were asked to earmark microaneurysms on the same set of color fundus photographs. Results: The total numbers of microaneurysms earmarked in each of 5 visits suggest that microaneurysms remain stable over time (p ≥ 0.138). However, an analysis of each microaneurysm showed that only 29.4% remained at the same location. By computing the formation and disappearance rates of microaneurysms (2.3 and 1.7 microaneurysms/year, respectively), a significant turnover of microaneurysms was found. Conclusions: The formation and disappearance rates of microaneurysms obtained from color fundus photographs using MA-Tracker show very good agreement between different graders, and can be used as indicators of microaneurysm turnover in the initial stages of diabetic retinopathy.

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

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Computer-Assisted Microaneurysm Turnover in the Early Stages of Diabetic Retinopathy

Bernardes¹,

Nunes²,

Pereira³

et al. 2009

Ophthalmologica

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“…The second is the fact that the ETDRS classification was constructed on the basis that DR, given time, uniformly progresses to proliferative retinopathy. It is now apparent, from the data available from a variety of longitudinal studies and from clinical experience, that the evolution and progression of DR varies between different individuals and does not necessarily progress in every patient to the terminal stage of proliferative retinopathy [13]. …”

Section: Discussionmentioning

confidence: 99%

Microaneurysm Turnover Is a Biomarker for Diabetic Retinopathy Progression to Clinically Significant Macular Edema: Findings for Type 2 Diabetics with Nonproliferative Retinopathy

et al. 2009

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Purpose: To examine the relationship between microaneurysm turnover (formation rate), using a new semi-automatic method (MA-Tracker) based on color fundus photographs, and diabetic retinopathy (DR) progression to clinically significant macular edema (CSME). Methods: In total, 113 patients/eyes with nonproliferative DR (NPDR) were followed up every 6 months for 2 years as controls of the DR clinical trials, and by conventional general and ophthalmological care for the next 8 years (over a total of 10 years’ follow-up). Microaneurysm turnover for the 2 first years was computed using the MA-Tracker. Results: The 17 patients that developed CSME over the 10 years of follow-up presented a microaneurysm formation rate of 9.2 ± 18.2 microaneurysms/year (mean ± SD) during the first 2 years, which was statistically higher than the eyes that did not develop CSME (0.5 ± 1.2 microaneurysms/year, p < 0.001). These 17 patients also presented higher HbA_1C levels at baseline (8.5 ± 1.2%) compared to the patients who did not develop CSME (7.3 ± 1.2%, p = 0.001). Conclusions: A high microaneurysm formation rate on color fundus photographs appears to be a good biomarker for DR progression to CSME in type 2 diabetic patients with NPDR.

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“…Developments based on high-speed confocal scanning laser ophthalmoscopy brought new insights into the onset and progression of DR from its earliest to its most advanced stages [152,153,154,155,156,157,158]. …”

Section: Other Imaging Modalitiesmentioning

confidence: 99%

Digital Ocular Fundus Imaging: A Review

Bernardes

Serranho

Lobo³

2011

Ophthalmologica

174

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Ocular fundus imaging plays a key role in monitoring the health status of the human eye. Currently, a large number of imaging modalities allow the assessment and/or quantification of ocular changes from a healthy status. This review focuses on the main digital fundus imaging modality, color fundus photography, with a brief overview of complementary techniques, such as fluorescein angiography. While focusing on two-dimensional color fundus photography, the authors address the evolution from nondigital to digital imaging and its impact on diagnosis. They also compare several studies performed along the transitional path of this technology. Retinal image processing and analysis, automated disease detection and identification of the stage of diabetic retinopathy (DR) are addressed as well. The authors emphasize the problems of image segmentation, focusing on the major landmark structures of the ocular fundus: the vascular network, optic disk and the fovea. Several proposed approaches for the automatic detection of signs of disease onset and progression, such as microaneurysms, are surveyed. A thorough comparison is conducted among different studies with regard to the number of eyes/subjects, imaging modality, fundus camera used, field of view and image resolution to identify the large variation in characteristics from one study to another. Similarly, the main features of the proposed classifications and algorithms for the automatic detection of DR are compared, thereby addressing computer-aided diagnosis and computer-aided detection for use in screening programs.

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Three-Year Follow-up Study of Blood-Retinal Barrier and Retinal ThicknessAlterations in Patients With Type 2 Diabetes Mellitus and Mild NonproliferativeDiabetic Retinopathy

Cited by 44 publications

References 15 publications

Computer-Assisted Microaneurysm Turnover in the Early Stages of Diabetic Retinopathy

Computer-Assisted Microaneurysm Turnover in the Early Stages of Diabetic Retinopathy

Microaneurysm Turnover Is a Biomarker for Diabetic Retinopathy Progression to Clinically Significant Macular Edema: Findings for Type 2 Diabetics with Nonproliferative Retinopathy

Digital Ocular Fundus Imaging: A Review

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