Characterization of One-Year Progression of Risk Phenotypes of Diabetic Retinopathy.

Autor: Ribeiro L; AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal. mlribeiro@aibili.pt.; Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal. mlribeiro@aibili.pt.; Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548, Coimbra, Portugal. mlribeiro@aibili.pt., Marques IP; AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.; Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.; Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548, Coimbra, Portugal., Coimbra R; AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal., Santos T; AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal., Madeira MH; AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.; Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.; Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548, Coimbra, Portugal., Santos AR; AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.; Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.; Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548, Coimbra, Portugal.; Department of Orthoptics, School of Health, Polytechnic of Porto, Porto, Portugal., Barreto P; AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal., Lobo C; AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.; Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.; Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548, Coimbra, Portugal.; Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal., Cunha-Vaz J; AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal. cunhavaz@aibili.pt.; Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal. cunhavaz@aibili.pt.; Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548, Coimbra, Portugal. cunhavaz@aibili.pt.
Jazyk: angličtina
Zdroj: Ophthalmology and therapy [Ophthalmol Ther] 2022 Feb; Vol. 11 (1), pp. 333-345. Date of Electronic Publication: 2021 Dec 05.
DOI: 10.1007/s40123-021-00437-z
Abstrakt: Introduction: We characterized the progression of different diabetic retinopathy (DR) phenotypes in type 2 diabetes (T2D).
Methods: A prospective longitudinal cohort study (CORDIS, NCT03696810) was conducted with three visits (baseline, 6 months, and 1 year). Demographic and systemic data included age, sex, diabetes duration, lipid profile, and hemoglobin A1c (HbA1c). Ophthalmological examinations included best-corrected visual acuity (BCVA), color fundus photography (CFP), and optical coherence tomography (OCT and OCTA). Phenotype classification was performed at the 6-month visit based on microaneurysm turnover (MAT, on CFP) and central retinal thickness (CRT, on OCT). Only risk phenotypes B (MAT < 6 and increased CRT) and C (MAT ≥ 6 with or without increased CRT) were included. ETDRS grading was performed at the baseline visit based on seven-field CFP.
Results: A total of 133 T2D individuals were included in the study; 81 (60%) eyes were classified as phenotype B and 52 (40%) eyes as phenotype C. Of these, 128 completed the 1-year follow-up. At baseline, eyes with phenotype C showed greater capillary closure (superior capillary plexus, deep capillary plexus, and full retina, p < 0.001) and increased foveal avascular zone (FAZ) area (p < 0.001), indicating more advanced microvascular disease. Neurodegeneration represented by thinning of the ganglion cell layer + inner plexiform layer (GCL + IPL) was present in both phenotypes. When analyzing the 1-year progression of each phenotype, only phenotype C revealed a significant decrease in BCVA (p = 0.02) and enlargement of the FAZ (p = 0.03). A significant progressive decrease in the vessel density of the deep capillary layer and in MAT occurred in both phenotypes, but these changes were particularly relevant in phenotype C and ETDRS grades 43-47. During the 1-year period, both phenotypes B and C showed progression in GCL + IPL thinning (p < 0.001).
Conclusions: In the 1-year period of follow-up, both phenotypes B and C showed progression in retinal neurodegeneration, whereas phenotype C showed more marked disease progression at the microvascular level.
(© 2021. The Author(s).)
Databáze: MEDLINE
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