RT Journal Article
SR Electronic
T1 Retinal arteriolar calibre and venular fractal dimension predict progression of proliferative diabetic retinopathy 6 months after panretinal photocoagulation: a prospective, clinical interventional study
JF BMJ Open Ophthalmology
JO BMJ Open Ophth
FD BMJ Publishing Group Ltd
SP e000661
DO 10.1136/bmjophth-2020-000661
VO 6
IS 1
A1 Thomas Lee Torp
A1 Ryo Kawasaki
A1 Tien Yin Wong
A1 Tunde Peto
A1 Jakob Grauslund
YR 2021
UL http://bmjophth.bmj.com/content/6/1/e000661.abstract
AB Objective We examined the hypothesis that baseline retinal vascular geometry in patients with proliferative diabetic retinopathy (PDR) predicts disease activity 6 months after panretinal photocoagulation (PRP).Methods and analysis We included 47 eyes from 40 patients with treatment-naïve PDR in a 6-month prospective study. Diagnosis of PDR and disease activity was evaluated by wide-field fluorescein angiography (Optomap, Optos, Dunfermline, Scotland, UK). At baseline and 6-month follow-up, the retinal vessel geometry was measured on optic disc centred images using semiautomated software Vessel Assessment and Measurement Platform for Images of the Retina (VAMPIRE, Dundee, Scotland).Results At baseline, mean age and duration of diabetes was 51.6 and 21.4 years, and 62.5% were men. Seventeen eyes (36.2%) had progression of PDR during follow-up. At baseline, we found higher retinal arteriolar calibre (31.3±0.8 vs 28.8±0.8 pixels, p=0.02) and venous fractal dimension (FD) (1.257±0.011 vs 1.222±0.011, p=0.02) in eyes with progression of PDR as compared with eyes with non-progression. In a multiple logistic regression model, both higher retinal arteriolar calibre (OR 1.34, 95% CI, 1.09 to 1.64, p<0.01) and venular FD (OR 1.15, 95% CI, 1.04 to 1.27, p<0.01) predicted progression of PDR. Venular calibre was seen to increase from baseline to month six regardless of disease progression (non-progression 45.0±0.7 vs 52.7±1.8 pixels, p<0.01; progression 46.2±0.8 vs 51.0±1.7 pixels, p<0.01).Conclusion Our prospective study showed that arteriolar calibre and venular FD at baseline were predictive of disease activity 6 months after PRP treatment in patients with treatment-naïve PDR.