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Imaging discovers retina damage in patients with mild diabetic retinopathy
Researchers at Indiana University announced last week the results of a study that could aid in monitoring patients with diabetes, specifically in regard to their sight.
Burns and colleagues reported in Biomedical Optics Express that patients with diabetes demonstrated extensive capillary remodeling in their retinas even though they had only been diagnosed with mild or moderate nonproliferative diabetic retinopathy (NPDR).
"We had not expected to see such striking changes to the retinas at such early stages," Ann Elsner, OD, professor and associate dean in the IU School of Optometry and lead author of the study, said in the announcement. "We set out to study the early signs, in volunteer research subjects whose eyes were not thought to have very advanced disease. There was damage spread widely across the retina, including changes to blood vessels that were not thought to occur until the more advanced disease states."
"It is shocking to see that there can be large areas of retina with insufficient blood circulation," Stephen Burns, OD, professor and associate dean at the IU School of Optometry, said in the release. "The consequence for individual patients is that some have far more advanced damage to their retinas than others with the same duration of diabetes."
The researchers used a confocal adaptive optics scanning laser ophthalmoscope (AOSLO) as well as other instruments to look at the retinas of seven patients with NPDR. In the press release, the university stated that other diagnostic techniques were not able to provide images of the retinal changes.
"Using large aperture AOSLO imaging has allowed us to visualize directly numerous capillary abnormalities in subjects with mild and moderate NPDR, indicating that pre-neovascular processes are already occurring in some individuals," the authors concluded in the study. "These observed changes could contribute to the variability in response to treatment in diabetic patients. Thus, these microvascular changes that include extensive blood vessel remodeling, nonperfusion and vascular leakage resulting in small hard exudates could hold the key for improved clinical classification of diabetic patients, better understanding of the mechanisms of diabetic retinopathy and development of more effective therapies through better patient monitoring of pharmacological intervention using this technology."
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Biomed Opt Express. 2014;doi: 10.1364/BOE.5.000961.