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Evaluate hemorrhages, microaneurysm with UWFI to determine DR progression risk
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More peripheral and total microaneurysms were associated with increased diabetic retinopathy progression over 4 years in patients with mild to moderate nonproliferative diabetic retinopathy at baseline, according to research presented at the Association for Research and Vision in Ophthalmology annual meeting.
“Automation of microaneurysm localization and counting holds promise for future rapid and large-scale assessment of these parameters from ultra-widefield images in clinical, research and screening programs,” Paolo S. Silva, MD, said in an interview with Primary Care Optometry News.
The single-site, prospective, 4-year longitudinal study included 102 eyes with mild to moderate nonproliferative diabetic retinopathy (NPDR) on Early Treatment Diabetic Retinopathy Study photos.
Mild NPDR was found in 48 eyes, and moderate NPDR was found in 54 eyes.
Four-year follow-up photos were obtained in 38 eyes with mild and 44 eyes with moderate NPDR. In mild NPDR, 12 had predominantly peripheral (PPL) microaneurysms and 26 had post-microaneurysms.
DR severity progressed at least two steps in 16.7% with PPL microaneurysms and 0% with post-hemorrhages and/or microaneurysm (HMa). In moderate NPDR, five had PPL-HMa, and 39 had post-HMa, according to the study.
Those with at least two-step progression with PPL-HMa made up 20% vs. 23% with post-HMa.
In mild NPDR, eight had HMa count of at least 80 and 30 had at less than 80.
In mild-to-moderate NPDR, an increase of 10 HMa on ultra-widefield imaging (UWFI) increased the risk for two-step progression, which remained significant after correcting for baseline DR severity, according to researchers.
For every 10 HMa identified on UWFI, the risk for DR progression over 4 years may be increased 24%, Silva explained.
Researchers suggest that the larger the retinal area imaged and the greater the number of HMa seen on ultra-widefield imaging may provide a better overall assessment of DR and risk of progression.
“The quantification of HMa and their distribution on UWF images may provide more accurate information regarding diabetic retinopathy progression risk,” Silva concluded. – by Abigail Sutton
Reference:
Silva PA, et al. Hemorrhages and/or microaneurysm distribution and counts identified on ultra-widefield imaging and the risk of diabetic retinopathy progression over 4 years. Presented at: Association of Research in Vision and Ophthalmology annual meeting; May 7-11, 2017; Baltimore.
Disclosure : Silva receives financial support from Optos. Please see the abstract for all other authors’ financial disclosures.