Spatial distribution of early red lesions is a risk factor for development of vision-threatening diabetic retinopathy

Ometto, Giovanni and Assheton, Phil and Caliva, Francesco and Chudzik, Piotr and Al-Diri, Bashir and Hunter, Andrew and Bek, toke (2017) Spatial distribution of early red lesions is a risk factor for development of vision-threatening diabetic retinopathy. Diabetologia, 60 (12). pp. 2361-2367. ISSN 0012-186X

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Aims/hypothesis Diabetic retinopathy is characterised by morphological lesions related to
disturbances in retinal blood flow. It has previously been shown that the early development
of retinal lesions temporal to the fovea may predict the development of treatment-requiring
diabetic maculopathy. The aim of this study was to map accurately the area where lesions
could predict progression to vision-threatening retinopathy.
Methods The predictive value of the location of the earliest red lesions representing
haemorrhages and/or microaneurysms was studied by comparing their occurrence in a
group of individuals later developing vision-threatening diabetic retinopathy with that in a
group matched with respect to diabetes type, age, sex and age of onset of diabetes mellitus
who did not develop vision-threatening diabetic retinopathy during a similar observation
Results The probability of progression to vision-threatening diabetic retinopathy was higher
in a circular area temporal to the fovea, and the occurrence of the first lesions in this area
was predictive of the development of vision-threatening diabetic retinopathy. The calculated
peak value showed that the risk of progression was 39.5% higher than the average. There
was no significant difference in the early distribution of lesions in participants later
developing diabetic maculopathy or proliferative diabetic retinopathy.
Conclusions/interpretation The location of early red lesions in diabetic retinopathy is
predictive of whether or not individuals will later develop vision-threatening diabetic
retinopathy. This evidence should be incorporated into risk models used to recommend
control intervals in screening programmes for diabetic retinopathy.

Keywords:Diabetic retinopathy, Haemorrhages, Imaging, Microaneurysms, Retinal lesions, Risk factors
Divisions:College of Science > School of Engineering
ID Code:28466
Deposited On:31 Aug 2017 13:27

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