Capillary Dropout in Diabetic Retinopathy

Kowluru, Renu A.; Chan, Pooi-See

doi:10.1007/978-1-59745-563-3_11

Cited by 9 publications

(6 citation statements)

References 108 publications

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“…Finally, decreases in vessel density involving both the DRP and SRP appear to be the only feature that shows clear association with increase in retinopathy severity, as identified by ETDRS level. Our findings support the concept that capillary dropout is a critical process in DR (14).…”

Section: Discussionsupporting

confidence: 90%

Multimodal Imaging of the Initial Stages of Diabetic Retinopathy: Different Disease Pathways in Different Patients

et al. 2018

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The objective of this study was to evaluate the prevalence of different disease pathways (ischemia, neurodegeneration, and edema) in the initial stages of diabetic retinopathy. In this retrospective cross-sectional study, eyes were grouped by diabetic retinopathy severity using the 7-field Early Treatment Diabetic Retinopathy Study (ETDRS) protocol (levels 10–20, 35, and 43–47). Neurodegeneration was identified by thinning of the retinal nerve fiber layer and/or ganglion cell layer. Edema was identified by thickening of the inner nuclear layer, outer plexiform layer, or full retina. Ischemia was identified by metrics of retinal vessel density. Imaging was performed in 142 eyes from 142 patients (28% women) aged 52–88 years. Vessel density (ischemia) was significantly different between the ETDRS groups (P < 0.020). On multivariate regression analysis, it remained significantly different between stages of the disease and showed associations with age (P < 0.001), sex (P = 0.028), and metabolic control (P = 0.034). No significant differences between ETDRS groups were found in retinal thinning (neurodegeneration) or retinal thickness (edema). Eyes with the same ETDRS retinopathy grading from different patients with diabetes showed that the prevalence of different disease pathways varies between patients, even within the same severity group. Ischemia (capillary dropout) is the only disease pathway that shows correlation with retinopathy severity and metabolic control.

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Section: Discussionsupporting

confidence: 90%

Multimodal Imaging of the Initial Stages of Diabetic Retinopathy: Different Disease Pathways in Different Patients

et al. 2018

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“…Cell populations are known to change dramatically in disease (Kowluru and Chan, 2008), which can confound metrics of colocalization. Intercellular colocalization events depend on the prevalence of the two interacting cell populations, and generic statistics cannot ascertain changes in colocalization because the data cannot be normalized to both cell populations simultaneously.…”

Section: Introductionmentioning

confidence: 99%

“…An example where large changes in cellular density are observed is diabetic retinopathy, a disease that is marked by progressive damage to the retina (Wong et al , 2016). Decreases in the densities of both blood vessels (Kowluru and Chan, 2008) and pericytes (Ejaz et al , 2008), a cell type that colocalizes with and stabilizes the microvasculature, have been observed in early diabetes and are thought to initiate the degradation of the retina (Beltramo and Porta, 2013). Toward cell-based therapies, previous work has shown that injecting adipose-derived stem cells (ASCs) can ameliorate microvessel loss when ASCs colocalize with blood vessels and adopt a pericyte-like morphology in the retina and other tissues (Amos et al , 2008; Mendel et al , 2013).…”

Section: Introductionmentioning

confidence: 99%

CIRCOAST: a statistical hypothesis test for cellular colocalization with network structures

et al. 2018

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“…The ETDRS classification is based on the presence of different features identified by fundus photography. These alterations are considered to be related to the presence of capillary closure and ischemia [70]. It is, there-Ophthalmic Res 2021;64:871-887 DOI: 10.1159/000518620 fore, reasonable to think that capillary closure, if reliably quantified and measured, may be an appropriate indicator of changes identified by fundus photography and become an alternative to the ETDRS classification.…”

Section: Oct-a Role As An Alternative To Etdrs Gradingmentioning

confidence: 99%

Standardization of Optical Coherence Tomography Angiography Imaging Biomarkers in Diabetic Retinal Disease

et al. 2021

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Optical coherence tomography Angiography (OCT-A) represents a revolution in the noninvasive evaluation of retinal and choroidal circulation especially in detecting early clinical signs of diabetic retinal disease (DRD). With appropriate use, OCT-A characteristics and measurements have the potential to become new imaging biomarkers in managing and treating DRD. Major challenges include (a) provision of standardized outputs from different OCT-A instruments providing standardized terminology to correctly interpret data; (b) the presence of artifacts; (c) the absence of standardized grading or interpretation method in the evaluation of DRD, similar to that already established in fundus photography; and (d) establishing how OCT-A might be able to provide surrogate markers to demonstrate blood retinal barrier breakdown and vascular leakage, commonly associated with DRD. In fact, OCT-A guidelines for DRD are still evolving. The outputs of quantitative OCT-A data offer a unique opportunity to develop tools based on artificial intelligence to assist the clinicians in diagnosing, monitoring, and managing patients with diabetes. In addition, OCT-A has the potential to become a useful tool for the evaluation of cardiovascular diseases and different neurological diseases including cognitive impairment. This article written by the members of Diabetic Retinopathy expert committee of the European Vision Clinical Research network will review the available evidence on the use of OCT-A as an imaging biomarker in DRD and discuss the limits and the current application as well as future developments for its use in both clinical practice and research trials of DRD.

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Capillary Dropout in Diabetic Retinopathy

Cited by 9 publications

References 108 publications

Multimodal Imaging of the Initial Stages of Diabetic Retinopathy: Different Disease Pathways in Different Patients

Multimodal Imaging of the Initial Stages of Diabetic Retinopathy: Different Disease Pathways in Different Patients

CIRCOAST: a statistical hypothesis test for cellular colocalization with network structures

Standardization of Optical Coherence Tomography Angiography Imaging Biomarkers in Diabetic Retinal Disease

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