Microaneurysm Formation Rate as a Predictive Marker for Progression to Clinically Significant Macular Edema in Nonproliferative Diabetic Retinopathy

Haritoglou, Christos; Kernt, Marcus; Neubauer, Aljoscha S.; Gerß, Joachim; Oliveira, Carlos Manta; Kampik, Anselm; Ulbig, Michael W.

doi:10.1097/iae.0b013e318295f6de

Cited by 54 publications

(43 citation statements)

References 16 publications

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“…The images were cropped (the periphery outside the retinal arcades was removed) prior to the analysis and then analyzed with the RetmarkerDR software as described previously [10]. …”

Section: Methodsmentioning

confidence: 99%

“…Recent studies have emphasized the turnover of MAs assessed by an automated analysis (RetmarkerDR) as a predictive factor for the progression to clinically significant macular edema (CSME) and to identify patients being at risk to develop sight-threatening complications [9,10]. …”

Section: Introductionmentioning

confidence: 99%

“…Therefore, the present study was conducted to compare MA turnover in diabetic eyes with and without CSME and in the eyes with CSME receiving ranibizumab treatment in order to assess whether there is any association between MA turnover and edema resolution as measured by OCT [10]. …”

Section: Introductionmentioning

confidence: 99%

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Microaneurysm Turnover in Diabetic Retinopathy Assessed by Automated RetmarkerDR Image Analysis - Potential Role as Biomarker of Response to Ranibizumab Treatment

et al. 2014

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Purpose: To evaluate the influence of a ranibizumab treatment on microaneurysm (MA) turnover in diabetic retinopathy. Methods: Sixty-nine eyes were included in this retrospective study. We compared a group of 33 eyes with ranibizumab treatment for diabetic macular edema to 36 eyes with nonproliferative diabetic retinopathy only. Nonmydriatic ultra-widefield scanning laser ophthalmoscopy (Optomap) images were obtained at a mean 4.76 ± 1.69 days prior to the first ranibizumab injection (baseline) and again 35.94 ± 2.44 days after the third consecutive injection in a 4-week interval. In untreated controls, images were obtained at baseline and 97.81 ± 3.16 days thereafter. Images were analyzed using the RetmarkerDR software (Critical Health SA, Coimbra, Portugal), and the turnover of MAs was documented and analyzed. Thereafter, MA turnover was correlated with central retinal thickness (CRT) as assessed by OCT. Results: At baseline, patients in the treatment group had 5.64 ± 0.75 MAs. One month after 3 ranibizumab injections, measured MAs decreased to 4.03 ± 0.66. In the untreated control group, the initial number of 3.36 ± 0.6 MAs remained almost unchanged over 3-4 months (2.89 ± 0.57 MAs). Dynamic analysis showed that after ranibizumab treatment 3.06 ± 0.5 new MAs appeared, while 5.09 ± 0.79 disappeared. In the control group, 2.11 ± 0.4 new MAs appeared and 2.61 ± 0.48 disappeared. MA turnover was significantly higher with ranibizumab compared to the control group (8.15 ± 1.14 vs. 4.72 ± 0.81, p < 0.001). Consistently, CRT decreased from 444 to 330 µm in the ranibizumab group, while there was no change in the control group (291 vs. 288 µm). Conclusion: The treatment of macular edema using ranibizumab does not only reduce macular thickness, but also has an impact on the turnover of MAs in diabetic retinopathy. RetmarkerDR analysis showed that more pre-existent MAs disappeared than new MAs developed, and the absolute number of MAs also decreased.

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“…The images were cropped (the periphery outside the retinal arcades was removed) prior to the analysis and then analyzed with the RetmarkerDR software as described previously [10]. …”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Microaneurysm Turnover in Diabetic Retinopathy Assessed by Automated RetmarkerDR Image Analysis - Potential Role as Biomarker of Response to Ranibizumab Treatment

et al. 2014

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“…In SIVA, fractal dimension is calculated from a skeletonised line tracing using the box-counting method, in which each digital photograph is divided into a series of squares for various side lengths and then the number of boxes is counted. Higher values, reflecting increased complexity, are represented by a higher density of the spacefilling pattern of the retinal vascular tree that a high turnover, based on the results of computer-assisted detection, is a predictor for the development of diabetic macular oedema (DMO) in eyes with non-proliferative diabetic retinopathy [10,11,35] and for anti-VEGF treatment response in eyes with macular oedema [36]. These studies suggest that microaneurysm turnover can identify diabetic patients at higher risk for worsening of retinopathy and may be an indicator of vascular disease activity.…”

Section: Assessment Of Structural Changes In the Retinal Microvasculamentioning

confidence: 99%

“…Advances in retinal photography and computer software technologies permit a more objective and precise measurement of retinal vascular changes, such as arteriolar and venular calibres, retinal fractal dimensions and vessel tortuosity [9]. There are also techniques to detect and quantify retinal microaneurysms, and microaneurysm turnover (appearance and disappearance of these lesions over time), a measure of the dynamic process and disease activity in early diabetic retinopathy [10,11]. Moreover, new retinal imaging techniques can now assess functional alterations in the retinal vasculature, providing a better understanding of the effects of chronic hyperglycaemia, inflammation and endothelial dysfunction on the microvasculature in diabetes.…”

Section: Introductionmentioning

confidence: 99%

The clinical implications of recent studies on the structure and function of the retinal microvasculature in diabetes

et al. 2015

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The retinal blood vessels provide the opportunity to study early structural and functional changes in the microvasculature prior to clinically significant microvascular and macrovascular complications of diabetes. Advances in digital retinal photography and computerised assessment of the retinal vasculature have provided more objective and precise measurements of retinal vascular changes. Clinic-and population-based studies have reported that these quantitatively measured retinal vascular changes (e.g. retinal arteriolar narrowing and venular widening) are associated with preclinical structural changes in other microvascular systems (e.g. infarct in the cerebral microcirculation), as well as diabetes and diabetic complications, suggesting that they are markers of early microvascular dysfunction. In addition, there are new retinal imaging techniques to further assess alterations in retinal vascular function (e.g. flicker-induced vasodilatory response, blood flow and oxygen saturation) in diabetes and complications that result from the effects of chronic hyperglycaemia, inflammation and endothelial dysfunction.In this review, we summarise the latest findings on the relationships between quantitatively measured structural and functional retinal vascular changes with diabetes and diabetic complications. We also discuss clinical implications and future research to evaluate whether detection of retinal vascular changes has additional value beyond that achieved with methods currently used to stratify the risk of diabetes and its complications.

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Artificial Intelligence in Diabetic Retinopathy

Grzybowski

Brona²

2021

Artificial Intelligence in Ophthalmology

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Microaneurysm Formation Rate as a Predictive Marker for Progression to Clinically Significant Macular Edema in Nonproliferative Diabetic Retinopathy

Cited by 54 publications

References 16 publications

Microaneurysm Turnover in Diabetic Retinopathy Assessed by Automated RetmarkerDR Image Analysis - Potential Role as Biomarker of Response to Ranibizumab Treatment

Microaneurysm Turnover in Diabetic Retinopathy Assessed by Automated RetmarkerDR Image Analysis - Potential Role as Biomarker of Response to Ranibizumab Treatment

The clinical implications of recent studies on the structure and function of the retinal microvasculature in diabetes

Artificial Intelligence in Diabetic Retinopathy

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