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M. Yanagi, R. Kawasaki, L. Maple-Brown, E. L. Lamoureux, A. Harper, T. Y. Wong, S. Tatipata, T. Dunbar, K. O'Dea, J. Cunningham; Retinal Vascular Fractals and Diabetic Retinopathy: DRUID Study. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2090.
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© ARVO (1962-2015); The Authors (2016-present)
Fractal analysis is a new concept designed to quantify complex geometry branching patterns. We investigated the association between fractal dimension of the retinal vasculature (Df) and diabetic retinopathy (DR) in the Diabetes and Related conditions in Urban Indigenous people in the Darwin region, Northern Australia (DRUID) study.
Of the study participants, we identified 94 diabetic patients (mean age ±standard deviation [SD]: 50.9±11.2; female 70 [74.4%]) with good quality photographs for both Df and DR grading. Retinal photographs were assessed by retinal specialist for presence and severity of DR and Df in right eye was measured using standardized grading software (IRIS-Fractal, patent pending). We compared mean Df difference between eyes with or without DR adjusting for possible confounders.
Mean values (±SD) Df for patients with and without DR were 1.416 (±0.036) and 1.435 (±0.027), respectively; this difference was not statistically significant (p=0.34) after multivariate adjustment. Eyes with severe non-proliferative DR or proliferative DR had (95% confidence interval -0.08, -0.003) smaller Df compared to eyes without DR (p=0.035).
In indigenous Australian diabetic patients, eyes with severe stage DR have smaller Df compared to eyes without DR Although the study was based on small numbers, the data suggests altered retinal vascular architecture in eyes with advanced DR, and fractal imaging analysis may be useful in understanding vascular patterns in the pathogenesis of DR.
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