Microaneurysm Turnover in eyes with mild nonproliferative diabetic retinopathy is associated with progression and development of sight-threatening complications: a 5-year longitudinal study

Abstract

Purpose : To evaluate microaneurysm turnover (MAT) as a predictive biomarker for retinopathy progression and development of sight-threatening complications, diabetic macular edema (DME) or proliferative retinopathy (PDR), in patients with type 2 diabetes and mild nonproliferative retinopathy (NPDR) in a 5-year follow-up.

Methods : A 5-year prospective, longitudinal study was designed to follow 212 patients with type 2 diabetes (T2D) and mild NPDR (ETDRS grades 20 and 35). Ophthalmological examinations of the study eye including color fundus photography (CFP) and optical coherence tomography were performed at baseline, at the first 6-months visit and annually. Outcomes were DME and/or PDR development. MAT analysis included determination of MA formation and disappearance rates, automatically assessed using the RetMarkerDR at 12-month visits. Retinopathy severity progression was evaluated using step increase in ETDRS severity grades.

Results : Of the 212 individuals with T2D and mild NPDR, 162 completed the 5-year follow up period of the study or developed an endpoint (n=25). MAT calculated on the first year showed significant association with the development of any endpoint (p = 0.0178), in particularly MA disappearance rate (p= 0.007). MAT showed also significant association with ETDRS severity worsening in the 5-year period (p= 0.0353). There were variations between MAT values in the first year of follow-up (2.04±3.18) and the 5-year (2.26±3.06; p=0.060), with a clear increase in the MA disappearance rate being observed in the last year of the study (1.50±1.93) compared with the first-year of follow-up (1.05±1.99; p=0.003).

Conclusions : MAT in eyes with T2D and mild NPDR is associated with retinopathy severity progression and development of DME and/or PDR in a period of 5-years.

This is a 2021 ARVO Annual Meeting abstract.