PMID- 35066579 OWN - NLM STAT- MEDLINE DCOM- 20230126 LR - 20230511 IS - 1476-5454 (Electronic) IS - 0950-222X (Print) IS - 0950-222X (Linking) VI - 37 IP - 2 DP - 2023 Feb TI - Characterisation of progression of macular oedema in the initial stages of diabetic retinopathy: a 3-year longitudinal study. PG - 313-319 LID - 10.1038/s41433-022-01937-3 [doi] AB - BACKGROUND/OBJECTIVES: To characterise the prevalence and three-year progression of centre-involving diabetic macular oedema (CI-DMO) in minimal to moderate non-proliferative diabetic retinopathy, using optical coherence tomography (OCT) and measurements of retinal fluid using tissue optical reflectivity ratios (OCT-Leakage). METHODS/METHODS: Seventy-four eyes from 74 patients were followed in a 3-year prospective longitudinal observational cohort of type 2 diabetes (T2D) patients using spectral-domain optical coherence tomography (SD-OCT), OCT-Angiography (OCT-A) and OCT-Leakage (OCT-L). Eyes were examined four times with 1-year intervals. Sixteen eyes (17.8%) were excluded from the analysis due to quality control standards. Retinal oedema was measured by central retinal thickness and retinal fluid by using optical reflectivity ratios obtained with the OCT-L algorithm. Vessel density was measured by OCT-A. Thinning of the ganglion cell and inner plexiform layers (GCL + IPL) was examined to identify retinal neurodegenerative changes. Diabetic retinopathy ETDRS classification was performed using the seven-field ETDRS protocol. RESULTS: CI-DMO was identified in the first visit in 9% of eyes in ETDRS groups 10-20, 10% of eyes in ETDRS group 35 and 15% of eyes in ETDRS groups 43-47. The eyes with CI-DMO and subclinical CI-DMO showed a progressive increase in retinal extracellular fluid during the 3-year period of follow-up. The eyes with CI-DMO and increased retinal extracellular fluid accumulation were associated with vision loss. CONCLUSIONS: The prevalence of subclinical CI-DMO and CI-DMO in the initial stages of NPDR occurs independently of severity grading of the retinopathy, showing progressive increase in retinal extracellular fluid and this increase is associated with vision loss (82% 9 out of 11 cases). CI - (c) 2022. The Author(s). FAU - Lobo, Conceicao AU - Lobo C AD - AIBILI - Association for Innovation and Biomedical Research on Light and Image, 3000-548, Coimbra, Portugal. AD - University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, 3000-548, Coimbra, Portugal. AD - Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548, Coimbra, Portugal. AD - Department of Ophthalmology, Centro Hospitalar e Universitario de Coimbra (CHUC), 3000-548, Coimbra, Portugal. FAU - Santos, Torcato AU - Santos T AD - AIBILI - Association for Innovation and Biomedical Research on Light and Image, 3000-548, Coimbra, Portugal. FAU - Marques, Ines P AU - Marques IP AD - AIBILI - Association for Innovation and Biomedical Research on Light and Image, 3000-548, Coimbra, Portugal. AD - University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, 3000-548, Coimbra, Portugal. AD - Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548, Coimbra, Portugal. FAU - Madeira, Maria H AU - Madeira MH AUID- ORCID: 0000-0001-6282-3553 AD - AIBILI - Association for Innovation and Biomedical Research on Light and Image, 3000-548, Coimbra, Portugal. AD - University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, 3000-548, Coimbra, Portugal. AD - Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548, Coimbra, Portugal. FAU - Santos, Ana Rita AU - Santos AR AUID- ORCID: 0000-0003-3761-3292 AD - AIBILI - Association for Innovation and Biomedical Research on Light and Image, 3000-548, Coimbra, Portugal. AD - University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, 3000-548, Coimbra, Portugal. AD - Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548, Coimbra, Portugal. AD - Department of Orthoptics, School of Health, Polytechnic of Porto, Porto, Portugal. FAU - Figueira, Joao AU - Figueira J AD - AIBILI - Association for Innovation and Biomedical Research on Light and Image, 3000-548, Coimbra, Portugal. AD - University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, 3000-548, Coimbra, Portugal. AD - Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548, Coimbra, Portugal. AD - Department of Ophthalmology, Centro Hospitalar e Universitario de Coimbra (CHUC), 3000-548, Coimbra, Portugal. FAU - Cunha-Vaz, Jose AU - Cunha-Vaz J AD - AIBILI - Association for Innovation and Biomedical Research on Light and Image, 3000-548, Coimbra, Portugal. cunhavaz@aibili.pt. AD - University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, 3000-548, Coimbra, Portugal. cunhavaz@aibili.pt. AD - Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548, Coimbra, Portugal. cunhavaz@aibili.pt. LA - eng PT - Journal Article DEP - 20220122 PL - England TA - Eye (Lond) JT - Eye (London, England) JID - 8703986 SB - IM MH - Humans MH - *Macular Edema/diagnosis/etiology MH - *Diabetic Retinopathy/complications/diagnosis MH - Longitudinal Studies MH - *Diabetes Mellitus, Type 2/complications MH - Prospective Studies MH - Tomography, Optical Coherence/methods PMC - PMC9873671 COIS- CL, TS, IPM, MHM and ARS declare no conflicts of interest. JF reports being a member of Advisory Boards for Alimera, Allergan, Bayer, Bhoeringer, and Novartis. JC-V reports grants from Carl Zeiss Meditec and is a consultant for Alimera Sciences, Allergan, Bayer, Gene Signal, Novartis, Pfizer, Precision Ocular Ltd., Roche, Sanofi-Aventis, Vifor Pharma, and Carl Zeiss Meditec. The funders had no role in the design or writing of the manuscript. EDAT- 2022/01/24 06:00 MHDA- 2023/01/27 06:00 PMCR- 2022/01/22 CRDT- 2022/01/23 20:37 PHST- 2021/06/07 00:00 [received] PHST- 2022/01/13 00:00 [accepted] PHST- 2021/12/14 00:00 [revised] PHST- 2022/01/24 06:00 [pubmed] PHST- 2023/01/27 06:00 [medline] PHST- 2022/01/23 20:37 [entrez] PHST- 2022/01/22 00:00 [pmc-release] AID - 10.1038/s41433-022-01937-3 [pii] AID - 1937 [pii] AID - 10.1038/s41433-022-01937-3 [doi] PST - ppublish SO - Eye (Lond). 2023 Feb;37(2):313-319. doi: 10.1038/s41433-022-01937-3. Epub 2022 Jan 22.