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Title: Characterization of One-Year Progression of Risk Phenotypes of Diabetic Retinopathy
Authors: Ribeiro, Luísa 
Marques, Inês P. 
Coimbra, Rita 
Santos, Torcato 
Madeira, Maria H. 
Santos, Ana Rita 
Barreto, Patrícia Susana Correia Lopes 
Lobo, Conceição 
Vaz, José Guilherme Fernandes da Cunha 
Keywords: Diabetes; Retinopathy; Capillary closure; Neurodegeneration
Issue Date: Feb-2022
Publisher: Adis
Project: AIBILI, COMPETE Portugal2020, Foundation for Science and Technology (Project no: 02/SAICT/2017-032412) 
Fundo de Inovação, Tecnologia e Economia Circular (FITEC)—Programa Interface (FITEC/CIT/2018/2). 
Serial title, monograph or event: Ophthalmology and Therapy
Volume: 11
Issue: 1
Abstract: Introduction: We characterized the progression of different diabetic retinopathy (DR) phenotypes in type 2 diabetes (T2D). Methods: A prospective longitudinal cohort study (CORDIS, NCT03696810) was conducted with three visits (baseline, 6 months, and 1 year). Demographic and systemic data included age, sex, diabetes duration, lipid profile, and hemoglobin A1c (HbA1c). Ophthalmological examinations included best-corrected visual acuity (BCVA), color fundus photography (CFP), and optical coherence tomography (OCT and OCTA). Phenotype classification was performed at the 6-month visit based on microaneurysm turnover (MAT, on CFP) and central retinal thickness (CRT, on OCT). Only risk phenotypes B (MAT\6 and increased CRT) and C (MAT C 6 with or without increased CRT) were included. ETDRS grading was performed at the baseline visit based on seven-field CFP. Results: A total of 133 T2D individuals were included in the study; 81 (60%) eyes were classified as phenotype B and 52 (40%) eyes as phenotype C. Of these, 128 completed the 1-year follow-up. At baseline, eyes with phenotype C showed greater capillary closure (superior capillary plexus, deep capillary plexus, and full retina, p\0.001) and increased foveal avascular zone (FAZ) area (p\0.001), indicating more advanced microvascular disease. Neurodegeneration represented by thinning of the ganglion cell layer ? inner plexiform layer (GCL ? IPL) was present in both phenotypes. Whenanalyzing the 1-year progression of each phenotype, only phenotype C revealed a significant decrease in BCVA (p = 0.02) and enlargement of the FAZ (p = 0.03). A significant progressive decrease in the vessel density of the deep capillary layer and in MAT occurred in both phenotypes, but these changes were particularly relevant in phenotype C and ETDRS grades 43–47. During the 1-year period, both phenotypes B and C showed progression in GCL ? IPL thinning (p\0.001). Conclusions: In the 1-year period of follow-up, both phenotypes B and C showed progression in retinal neurodegeneration, whereas phenotype C showed more marked disease progression at the microvascular level.
ISSN: 2193-8245
DOI: 10.1007/s40123-021-00437-z
Rights: openAccess
Appears in Collections:I&D ICBR - Artigos em Revistas Internacionais
I&D CIBB - Artigos em Revistas Internacionais
I&D IBILI - Artigos em Revistas Internacionais

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