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Title: Retinopathy Phenotypes in Type 2 Diabetes with Different Risks for Macular Edema and Proliferative Retinopathy
Authors: Marques, Inês P. 
Madeira, Maria H. 
Messias, Ana L. 
Santos, Torcato 
Martinho, António C-V 
Figueira, João 
Cunha-Vaz, José 
Keywords: diabetes; retinopathy; macular edema; proliferative retinopathy
Issue Date: 12-May-2020
Publisher: MDPI
Project: AIBILI, COMPETE Portugal2020, and the Fundo de Inovação, Tecnologia e Economia Circular (FITEC)—Programa Interface (FITEC/CIT/2018/2) 
Serial title, monograph or event: Journal of Clinical Medicine
Volume: 9
Issue: 5
Abstract: Our group reported that three diabetic retinopathy (DR) phenotypes: A, characterized by low microaneurysm turnover (MAT < 6) and normal central retinal thickness (CRT); B, low MAT (<6) and increased CRT, and C, high MAT (≥6), present different risks for development of macular edema (DME) and proliferative retinopathy (PDR). To test these findings, 212 persons with type 2 diabetes (T2D) and mild nonproliferative retinopathy (NPDR), one eye per person, were followed for five years with annual visits. Of these, 172 completed the follow-up or developed an outcome: PDR or DME (considering both clinically significant macular edema (CSME) and center-involved macular edema (CIME)). Twenty-seven eyes (16%) developed either CSME (14), CIME (10), or PDR (4), with one eye developing both CSME and PDR. Phenotype A showed no association with development of vision-threatening complications. Seven eyes with phenotype B and three with phenotype C developed CIME. Phenotype C showed higher risk for CSME development, with 17.41 odds ratio (p = 0.010), compared with phenotypes A + B. All eyes that developed PDR were classified as phenotype C. Levels of HbA1c and triglycerides were increased in phenotype C (p < 0.001 and p = 0.018, respectively). In conclusion, phenotype C identifies eyes at higher risk for development of CSME and PDR, whereas phenotype A identifies eyes at very low risk for vision-threatening complications.
ISSN: 2077-0383
DOI: 10.3390/jcm9051433
Rights: openAccess
Appears in Collections:I&D CIBIT - Artigos em Revistas Internacionais
FMUC Med. Dentária - Artigos em Revistas Internacionais

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