Abstract
BackgroundDiabetic retinopathy (DR) is a microvascular complication of diabetes and a leading cause of blindness in working-age adults. The likelihood of visual impairment associated with DR is two-fold higher in the African-American (AA) compared to non-Hispanic white. Although alterations in retinal vessel oxygenation and morphology have been reported in DR, there is limited knowledge about these vascular changes in AA subjects. The purpose of the current study was to investigate alterations in retinal vascular oxygen saturation (SO2), vessel diameter (D) and tortuosity at severity stages of DR in AA subjects.MethodsA nested case-control study of 56 AA subjects was conducted. Right eyes were grouped as non-diabetic (ND) (N = 26), no clinical DR (NDR) (N = 19), or moderate/severe non-proliferative DR (NPDR) (N = 11). Imaging was performed using a commercially available scanning laser ophthalmoscope. Images were analyzed to determine retinal arterial and venous SO2 (SO2A and SO2V), diameter (DA and DV), and vessel tortuosity index (VTI) (VTIA and VTIV).ResultsSO2V and DV were higher in NPDR compared to ND and NDR groups (P < 0.05). There were no significant differences in SO2A and DA among ND, NDR, and NPDR groups (P > 0.8). Maximum VTIA was higher in diabetics (NDR and NPDR) compared to non-diabetics (P < 0.03). There was no significant difference in maximum VTIV among the 3 groups (P = 0.5).ConclusionsThe findings advance our understanding of DR pathophysiology in the AA population and may propel identification of race-specific retinal vascular biomarkers for improved diagnosis and monitoring of DR.
Highlights
Diabetic retinopathy (DR) is a microvascular complication of diabetes and a leading cause of blindness in working-age adults
Glycated hemoglobin (HbA1C) level was higher in the no clinical DR (NDR) and non-proliferative DR (NPDR) as compared to ND (P < 0.001)
In the current study, we demonstrated increased venous Oxygen saturation (SO2), venous diameter, and arterial tortuosity in moderate/severe NPDR in AA subjects
Summary
Diabetic retinopathy (DR) is a microvascular complication of diabetes and a leading cause of blindness in working-age adults. Alterations in retinal vessel oxygenation and morphology have been reported in DR, there is limited knowledge about these vascular changes in AA subjects. Diabetic retinopathy (DR), a microvascular complication of diabetes, is one of the leading causes of blindness in the United States [1]. DR subjects are 29 times more likely to go blind as compared with non-diabetics of similar age and gender [2]. Despite the fact that racial minorities in the United States have experienced an increased rate of diabetes, race-specific data on the development of blindness and DR in AA populations is scarce
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