Validation of a predictive model for diabetic retinopathy progression in type‐2 diabetic patients with mild nonproliferative diabetic retinopathy.

Abstract

Abstract Purpose To validate a predictive model for diabetic retinopathy progression in type‐2 diabetic patients with mild nonproliferative diabetic retinopathy (NPDR) using non‐invasive examinations, previously reported by Lobo et al. [Arch Ophthalmol. 2004; 122(2):211‐7]. Methods Four‐hundred type‐2 diabetic patients with mild NPDR were included in this 2‐years observational and prospective study. Sixty‐three patients performed the baseline and the 6‐month visits underwenting: color fundus photography, retinal thickness (RT) measurements and blood tests. Microaneurysm formation rate (MAFR) was computed from color fundus photographs using a new method that assists graders on earmarking MAs (MA‐Tracker). Increased RT maps (Stratus OCT – Carl Zeiss Meditec, Dublin, CA, USA) were computed using proprietary software. Patients were classified into one of the 3 different phenotypes of DR progression characterized by: Phenotype 1 – eyes with low MAFR and normal RT; Phenotype 2 – eyes with increased RT and; Phenotype 3 – eyes with high MAFR. Results Twenty‐six patients (41.6%) were classified as being of Phenotype 1; 17 (27.0%) as Phenotype 2 and; 20 (31.7%) as Phenotype 3. This distribution of patients in each phenotype is similar to the one previously found when establishing the predictive model. Conclusion Preliminary data confirms the existence of 3 different phenotypes of DR progression.