This study aimed to investigate correlations between photoreceptor and vascular parameters in varying stages of diabetic retinopathy (DR) using adaptive optics (AO) imaging. In this single-center, prospective cohort study, 29 participants (46 eyes) were classified into control/mild non-proliferative DR (NPDR), moderate/severe NPDR, and proliferative DR. AO images of photoreceptors and retinal vasculature were analyzed, and Spearman's correlation (ρ) was used to assess relationships between photoreceptor density and vascular parameters. Higher cone density was inversely associated with total vessel (ρ = 0.22, P = 0.03) and lumen diameters (ρ = -0.24, P = 0.01), while higher dispersion was associated with total vessel (ρ = 0.19, P = 0.06) and lumen diameters (ρ = 0.21, P = 0.04). These associations were primarily significant in mild NPDR. No significant correlations were found in advanced DR stages. This study underscores intricate neurovascular correlations in early-stage DR, suggesting these parameters may aid in early disease detection. Further research is needed to understand whether similar correlations exist in advanced DR. [Ophthalmic Surg Lasers Imaging Retina 2024;55:XX-XX.].
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