Quantification of microvascular lesions in the central retinal field: could it predict the severity of diabetic retinopathy?

ABSTRACT Objective Diabetic retinopathy (DR) is a neurodegenerative disease characterized by the presence of microcirculatory lesions. Among them, microaneurysms (MAs) are the first observable hallmark of early ophthalmological changes. The present work aims at studying whether the quantification of MA, haemorrhages (Hmas) and hard exudates (HEs) in the central retinal field (CRF) could have a predictive value on DR severity. Research Design and Methods Retinal lesions (MAs, Hmas and HEs) were quantified in the CRF of 160 retinographies from diabetic patients from the IOBA’s reading center, previously classified by two expert readers with the 3 fields-Joslin system. Samples included different disease severity levels and excluded proliferating forms: no DR (n=30), mild non-proliferative (n=30), moderate (n=50) and severe (n=50). Results Quantification of MAs, Hmas, and HEs revealed an increase trend of these lesions as DR severity progresses. Differences between severity levels were statistically significant, suggesting that the analysis of the CRF provides valuable information on severity level and could be used as a valuable tool to assess DR grading in the clinical practice. Conclusions Even though further validation is needed, the counting of microvascular lesions in the central retinal field can be proposed as a rapid screening system to classify DR patients with different stages of severity according to the international classification.