Venous Beading in Two or More Quadrants Might Not Be a Sensitive Grading Criterion for Severe Nonproliferative Diabetic Retinopathy

Overview

Journal Graefes Arch Clin Exp Ophthalmol

Specialty Ophthalmology

Date 2018 Apr 8

PMID 29626228

Citations 8

Authors

Ling Chen

Xiongze Zhang

Feng Wen

Affiliations

Soon will be listed here.

Abstract

Purpose: To determine whether venous beading (VB) in two or more quadrants is an appropriate grading criterion for severe nonproliferative diabetic retinopathy (NPDR).

Methods: A hospital-based, retrospective, cross-sectional study. A total of 806 patients admitted with diabetic retinopathy (DR) from January 2014 to April 2017 were included in this study. DR severity was graded by the international grading criterion. The status of VB, intraretinal microvascular abnormalities (IRMA), capillary nonperfusion, arteriovenous nicking, and diabetic macular edema was evaluated based on fundus fluorescein angiography.

Results: The prevalence of VB in eyes with proliferative diabetic retinopathy (PDR), severe NPDR, and moderate NPDR was 41.3% (327/791), 5.9% (31/526), and 0% (0/295), respectively (p < 0.001). Moreover, the proportion of VB in two or more quadrants was even lower (27.1% for PDR and 2.1% for severe NPDR, p < 0.001), and among the total of 225 eyes with VB in two or more quadrants, 214 eyes (95.1%) were graded as PDR. Furthermore, VB formation was significantly correlated with capillary nonperfusion, duration of diabetes (both p < 0.001), and smoking (p < 0.05). After adjusting for age, sex, and other possible factors, VB (OR = 7.479, p < 0.001) and IRMA (OR = 2.433, p < 0.001) were determined as independent risk factors for developing PDR.

Conclusions: Our study suggested that VB in two or more quadrants might not be a sensitive grading criterion for severe NPDR among a Chinese population with type 2 diabetes. Nevertheless, VB has a great specificity to define an advanced form of DR.

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References

Imesch P, Bindley C, Wallow I . Clinicopathologic correlation of intraretinal microvascular abnormalities. Retina. 1997; 17(4):321-9. DOI: 10.1097/00006982-199707000-00008. View

Penman A, Hancock H, Papavasileiou E, James M, Idowu O, Riche D . Risk Factors for Proliferative Diabetic Retinopathy in African Americans with Type 2 Diabetes. Ophthalmic Epidemiol. 2016; 23(2):88-93. PMC: 4851860. DOI: 10.3109/09286586.2015.1119287. View

Lin S, Ramulu P, Lamoureux E, Sabanayagam C . Addressing risk factors, screening, and preventative treatment for diabetic retinopathy in developing countries: a review. Clin Exp Ophthalmol. 2016; 44(4):300-20. DOI: 10.1111/ceo.12745. View

Bloomgarden Z . Diabetic retinopathy. Diabetes Care. 2008; 31(5):1080-3. DOI: 10.2337/dc08-zb05. View

Wilkinson C, Ferris 3rd F, Klein R, Lee P, Agardh C, Davis M . Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology. 2003; 110(9):1677-82. DOI: 10.1016/S0161-6420(03)00475-5. View

. Grading diabetic retinopathy from stereoscopic color fundus photographs--an extension of the modified Airlie House classification. ETDRS report number 10. Early Treatment Diabetic Retinopathy Study Research Group. Ophthalmology. 1991; 98(5 Suppl):786-806. View

Sato Y, Kamata A, Matsui M . Clinical study of venous abnormalities in diabetic retinopathy. Jpn J Ophthalmol. 1993; 37(2):136-42. View

Wang F, Liang Y, Zhang F, Wang J, Wei W, Tao Q . Prevalence of diabetic retinopathy in rural China: the Handan Eye Study. Ophthalmology. 2009; 116(3):461-7. DOI: 10.1016/j.ophtha.2008.10.003. View

Cole E, Novais E, Louzada R, Waheed N . Contemporary retinal imaging techniques in diabetic retinopathy: a review. Clin Exp Ophthalmol. 2016; 44(4):289-99. DOI: 10.1111/ceo.12711. View

10.

Chappelow A, Tan K, Waheed N, Kaiser P . Panretinal photocoagulation for proliferative diabetic retinopathy: pattern scan laser versus argon laser. Am J Ophthalmol. 2011; 153(1):137-42.e2. DOI: 10.1016/j.ajo.2011.05.035. View

11.

Patel S, Klufas M, Ryan M, Jonas K, Ostmo S, Martinez-Castellanos M . Color fundus photography versus fluorescein angiography in identification of the macular center and zone in retinopathy of prematurity. Am J Ophthalmol. 2015; 159(5):950-7.e2. PMC: 4764125. DOI: 10.1016/j.ajo.2015.01.027. View

12.

Yang W, Lu J, Weng J, Jia W, Ji L, Xiao J . Prevalence of diabetes among men and women in China. N Engl J Med. 2010; 362(12):1090-101. DOI: 10.1056/NEJMoa0908292. View

13.

Keyser B, Ferguson 3rd J . Retinal venous beading with recurrent preretinal hemorrhage. Am J Ophthalmol. 1997; 123(5):696-8. DOI: 10.1016/s0002-9394(14)71087-6. View

14.

Zou W, Ni L, Lu Q, Zou C, Zhao M, Xu X . Diabetes Onset at 31-45 Years of Age is Associated with an Increased Risk of Diabetic Retinopathy in Type 2 Diabetes. Sci Rep. 2016; 6:38113. PMC: 5126680. DOI: 10.1038/srep38113. View

15.

Beltramo E, Porta M . Pericyte loss in diabetic retinopathy: mechanisms and consequences. Curr Med Chem. 2013; 20(26):3218-25. DOI: 10.2174/09298673113209990022. View

16.

Olafsdottir E, Andersson D, Dedorsson I, Svardsudd K, Jansson S, Stefansson E . Early detection of type 2 diabetes mellitus and screening for retinopathy are associated with reduced prevalence and severity of retinopathy. Acta Ophthalmol. 2016; 94(3):232-9. DOI: 10.1111/aos.12954. View

17.

Unnikrishnan R, Anjana R, Mohan V . Diabetes mellitus and its complications in India. Nat Rev Endocrinol. 2016; 12(6):357-70. DOI: 10.1038/nrendo.2016.53. View

18.

Lee V, Kingsley R, Lee E, Lu M, Russell D, Asal N . The diagnosis of diabetic retinopathy. Ophthalmoscopy versus fundus photography. Ophthalmology. 1993; 100(10):1504-12. DOI: 10.1016/s0161-6420(93)31449-1. View

19.

. Classification of diabetic retinopathy from fluorescein angiograms. ETDRS report number 11. Early Treatment Diabetic Retinopathy Study Research Group. Ophthalmology. 1991; 98(5 Suppl):807-22. View

20.

Leese G, Stratton I, Land M, Bachmann M, Jones C, Scanlon P . Progression of diabetes retinal status within community screening programs and potential implications for screening intervals. Diabetes Care. 2014; 38(3):488-94. DOI: 10.2337/dc14-1778. View