Retinal Vascular Fractal Dimension and Risk of Early Diabetic Retinopathy

OBJECTIVE To examine the prospective association of retinal vascular fractal dimension with diabetic retinopathy risk in young people with type 1 diabetes. RESEARCH DESIGN AND METHODS This was a hospital-based prospective study of 590 patients aged 12–20 years with type 1 diabetes free of retinopathy at baseline. All patients had seven-field retinal photographs taken of both eyes. Incident retinopathy was ascertained from retinal photographs taken at follow-up visits. Fractal dimension was measured from baseline photographs using a computer-based program following a standardized protocol. RESULTS Over a mean ± SD follow-up period of 2.9 ± 2.0 years, 262 participants developed mild nonproliferative diabetic retinopathy (15.0 per 100 person-years). After adjusting for age, sex, diabetes duration, A1C, and other risk factors, we found no association between retinal vascular fractal dimension and incident retinopathy. CONCLUSIONS Retinal vascular fractal dimension was not associated with incident early diabetic retinopathy in this sample of children and adolescents with type 1 diabetes.

[1]  T. MacGillivray,et al.  Fractal analysis of the retinal vascular network in fundus images , 2007, 2007 29th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[2]  Martin A Mainster,et al.  The fractal properties of retinal vessels: Embryological and clinical implications , 1990, Eye.

[3]  A. Daxer,et al.  Mechanisms in retinal vasculogenesis: an analysis of the spatial branching site correlation. , 1995, Current eye research.

[4]  John I. Clark,et al.  Fractal analysis of region-based vascular change in the normal and non-proliferative diabetic retina , 2002, Current eye research.

[5]  M. Craig,et al.  The case for biennial retinopathy screening in children and adolescents. , 2005, Diabetes care.

[6]  A. Daxer Characterisation of the neovascularisation process in diabetic retinopathy by means of fractal geometry: diagnostic implications , 1993, Graefe's Archive for Clinical and Experimental Ophthalmology.

[7]  A. Daxer,et al.  The fractal geometry of proliferative diabetic retinopathy: implications for the diagnosis and the process of retinal vasculogenesis. , 1993, Current eye research.

[8]  T. Wong,et al.  Quantitative Assessment of Early Diabetic Retinopathy Using Fractal Analysis , 2009, Diabetes Care.

[9]  M. Craig,et al.  Discordant trends in microvascular complications in adolescents with type 1 diabetes from 1990 to 2002. , 2005, Diabetes care.

[10]  Tien Yin Wong,et al.  Retinal Arteriolar Dilation Predicts Retinopathy in Adolescents With Type 1 Diabetes , 2008, Diabetes Care.

[11]  P. Mitchell,et al.  The retinal vasculature as a fractal: methodology, reliability, and relationship to blood pressure. , 2008, Ophthalmology.

[12]  K. Donaghue,et al.  The Effect of Prepubertal Diabetes Duration on Diabetes: Microvascular Complications in Early and Late Adolescence , 1997, Diabetes Care.

[13]  B. Masters,et al.  Fractal analysis of the vascular tree in the human retina. , 2004, Annual review of biomedical engineering.

[14]  J. Shaw,et al.  Retinal Arteriolar Caliber Predicts Incident Retinopathy , 2008, Diabetes Care.

[15]  Tien Yin Wong,et al.  Relationship of Retinal Vascular Caliber With Diabetes and Retinopathy , 2008, Diabetes Care.