Microaneurysm Counting as a Biomarker for the Hyperperfusion Stage of Nonproliferative Diabetic Retinopathy.

IF 2.6 3区医学 Q2 OPHTHALMOLOGY

Ophthalmology and Therapy Pub Date : 2025-08-01 Epub Date: 2025-07-01 DOI:10.1007/s40123-025-01179-y

Luís Mendes, Ana Rocha, Marta Lopes, Ana Almeida, Nicole Duarte, Débora Reste-Ferreira, António Martinho, Pedro Pereira, Inês Marques, Conceição Lobo, José Cunha-Vaz

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引用次数: 0

Abstract

Introduction: This study aimed to investigate the utility of microaneurysm (MA) counting as a tool for characterizing the hyperperfusion stage of nonproliferative diabetic retinopathy (NPDR) and to examine the hypothesis that MAs can serve as a surrogate biomarker for the presence of intraretinal microvascular abnormalities (IRMAs).

Methods: Forty-nine (n = 49) eyes with type 2 diabetes mellitus with NPDR were included in this analysis: 12 with Early Treatment Diabetic Retinopathy Study (ETDRS) levels 43 and 37 with levels 47-53. Automated MA detection was performed using the RetmarkerDR software (Retmarker SA, Meteda Group, Italy), alongside manual detection, both done in the central retina (field 2). Based on MA counts, microaneurysm turnover (MAT) was computed. IRMAs were manually counted based on swept-source optical coherence tomography (SS-OCT) angiography on PLEX® Elite 9000 (ZEISS, Dublin, CA, USA). The statistically significant differences between ETDRS groups were studied by comparing Mann-Whitney U test p values (significance value < 0.05). The correlation between the presence of MAs and IRMAs and MAT and IRMAs was examined using Spearman correlation analysis.

Results: There was an observed increase in the number of IRMAs, MAs, and MAT values as NPDR progressed, independently of the counting method used. Specifically, this increase was noted when transitioning from ETDRS groups characterized by the predominance of the hypoperfusion stage (ETDRS 43) to those associated with the hyperperfusion stage (ETDRS 47-53). When MAs were counted manually, a moderate correlation was identified between the number of MAs and the presence of IRMAs (ρ = 0.40; p value = 0.005). Additionally, a similar correlation was found between MAT and the presence of IRMAs (ρ = 0.43; p value = 0.002).

Conclusions: This study underscores the potential relevance of MAs as a pivotal indicator of the hyperperfusion stage of NPDR and supports their role as surrogate biomarkers for IRMAs. These results suggest a role for MA counting in the assessment and management of diabetic eye disease.

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微动脉瘤计数作为非增殖性糖尿病视网膜病变高灌注期的生物标志物。

本研究旨在探讨微动脉瘤（MA）计数作为表征非增殖性糖尿病视网膜病变（NPDR）高灌注阶段的工具的用途，并检验MAs可以作为视网膜内微血管异常（IRMAs）存在的替代生物标志物的假设。方法：49只（n = 49） 2型糖尿病合并NPDR患者纳入本分析：12只早期治疗糖尿病视网膜病变研究（ETDRS）水平为43,37只水平为47-53。使用RetmarkerDR软件（Retmarker SA, Meteda Group, Italy）进行自动MA检测，同时进行人工检测，均在中央视网膜（视场2）进行。根据MA计数计算微动脉瘤周转率（MAT）。基于PLEX®Elite 9000 （ZEISS, Dublin， CA， USA）的扫描源光学相干断层扫描（SS-OCT）血管造影，人工计数irma。通过比较Mann-Whitney U检验p值（显著性值）来研究ETDRS组之间的统计学差异。结果：随着NPDR的进展，irma、MAs和MAT值的数量增加，与使用的计数方法无关。具体来说，当以低灌注期（ETDRS 43）为主的ETDRS组过渡到与高灌注期相关的ETDRS组（ETDRS 47-53）时，这种增加被注意到。当人工计算MAs时，发现MAs数量与IRMAs存在之间存在中度相关性(ρ = 0.40；p值= 0.005)。此外，MAT与irma之间也存在类似的相关性(ρ = 0.43；P值= 0.002)。结论：本研究强调了MAs作为NPDR高灌注阶段关键指标的潜在相关性，并支持其作为irma替代生物标志物的作用。这些结果提示了MA计数在糖尿病性眼病的评估和治疗中的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ophthalmology and Therapy OPHTHALMOLOGY-

CiteScore

4.20

自引率

3.00%

发文量

157

审稿时长

6 weeks

期刊介绍： Aims and Scope Ophthalmology and Therapy is an international, open access, peer-reviewed (single-blind), and rapid publication journal. The scope of the journal is broad and will consider all scientifically sound research from preclinical, clinical (all phases), observational, real-world, and health outcomes research around the use of ophthalmological therapies, devices, and surgical techniques. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/series, trial protocols and short communications such as commentaries and editorials. Ophthalmology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. Rapid Publication The journal’s publication timelines aim for a rapid peer review of 2 weeks. If an article is accepted it will be published 3–4 weeks from acceptance. The rapid timelines are achieved through the combination of a dedicated in-house editorial team, who manage article workflow, and an extensive Editorial and Advisory Board who assist with peer review. This allows the journal to support the rapid dissemination of research, whilst still providing robust peer review. Combined with the journal’s open access model this allows for the rapid, efficient communication of the latest research and reviews, fostering the advancement of ophthalmic therapies. Open Access All articles published by Ophthalmology and Therapy are open access. 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