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Quantitative assessment of early diabetic retinopathy using fractal analysis.
- Source :
-
Diabetes care [Diabetes Care] 2009 Jan; Vol. 32 (1), pp. 106-10. Date of Electronic Publication: 2008 Oct 03. - Publication Year :
- 2009
-
Abstract
- Objective: Fractal analysis can quantify the geometric complexity of the retinal vascular branching pattern and may therefore offer a new method to quantify early diabetic microvascular damage. In this study, we examined the relationship between retinal fractal dimension and retinopathy in young individuals with type 1 diabetes.<br />Research Design and Methods: We conducted a cross-sectional study of 729 patients with type 1 diabetes (aged 12-20 years) who had seven-field stereoscopic retinal photographs taken of both eyes. From these photographs, retinopathy was graded according to the modified Airlie House classification, and fractal dimension was quantified using a computer-based program following a standardized protocol.<br />Results: In this study, 137 patients (18.8%) had diabetic retinopathy signs; of these, 105 had mild retinopathy. Median (interquartile range) retinal fractal dimension was 1.46214 (1.45023-1.47217). After adjustment for age, sex, diabetes duration, A1C, blood pressure, and total cholesterol, increasing retinal vascular fractal dimension was significantly associated with increasing odds of retinopathy (odds ratio 3.92 [95% CI 2.02-7.61] for fourth versus first quartile of fractal dimension). In multivariate analysis, each 0.01 increase in retinal vascular fractal dimension was associated with a nearly 40% increased odds of retinopathy (1.37 [1.21-1.56]). This association remained after additional adjustment for retinal vascular caliber.<br />Conclusions: Greater retinal fractal dimension, representing increased geometric complexity of the retinal vasculature, is independently associated with early diabetic retinopathy signs in type 1 diabetes. Fractal analysis of fundus photographs may allow quantitative measurement of early diabetic microvascular damage.
- Subjects :
- Adolescent
Age of Onset
Australia epidemiology
Child
Cross-Sectional Studies
Diabetic Retinopathy epidemiology
Female
Functional Laterality
Humans
Male
Photography
Prevalence
Severity of Illness Index
Young Adult
Diabetes Mellitus, Type 1 physiopathology
Diabetic Retinopathy physiopathology
Fractals
Retinal Artery physiopathology
Retinal Vein physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1935-5548
- Volume :
- 32
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Diabetes care
- Publication Type :
- Academic Journal
- Accession number :
- 18835945
- Full Text :
- https://doi.org/10.2337/dc08-1233