Diabetic retinopathy: current and future methods for early screening from a retinal hemodynamic and geometric approach

Abstract

Diabetic retinopathy (DR) is a major disease and is the number one cause of blindness in the UK. In England alone, 4200 new cases appear every year and 1280 lead to blindness. DR is a result of diabetes mellitus, which affects the retina of the eye and specifically the vessel structure. Elevated levels of glucose cause a malfunction in the cell structure, which affects the vessel wall and, in severe conditions, leads to their breakage. Much research has been carried out on detecting the different stages of DR but not enough versatile research has been carried out on the detection of early DR before the appearance of any lesions. In this review, the authors approach the topic from the functional side of the human eye and how hemodynamic factors that are impaired by diabetes affect the vascular structure.

Keywords::

• diabetes mellitus
• diabetic retinopathy
• diagnosis
• geometric feature
• hemodynamic
• microcirculation
• retina

Financial & competing interest disclosure

This research was made possible by a Marie Curie grant from the European Commission in the framework of the REVAMMAD ITN (Initial Training Research network), Project number 316990. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Diabetic retinopathy (DR) is a major cause of blindness.

• There is no reliable biomarker yet that can predict or diagnose DR.

• Diabetes causes many changes to the body functionality that lead to DR.

• Oxygen saturation level in the veins and arteries is different between normal subjects, diabetic patients and DR patients.

• Endothelial cells’ function is severely altered during diabetes, which is a major complication that can lead to DR.

• Blood flow and vessel structure is highly affected during the development and progress of diabetes.

• Risk factors such as age, gender, duration of diabetes, other diseases, family history etc. are important parameters that have to be considered when studying the progress of diabetes.

Notes