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Progression of Diabetic Retinopathy. Identification of Signs and Surrogate outcomes (PROGRESS)
The global aim of this study is to improve the current knowledge of diabetic retinopathy (DR) progression. We aim to characterize both functionally and morphologically initial DR stages and to identify patients at risk of progression to centre involving macular oedema (CME) and/or proliferative diabetic retinopathy (PDR). We want to identify imaging patterns and characteristics that might be used as prognostic biomarkers for DR progression.
For this, ischemia and blood-retinal barrier alteration will be assessed using non-invasive retinal imaging methodologies. SD-OCT with layer-by-layer segmentation will be performed. Furthermore, a state-of-the-art methodology with OCT-Angiography will be used for identification of areas of capillary drop-out and leakage areas will be identified on SD-OCT without the need of a dye injection. In a subgroup of patients we will study neurodegeneration patterns using multifocal ERG examination.
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| Measure | Description | Time Frame |
|---|---|---|
| Phenotypic classification of DR in a 5-year period | Presence CME (Central Macular Edema) or PDR (Proliferative Diabetic Retinopathy) | 5 years |
| Measure | Description | Time Frame |
|---|---|---|
| DR severity level | ETDRS grading | 5 years |
| Retinal thickness analysis | Retinal thickness (RT) in central subfield, inner and outer rings, assessed by SD-OCT and using layer-by-layer segmentation |
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Inclusion Criteria:
Exclusion Criteria:
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Any patients followed under the normal clinical practice at AIBILI Clinical Trial Centre.
- Type 2 diabetes mellitus according to 1985 WHO criteria
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Aibili-Cec | Coimbra | 3000-548 | Portugal |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33158947 | Derived | Martinho AC, Marques IP, Messias AL, Santos T, Madeira MH, Sousa DC, Lobo C, Cunha-Vaz J. Ocular and Systemic Risk Markers for Development of Macular Edema and Proliferative Retinopathy in Type 2 Diabetes: A 5-Year Longitudinal Study. Diabetes Care. 2021 Jan;44(1):e12-e14. doi: 10.2337/dc20-1125. Epub 2020 Nov 6. No abstract available. | |
| 30523027 |
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| ID | Term |
|---|---|
| D003930 | Diabetic Retinopathy |
| ID | Term |
|---|---|
| D012164 | Retinal Diseases |
| D005128 | Eye Diseases |
| D003925 | Diabetic Angiopathies |
| D014652 | Vascular Diseases |
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| 5 years |
| Ellipsoid zone analysis | Degree of integrity of the ellipsoid zone, assessed by SD-OCT | 5 years |
| Choroidal thickness analysis | Choroidal thickness assessed by Enhanced Depth Imaging (EDI) SD-OCT | 5 years |
| SD- OCT- Angiography analysis | Vessel analysis, assessed by SD-OCT OCT-Angiography | 5 years |
| OCT-Leakage analysis | LOR (low optical reflectivity) ratio in central subfield, inner and outer ring for assessment of BRB breakdown, assessed by OCT-Leakage | 5 years |
| Retinal thickness quantification | Retinal nerve fiber layer thickness (RNFL) and ganglion cells layer (GCL) + inner plexiform layer thickness (IPL) thickness, assessed by layer-by-layer SD-OCT | 5 years |
| mfERG assessement | P1 implicit time and P1 amplitude by ring | 5 years |
| Marques IP, Alves D, Santos T, Mendes L, Santos AR, Lobo C, Durbin M, Cunha-Vaz J. Multimodal Imaging of the Initial Stages of Diabetic Retinopathy: Different Disease Pathways in Different Patients. Diabetes. 2019 Mar;68(3):648-653. doi: 10.2337/db18-1077. Epub 2018 Dec 6. |
| D002318 |
| Cardiovascular Diseases |
| D048909 | Diabetes Complications |
| D003920 | Diabetes Mellitus |
| D004700 | Endocrine System Diseases |