Decreased Oxygen Delivery and Non-Proliferative Diabetic Retinopathy

Decreased delivery of oxygen to retinal tissue is tied with the occurrence of non-proliferative diabetic retinopathy (NPDR) in young type-1 diabetes mellitus (DM1) patients, according to a recent study published in the Acta Ophthalmologica.

Diabetic retinopathy (DR) is a vision-threatening disease characterized by hypoxia, vascular alterations, and oedema. Oxygen (O₂) metabolism is involved in the development of diabetic retinopathy. New discoveries in retinal O₂ metabolism and vascular changes are essential to better understand the pathophysiology of DR. The O₂ saturation in larger retinal vessels is a marker of retinal metabolism and vascular function.

A group of researchers conducted a study to determine the contribution of retinal vessel density (VD), central retinal vessel diameter, and retinal oxygen (O₂) saturation independently of other known risk factors in the development of non-proliferative diabetic retinopathy (NPDR).

Macular optical coherence tomography angiography (OCTA), central retinal artery/vein equivalent diameter (CRAE/CRVE) measurements, and retinal oximetry were performed in a cross-sectional study of 166 eyes from 166 individuals with type 1 diabetes (T1D) aged 14–30 years. Multiple logistic regression analysis was used to investigate whether O₂ saturation, retinal vessel diameters, and vessel density in the deep capillary plexus (VD-DCP) were associated with NPDR, when adjusting for known risk factors. The individuals were allocated to one group without and one group with NPDR.

Results

Multiple logistic regression analysis showed that age (OR = 1.25, 95% CI: 1.04–1.49) and AV-difference in O₂ saturation (OR = 0.85, 95% CI 0.77–0.93) were significantly associated with NPDR.

Thus, the researchers concluded that findings suggest that age and lower AV-O₂ saturation difference contribute to explaining the grade of NPDR independently of other well-known risk factors. Reduced delivery of O₂ to the retinal tissue is associated with the development of NPDR in young patients with T1D and should be given appropriate weight in the risk stratification at early stages of the disease.

Reference

Retinal venular oxygen saturation is associated with non-proliferative diabetic retinopathy in young patients with type 1 diabetes by Nina C.B.B. Veiby et al published in the Acta Ophthalmologica. https://doi.org/10.1111/aos.15018