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Retinal oxygen saturation changes progressively over time in diabetic retinopathy

Retinal oxygen saturation changes progressively over time in diabetic retinopathy


Title: Retinal oxygen saturation changes progressively over time in diabetic retinopathy
Author: Harðarson, Sveinn Hákon
Stefánsson, Einar
Bek, Toke
Date: 2021-05-12
Language: English
Scope: e0251607
University/Institute: Landspitali - The National University Hospital of Iceland
Department: Faculty of Medicine
Other departments
Series: PLoS ONE; 16(5)
ISSN: 1932-6203
DOI: https://doi.org/10.1371/journal.pone.0251607
Subject: Augnsjúkdómar; Sykursýki; Sjónhimna; Adult; Aged; Cross-sectional studies; Diabetic retinopathy/diagnostic imaging; Disease progression; Female; Humans; Male; middle aged; Oximetry; Regina/diagnostic imaging; Severity of illness index; Severity of Illness Index; Retinal Vessels/physiopathology; Cross-Sectional Studies; Middle Aged; Disease Progression; Diabetic Retinopathy/diagnostic imaging; Retina/diagnostic imaging; Multidisciplinary
URI: https://hdl.handle.net/20.500.11815/2909

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Citation:

Harðarson , S H , Stefánsson , E & Bek , T 2021 , ' Retinal oxygen saturation changes progressively over time in diabetic retinopathy ' , PLoS ONE , vol. 16 , no. 5 , e0251607 , pp. e0251607 . https://doi.org/10.1371/journal.pone.0251607

Abstract:

Purpose According to cross-sectional studies, oxygen saturation is elevated in retinal vessels in diabetic patients. We evaluated how retinal oxygenation (metabolic marker), vessel diameters and retinopathy grade (structural markers) change over time in diabetic patients. Design Prospective cohort study following screening in a hospital setting. Methods Retinal oximetry images were acquired in 214 patients with the Oxymap T1 oximeter. Imaging was repeated after a median of 3.0 years (range 0.76 6.8 years). Oxygen saturation and vessel diameters were measured in the right eye. Semiquantitative grading of retinopathy according to international guidelines and red lesion count were performed on fundus photographs. Results Retinopathy grade according to the international semiquantitative grading system was unchanged. Arteriolar saturation increased by 0.75±0.15 percentage points per year of follow-up (p<0.0001). Venular saturation increased by 1.74±0.26 percentage points per year (p<0.0001) and arteriovenous difference decreased by 0.99±0.20 percentage points per year (p<0.0001). Arteriolar diameters decreased by 2.7±8.5μm (p<0.0001) between visits and venular diameters decreased by 2.4±9.1μm (p = 0.0002). Median increase in red lesion count between visits was 2 lesions (range-128 to 212 lesions, p<0.0001). The change in red lesion count and change in diameters did not correlate with the length of follow-up (p>0.44). Conclusions Oxygen saturation in larger retinal vessels can increase and arteriovenous difference can decrease over time in diabetic patients without any observable changes in retinopathy grade. The results suggest that changes in retinal oxygen saturation may precede progression of diabetic retinopathy or that oxygen saturation is more sensitive to disease progression than retinopathy grade.

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