In almost all diseases of the eye, early diagnosis leads to early treatment and, hopefully, better visual outcomes. But even better than diagnosis might be the ability to predict disease before it even begins to develop. That’s becoming possible, at least in the case of diabetic retinopathy (DR), according to new research published in Ophthalmology Retina.

An Australian research team is showing how imaging technology can now identify extended zones of retinal vessel caliber, a finding associated with DR. When found in adolescents with Type 1 diabetes, retinal vascular caliber may help predict moderate DR in these patients, the research noted in their paper.

The study reviewed the cases of 904 patients with a mean age of 14 years who were seen for diabetes complications assessments. For every patient, a retinal caliber was identified from baseline retinal photographs. “Standard zone” retinal vessel calibers were summarized as central retinal arteriolar (CRAE) and venular equivalents (CRVE), while “extended zone” vessels (greater than two disc diameters from the optic disc margin) were summarized as mean width of arterioles and venules. The researchers also checked in with these patients three years later.

In total, after the three years, 15% of the adolescents developed moderate DR. After adjusting for HbA1C and blood pressure, they found wider extended zone retinal arteriolar caliber and venular caliber predicted moderate DR. Meanwhile, standard zone CRAE and CRVE were not associated with moderate DR.

Velayutham V, Craig M, Liew G, et al. Extended zone retinal vascular caliber and risk of diabetic retinopathy in adolescents with Type 1 diabetes. Opthalmol Retina. May 20, 2020. [Epub ahead of print].