Year: 2025
Type: article
Abstract: Objective: To characterize the performance of 56 parameters from electroretinography (ERG)/pupillometry, color fundus photography (FP), OCT angiography (OCTA), and ultra-widefield fluorescein angiography (UWF-FA) for predicting which subjects with nonproliferative diabetic retinopathy (NPDR) will progress to vision-threating complications (VTCs) within 48 weeks. Design: A longitudinal prospective study from 44 trial sites in the United States. Participants: Subjects had moderate-to-severe NPDR and no center-involved diabetic macular edema. Among the 162 subjects, the mean age was 57 years and 58% were male. Intervention: Although this study tested an experimental drug, there was no indication of a treatment effect. Results are analyzed over all subjects regardless of study treatment. Main Outcome Measures: Specialized reading centers measured 56 parameters from 4 testing modalities (ERG/pupillometry, FP, OCTA, and UWF-FA) to evaluate diabetic retinopathy (DR) status. Kaplan-Meier analysis and a Cox proportional hazards model were applied to each parameter to identify significant predictors of progression to VTC, defined as progression to proliferative DR, diabetic macular edema, or treatment thereof. Results: < 0.05). Conclusions: Both functional (ERG, pupil response) and structural (FP, OCTA, UWF-FA) testing can predict progression to VTC from DR, with the DR score having the best predictive capability. These results suggest it is possible to improve the DR staging system which in turn may enable better allocation of health care resources. Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Source: Ophthalmology Science
Language: English
Subfield: Ophthalmology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,500
OpenAlex ID: W4411371082