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Retinal oxygen saturation is an independent risk factor for the severity of diabetic retinopathy
  1. Toke Bek1,
  2. Einar Stefánsson2,3,
  3. Sveinn Hákon Hardarson2,3
  1. 1 Departments of Ophthalmology, University of Iceland, Reykjavik, Iceland
  2. 2 Departments of Physiology, University of Iceland, Reykjavik, Iceland
  3. 3 Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
  1. Correspondence to Toke Bek, Department of Ophthalmology, Aarhus University Hospital, Aarhus 8000, Denmark; toke.bek{at}


Background The oxygen saturation in larger retinal vessels has been shown to increase with increasing diabetic retinopathy (DR) grade and to help predict the effect of antivascular endothelial growth factor treatment in patients with diabetic maculopathy. However, it is unknown to what extent the increased oxygen saturation co-varies with other risk factors and whether it is an independent risk factor for the severity of DR.

Methods Seven hundred and twenty-two successive patients referred for specialist evaluation of diabetic retinopathy including retinal oximetry were studied. Multiple regression analysis was used to investigate whether oxygen saturation in the larger retinal arterioles and venules contributed to the severity of diabetic retinopathy, independently of gender, age, diabetes duration, diabetes type, body mass index, blood pressure, haemoglobin A1c, visual acuity and central retinal thickness.

Results The included parameters could explain less than 15% of the variation in retinopathy grade. Approximately, one-third of the explained variation was related to the retinal oxygen saturation.

Conclusions Prospective studies are needed to evaluate whether retinal oxygen saturation is predictive for the development of diabetic retinopathy and how it interacts with other biomarkers and risk factors over time.

  • retina

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  • Presented at The study was presented at the Association in Research in Vision and Ophthalmology meeting in Baltimore, 7 May 11 2017.

  • Contributors All three authors have made substantial contributions to the conception of the study, acquisition of data and to the analysis and interpretation of data. All three authors have participated in drafting and revising the manuscript and have approved the final version of it. All authors agreed to be accountable for all aspects of the work ensuring that questions related to the accuracy of integrity of any part of the work are appropriately investigated and resolved.

  • Funding The study was supported by the VELUX Foundation and the Toyota Foundation. The sponsors had no role in the design or conduct of this research.

  • Competing interests ES is the shareholder and board member in Oxymap ehf. SHH is the shareholder in Oxymap ehf that produces retinal oximeters.

  • Patient consent Obtained.

  • Ethics approval Medical Ethics Committee for Region Central Denmark.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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