Aims To investigate the association between the choriocapillaris flow deficit percentage (CC FD%) and the 1-year incidence of referable diabetic retinopathy (RDR) in participants with type 2 diabetes mellitus (DM).
Methods This prospective cohort study included participants with type 2 DM. The DR status was graded based on the ETDRS-7 photography. The CC FD% in the central 1 mm area, inner circle (1.5 mm to 2.5 mm), outer circle (2.5 mm to 5.0 mm) and the entire area in the macular region were measured using swept-source optical coherence tomography angiography (SS-OCTA). Logistic regression analysis was used to examine the association between baseline CC FD% and 1-year incident RDR.
Results A total of 1222 patients (1222 eyes, mean age: 65.1±7.4 years) with complete baseline and 1-year follow-up data were included. Each 1% increase in baseline CC FD% was significantly associated with a 1.69 times (relative risk 2.69; 95% CI 1.53 to 4.71; p=0.001) higher odds for development of RDR after 1-year follow-up, after adjusting for other confounding factors.
Conclusions A greater baseline CC FD% detected by SS-OCTA reliably predicted higher risks of RDR in participants with type 2 DM. Thus, CC FD% may act as a novel biomarker for predicting the onset and progression of DR.
- Diagnostic tests/Investigation
Data availability statement
Data are available upon reasonable request.
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WW and WC are joint first authors.
WW and WC contributed equally.
Contributors Study concept and design: WW, ZZ; acquisition, analyses or interpretation: all authors; drafting of the manuscript: WW, SY, YC; critical revision of the manuscript for important intellectual content: all authors; statistical analyses: WW; obtained funding: WW, ZZ, WH; administrative, technical or material support: all authors; study supervision: WH; study guarantor: WH.
Funding This research was supported by the National Natural Science Foundation of China (82000901, 8217084), Science and Technology Planning Project of Guangdong Province (202102010162), Fundamental Research Funds of the State Key Laboratory of Ophthalmology (303060202400362).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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