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Article: Quantitative Assessment of Early Diabetic Retinopathy Using Fractal Analysis

TitleQuantitative Assessment of Early Diabetic Retinopathy Using Fractal Analysis
Authors
Issue Date2009
PublisherAmerican Diabetes Association. The Journal's web site is located at http://diabetes.diabetesjournals.org/
Citation
Diabetes Care, 2009, v. 32 n. 1, p. 106-110 How to Cite?
AbstractObjective - Fractal analysis can quantify the geometric complexity of the retinal vascular branching pattern and may therefore offer a new method to quantify early diabetic microvascular damage. In this study, we examined the relationship between retinal fractal dimension and retinopathy in young individuals with type 1 diabetes. Research design and methods - We conducted a cross-sectional study of 729 patients with type 1 diabetes (aged 12-20 years) who had seven-field stereoscopic retinal photographs taken of both eyes. From these photographs, retinopathy was graded according to the modified Airlie House classification, and fractal dimension was quantified using a computer-based program following a standardized protocol. Results - In this study, 137 patients (18.8%) had diabetic retinopathy signs; of these, 105 had mild retinopathy. Median (interquartile range) retinal fractal dimension was 1.46214 (1.45023-1.47217). After adjustment for age, sex, diabetes duration, A1C, blood pressure, and total cholesterol, increasing retinal vascular fractal dimension was significantly associated with increasing odds of retinopathy (odds ratio 3.92 [95% CI 2.02-7.61] for fourth versus first quartile of fractal dimension). In multivariate analysis, each 0.01 increase in retinal vascular fractal dimension was associated with a nearly 40% increased odds of retinopathy (1.37 [1.21- 1.56]). This association remained after additional adjustment for retinal vascular caliber. Conclusions - Greater retinal fractal dimension, representing increased geometric complexity of the retinal vasculature, is independently associated with early diabetic retinopathy signs in type 1 diabetes. Fractal analysis of fundus photographs may allow quantitative measurement of early diabetic microvascular damage. © 2009 by the American Diabetes Association.
Persistent Identifierhttp://hdl.handle.net/10722/183570
ISSN
2015 Impact Factor: 8.934
2015 SCImago Journal Rankings: 5.827
PubMed Central ID
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorCheung, Nen_US
dc.contributor.authorDonaghue, KCen_US
dc.contributor.authorLiew, Gen_US
dc.contributor.authorRogers, SLen_US
dc.contributor.authorWang, JJen_US
dc.contributor.authorLim, SWen_US
dc.contributor.authorJenkins, AJen_US
dc.contributor.authorHsu, Wen_US
dc.contributor.authorLee, MLen_US
dc.contributor.authorWong, TYen_US
dc.date.accessioned2013-05-28T06:14:51Z-
dc.date.available2013-05-28T06:14:51Z-
dc.date.issued2009en_US
dc.identifier.citationDiabetes Care, 2009, v. 32 n. 1, p. 106-110en_US
dc.identifier.issn0149-5992en_US
dc.identifier.urihttp://hdl.handle.net/10722/183570-
dc.description.abstractObjective - Fractal analysis can quantify the geometric complexity of the retinal vascular branching pattern and may therefore offer a new method to quantify early diabetic microvascular damage. In this study, we examined the relationship between retinal fractal dimension and retinopathy in young individuals with type 1 diabetes. Research design and methods - We conducted a cross-sectional study of 729 patients with type 1 diabetes (aged 12-20 years) who had seven-field stereoscopic retinal photographs taken of both eyes. From these photographs, retinopathy was graded according to the modified Airlie House classification, and fractal dimension was quantified using a computer-based program following a standardized protocol. Results - In this study, 137 patients (18.8%) had diabetic retinopathy signs; of these, 105 had mild retinopathy. Median (interquartile range) retinal fractal dimension was 1.46214 (1.45023-1.47217). After adjustment for age, sex, diabetes duration, A1C, blood pressure, and total cholesterol, increasing retinal vascular fractal dimension was significantly associated with increasing odds of retinopathy (odds ratio 3.92 [95% CI 2.02-7.61] for fourth versus first quartile of fractal dimension). In multivariate analysis, each 0.01 increase in retinal vascular fractal dimension was associated with a nearly 40% increased odds of retinopathy (1.37 [1.21- 1.56]). This association remained after additional adjustment for retinal vascular caliber. Conclusions - Greater retinal fractal dimension, representing increased geometric complexity of the retinal vasculature, is independently associated with early diabetic retinopathy signs in type 1 diabetes. Fractal analysis of fundus photographs may allow quantitative measurement of early diabetic microvascular damage. © 2009 by the American Diabetes Association.en_US
dc.languageengen_US
dc.publisherAmerican Diabetes Association. The Journal's web site is located at http://diabetes.diabetesjournals.org/en_US
dc.relation.ispartofDiabetes Careen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAge Of Onseten_US
dc.subject.meshAustralia - Epidemiologyen_US
dc.subject.meshChilden_US
dc.subject.meshCross-Sectional Studiesen_US
dc.subject.meshDiabetes Mellitus, Type 1 - Physiopathologyen_US
dc.subject.meshDiabetic Retinopathy - Epidemiology - Physiopathologyen_US
dc.subject.meshFemaleen_US
dc.subject.meshFractalsen_US
dc.subject.meshFunctional Lateralityen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshPhotographyen_US
dc.subject.meshPrevalenceen_US
dc.subject.meshRetinal Artery - Physiopathologyen_US
dc.subject.meshRetinal Vein - Physiopathologyen_US
dc.subject.meshSeverity Of Illness Indexen_US
dc.subject.meshYoung Adulten_US
dc.titleQuantitative Assessment of Early Diabetic Retinopathy Using Fractal Analysisen_US
dc.typeArticleen_US
dc.identifier.emailCheung, N: dannycheung@hotmail.comen_US
dc.identifier.authorityCheung, N=rp01752en_US
dc.description.naturelink_to_OA_fulltexten_US
dc.identifier.doi10.2337/dc08-1233en_US
dc.identifier.pmid18835945-
dc.identifier.pmcidPMC2606840-
dc.identifier.scopuseid_2-s2.0-64549123117en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-64549123117&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume32en_US
dc.identifier.issue1en_US
dc.identifier.spage106en_US
dc.identifier.epage110en_US
dc.identifier.isiWOS:000262188000022-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridCheung, N=8054683900en_US
dc.identifier.scopusauthoridDonaghue, KC=7003470857en_US
dc.identifier.scopusauthoridLiew, G=12796147900en_US
dc.identifier.scopusauthoridRogers, SL=12768398500en_US
dc.identifier.scopusauthoridWang, JJ=55664024800en_US
dc.identifier.scopusauthoridLim, SW=26637736700en_US
dc.identifier.scopusauthoridJenkins, AJ=7202458130en_US
dc.identifier.scopusauthoridHsu, W=7402002763en_US
dc.identifier.scopusauthoridLee, ML=7409117252en_US
dc.identifier.scopusauthoridWong, TY=35231271400en_US

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