TY - JOUR
T1 - A New Approach to Staging Diabetic Eye Disease
T2 - Staging of Diabetic Retinal Neurodegeneration and Diabetic Macular Edema
AU - Diabetic Retinal Neurodegeneration and Macular Edema working group of the Mary Tyler Moore Vision Initiative's Diabetic Retinal Disease Staging Update Project
AU - Channa, Roomasa
AU - Wolf, Risa M.
AU - Simo, Rafael
AU - Brigell, Mitchell
AU - Fort, Patrice
AU - Curcio, Christine
AU - Lynch, Stephanie
AU - Verbraak, Frank
AU - Abramoff, Michael D.
AU - Brigell, Mitch
AU - Gardner, Thomas W.
N1 - Publisher Copyright: © 2023 American Academy of Ophthalmology
PY - 2024/5/1
Y1 - 2024/5/1
N2 - Topic: The goal of this review was to summarize the current level of evidence on biomarkers to quantify diabetic retinal neurodegeneration (DRN) and diabetic macular edema (DME). Clinical relevance: With advances in retinal diagnostics, we have more data on patients with diabetes than ever before. However, the staging system for diabetic retinal disease is still based only on color fundus photographs and we do not have clear guidelines on how to incorporate data from the relatively newer modalities into clinical practice. Methods: In this review, we use a Delphi process with experts to identify the most promising modalities to identify DRN and DME. These included microperimetry, full-field flash electroretinogram, spectral-domain OCT, adaptive optics, and OCT angiography. We then used a previously published method of determining the evidence level to complete detailed evidence grids for each modality. Results: Our results showed that among the modalities evaluated, the level of evidence to quantify DRN and DME was highest for OCT (level 1) and lowest for adaptive optics (level 4). Conclusion: For most of the modalities evaluated, prospective studies are needed to elucidate their role in the management and outcomes of diabetic retinal diseases. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
AB - Topic: The goal of this review was to summarize the current level of evidence on biomarkers to quantify diabetic retinal neurodegeneration (DRN) and diabetic macular edema (DME). Clinical relevance: With advances in retinal diagnostics, we have more data on patients with diabetes than ever before. However, the staging system for diabetic retinal disease is still based only on color fundus photographs and we do not have clear guidelines on how to incorporate data from the relatively newer modalities into clinical practice. Methods: In this review, we use a Delphi process with experts to identify the most promising modalities to identify DRN and DME. These included microperimetry, full-field flash electroretinogram, spectral-domain OCT, adaptive optics, and OCT angiography. We then used a previously published method of determining the evidence level to complete detailed evidence grids for each modality. Results: Our results showed that among the modalities evaluated, the level of evidence to quantify DRN and DME was highest for OCT (level 1) and lowest for adaptive optics (level 4). Conclusion: For most of the modalities evaluated, prospective studies are needed to elucidate their role in the management and outcomes of diabetic retinal diseases. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
KW - Biomarkers
KW - Diabetic retinal disease
KW - Imaging modalities
KW - Neuro-retinal layers
UR - http://www.scopus.com/inward/record.url?scp=85184702053&partnerID=8YFLogxK
U2 - 10.1016/j.xops.2023.100420
DO - 10.1016/j.xops.2023.100420
M3 - Review article
C2 - 38284099
SN - 2666-9145
VL - 4
JO - Ophthalmology Science
JF - Ophthalmology Science
IS - 3
M1 - 100420
ER -