Retinal fractal dimension is increased in persons with diabetes but not impaired glucose metabolism: the Australian Diabetes, Obesity and Lifestyle (AusDiab) study

Yau, J. W. Y. and Kawasaki, R. and Islam, F. M. A. and Shaw, J. and Zimmet, P. and Wang, J. J. and Wong, T. Y. (2010) Retinal fractal dimension is increased in persons with diabetes but not impaired glucose metabolism: the Australian Diabetes, Obesity and Lifestyle (AusDiab) study. Diabetologia, 53 (9). pp. 2042-2045. ISSN 0012-186X


Aims/hypothesis: The fractal dimension (D f) of the retinal vasculature is a global measure of its branching pattern complexity. We examined the relationship of retinal D f with diabetes.
Methods: We conducted a cross-sectional study of 1,577 participants with diabetes and impaired glucose metabolism and normal controls from the population-based Australian Diabetes, Obesity and Lifestyle (AusDiab) study. Retinal D f was quantified from fundus photographs using a computer-based programme and diabetes status was determined by oral glucose tolerance test based on the WHO criteria. Results: After adjustment for age, sex and vascular risk factors, persons with higher retinal D f were more likely to have diabetes (OR 1.56; 95% CI 1.14-2.14, highest vs lowest fractal tertile). This relationship remained with further adjustment for retinal arteriolar calibre and presence of retinopathy (OR 1.64; 95% CI 1.19-2.27), and after excluding participants with retinopathy (OR 1.60; 95% CI 1.16-2.21). Retinal D f was not related to impaired glucose tolerance or impaired fasting glucose (OR 1.19; 95% CI 0.85-1.67).
Conclusions/interpretation: Individuals with diabetes, but not with impaired glucose metabolism, have greater retinal D f, reflecting greater complexity of the retinal vasculature. Our findings suggest the presence of early microvascular changes in the retinal vasculature of persons with diabetes, even in the absence of overt retinopathy.

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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: © 2010 Springer-Verlag. Permanent restricted access to published version in accordance with the copyright policy of the publisher.
Faculty/School / Institute/Centre: Historic - Faculty of Sciences - Department of Maths and Computing
Date Deposited: 29 Jul 2014 02:10
Last Modified: 10 Oct 2014 03:29
Uncontrolled Keywords: diabetes; diabetic retinopathy; fundus photographs; impaired glucose metabolism; microvascular changes; retinal fractal dimension
Fields of Research : 11 Medical and Health Sciences > 1103 Clinical Sciences > 110306 Endocrinology
11 Medical and Health Sciences > 1102 Cardiovascular Medicine and Haematology > 110202 Haematology
11 Medical and Health Sciences > 1113 Ophthalmology and Optometry > 111303 Vision Science
Socio-Economic Objective: C Society > 92 Health > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920104 Diabetes
Identification Number or DOI: 10.1007/s00125-010-1811-z

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