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Quantitative assessment of early diabetic retinopathy using fractal analysis.

Publication ,  Journal Article
Cheung, N; Donaghue, KC; Liew, G; Rogers, SL; Wang, JJ; Lim, S-W; Jenkins, AJ; Hsu, W; Li Lee, M; Wong, TY
Published in: Diabetes Care
January 2009

OBJECTIVE: 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.

Duke Scholars

Published In

Diabetes Care

DOI

EISSN

1935-5548

Publication Date

January 2009

Volume

32

Issue

1

Start / End Page

106 / 110

Location

United States

Related Subject Headings

  • Young Adult
  • Severity of Illness Index
  • Retinal Vein
  • Retinal Artery
  • Prevalence
  • Photography
  • Male
  • Humans
  • Functional Laterality
  • Fractals
 

Citation

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ICMJE
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Cheung, N., Donaghue, K. C., Liew, G., Rogers, S. L., Wang, J. J., Lim, S.-W., … Wong, T. Y. (2009). Quantitative assessment of early diabetic retinopathy using fractal analysis. Diabetes Care, 32(1), 106–110. https://doi.org/10.2337/dc08-1233
Cheung, Ning, Kim C. Donaghue, Gerald Liew, Sophie L. Rogers, Jie Jin Wang, Shueh-Wen Lim, Alicia J. Jenkins, Wynne Hsu, Mong Li Lee, and Tien Y. Wong. “Quantitative assessment of early diabetic retinopathy using fractal analysis.Diabetes Care 32, no. 1 (January 2009): 106–10. https://doi.org/10.2337/dc08-1233.
Cheung N, Donaghue KC, Liew G, Rogers SL, Wang JJ, Lim S-W, et al. Quantitative assessment of early diabetic retinopathy using fractal analysis. Diabetes Care. 2009 Jan;32(1):106–10.
Cheung, Ning, et al. “Quantitative assessment of early diabetic retinopathy using fractal analysis.Diabetes Care, vol. 32, no. 1, Jan. 2009, pp. 106–10. Pubmed, doi:10.2337/dc08-1233.
Cheung N, Donaghue KC, Liew G, Rogers SL, Wang JJ, Lim S-W, Jenkins AJ, Hsu W, Li Lee M, Wong TY. Quantitative assessment of early diabetic retinopathy using fractal analysis. Diabetes Care. 2009 Jan;32(1):106–110.

Published In

Diabetes Care

DOI

EISSN

1935-5548

Publication Date

January 2009

Volume

32

Issue

1

Start / End Page

106 / 110

Location

United States

Related Subject Headings

  • Young Adult
  • Severity of Illness Index
  • Retinal Vein
  • Retinal Artery
  • Prevalence
  • Photography
  • Male
  • Humans
  • Functional Laterality
  • Fractals