Microaneurysm count ‘important prognostic indicator’ for retinopathy
MedWire News: An elevated microaneurysm score is an important prognostic indicator for progression of diabetic retinopathy and reduced likelihood of regression, suggest study findings.
The researchers say that treatment of microaneurysms using renin-angiotensin system inhibitors may be effective for improving mild retinopathy.
Writing in the journal Diabetic Medicine, Anne Sjølie (Odense University Hospital, Denmark) and team report results from a post-hoc analysis of the DIabetic REtinopathy Candesartan Trials (DIRECT) study.
They included 893 patients with Type 1 (454 placebo; 439 candesartan treated) and 526 patients with Type 2 diabetes (264 placebo; 262 candesartan treated) with microaneurysms and diabetic retinopathy who were assessed for progression.
In addition, 438 patients with Type 1 and 216 with Type 2 diabetes who had significant potential to regress (Early Treatment Diabetic Retinopathy Study [ETDRS] severity scale score level 20 in both eyes) were also assessed for regression of retinopathy.
The researchers found that each additional microaneurysm observed at baseline on retinal photographs increased the risk for progression of retinopathy by 8% and 7% in Type 1 and Type 2 diabetes, respectively.
Chance of regression of retinopathy was reduced by a corresponding 21% and 15% per additional aneurysm scored at baseline.
Use of a renin-angiotensin system inhibitor, in this case candesartan, was observed to reduce the risk for microaneurysm score progression, note the authors.
"Our findings support the use of microaneurysm score as a useful surrogate clinical endpoint for progression and regression of retinopathy in clinical trials and may be more sensitive than the ETDRS in earlier stages," write Sjølie et al.
"It should be emphasized that this is not applicable to screening for sight-threatening retinopathy in clinical practice," they add.
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By Helen Albert