Microaneurysm turnover in the macula is a biomarker for development of clinically significant macular edema in type 2 diabetes

Abstract

The evolution and progression of diabetic retinopathy varies between individuals and does not necessarily progress to vision loss in every patient. However, it is difficult in clinical practice to predict the clinical course and to identify which eyes will develop vision-threatening complications, ie, clinically significant macular edema or proliferative retinopathy. There is a clear need to identify biomarkers of disease progression. Microaneurysm turnover computed automatically in digital color fundus photography images using the RetmarkerDR is a good biomarker for worsening of retinopathy and development of clinically significant macular edema. For long-term prediction (ten years), a microaneurysm formation rate higher than two per year predicts development of clinically significant macular edema. For short-term prediction (2 years), a microaneurysm turnover rate lower than nine indicates that development of clinically significant macular edema is highly unlikely.