Observational studyDiabetologia2021
Retinal venular tortuosity and fractal dimension predict incident retinopathy in adults with type 2 diabetes: the Edinburgh Type 2 Diabetes Study.
Observational study in Diabetologia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
30 citing papers in PubMed, 2 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Predicting systemic diseases in fundus images: systematic review of setting, reporting, bias, and models' clinical availability in deep learning studies.Eye (London, England) · 2024Pooled it
- Comprehensive Factors for Predicting the Complications of DiabetesMellitus: A Systematic Review.Current diabetes reviews · 2024Pooled it
- Deep Learning-Derived Retinal Vascular Morphology and Incident Treatment for Sight-Threatening Diabetic Retinopathy.Ophthalmology science · 2026Article
- Conjunctival Vascular Metrics Using Automated Vessel Detection from Slit Lamp Images for Hyperemia Severity Assessment.Diagnostics (Basel, Switzerland) · 2026Article
- Deep Learning Model to Detect Diabetic Retinopathy in 45° Images Using Ground Truth from Ultra-Widefield Imaging.Ophthalmology science · 2026Article
- Topology-preserving, diameter-specific framework for conjunctival vessel segmentation and tortuosity analysis in diabetes.Scientific reports · 2026Article
- Study on fundus characteristics of preschool children based on artificial intelligence quantitative technology.BMC ophthalmology · 2026Observational
- Diabetic retinopathy: why some eyes suffer more - a focus on retina-specific risk factors and metabolic memory.Journal of translational medicine · 2026Review
- Effect of RAS inhibitors on retinal microvasculature in DKD using AI-based ultra-wide-field images.Frontiers in endocrinology · 2026Article
- Artificial intelligence in fundus photography for type 2 diabetes: a scoping review of systemic biomarkers and multi-organ risk prediction.Frontiers in digital health · 2026Review
- Comparative analysis of retinal vascular structural parameters in populations with different glucose metabolism status based on color fundus photography and artificial intelligence.Frontiers in cell and developmental biology · 2025Article
- A panoramic perspective: application prospects and outlook of multimodal artificial intelligence in the management of diabetic retinopathy.Frontiers in public health · 2025Review
- Structure-preserving super-resolution of retinal fundus images via a dual-transformer residual network.Frontiers in medicine · 2025Article
- Early Diabetic Retinopathy Evaluation With OCTA: A Study on Vascular Branching and Fragmentation.Investigative ophthalmology & visual science · 2024Article
- Combining functional and morphological retinal vascular characteristics achieves high-precision diagnosis of mild non-proliferative diabetic retinopathy.Journal of translational medicine · 2024Article
- Correlation between retinal vascular geometric parameters and pathologically diagnosed type 2 diabetic nephropathy.Clinical kidney journal · 2024Article
- Advances in Structural and Functional Retinal Imaging and Biomarkers for Early Detection of Diabetic Retinopathy.Biomedicines · 2024Review
- Associations between retinal microvascular flow, geometry, and progression of diabetic retinopathy in type 2 diabetes: a 2-year longitudinal study.Acta diabetologica · 2024Article
- Retinal Vascular Geometry in Hypertension: cSLO-Based Method.Ophthalmology and therapy · 2023Article
- Using Artificial Intelligence to Analyse the Retinal Vascular Network: The Future of Cardiovascular Risk Assessment Based on Oculomics? A Narrative Review.Ophthalmology and therapy · 2023Review
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
aims/hypothesisOur aim was to determine whether a range of prespecified retinal vessel traits were associated with incident diabetic retinopathy in adults with type 2 diabetes.
methodsIn the prospective observational cohort Edinburgh Type 2 Diabetes Study of 1066 adults with type 2 diabetes, aged 60-75 years at recruitment, 718 were free from diabetic retinopathy at baseline. Baseline retinal traits including vessel widths, tortuosity (curvature) and fractal dimensions (network complexity), were quantified using fundus camera images and semiautomated software, and analysed using logistic regression for their association with incident diabetic retinopathy over 10 years.
resultsThe incidence of diabetic retinopathy was 11.4% (n = 82) over 10 years. After adjustment for a range of vascular and diabetes-related risk factors, both increased venular tortuosity (OR 1.51; 95% CI 1.15, 1.98; p = 0.003) and decreased fractal dimension (OR 0.75; 95% CI 0.58, 0.96; p = 0.025) were associated with incident retinopathy. There was no evidence of an association with arterial tortuosity, and associations between measurements of vessel widths and retinopathy lost statistical significance after adjustment for diabetes-related factors and vascular disease. Adding venular tortuosity to a model including established risk factors for diabetic retinopathy (HbA CONCLUSIONS/
interpretationIncreased retinal venular tortuosity and decreased fractal dimension are associated with incident diabetic retinopathy, independent of classical risk factors. There is some evidence that venular tortuosity may be a useful biomarker to improve the predictive ability of models based on established retinopathy risk factors, and its inclusion in further risk prediction modelling is warranted.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.