Retinal vessel measurements as clinically useful predictors in veterans

描述(由申请人提供)： 背景：我们假设，使用我们的自动化、精确、快速、新颖的工具测量视网膜图像中的视网膜血管，获得的视网膜血管衍生生物标记物可以在任何明显的视网膜病变或血压升高迹象出现之前，识别出糖尿病视网膜病变和高血压风险增加的退伍军人。人群研究表明，动脉和静脉直径的变化与这些并发症的未来发展有关。 目的：从彩色眼底照片中确定视网膜血管衍生生物标记物作为糖尿病视网膜病变(DR)和糖尿病退伍军人高血压的非侵入性独立危险因素的潜在实用性。 方法：目的：1.我们将自动获取视网膜血管参数(动脉和视网膜血管宽度和分支关系)作为不少于2年后高血压未来发展的早期生物标志物，目前血压正常。我们将比较500名患有糖尿病的退伍军人的视网膜图像中的这个生物标志物，这些人在成像时都没有高血压，而那些在不超过3年后被诊断为高血压的人和没有被诊断为高血压的人。 目的：评估自动派生的视网膜血管参数作为糖尿病退伍军人发生糖尿病视网膜病变(根据国际临床糖尿病视网膜病变和糖尿病黄斑水肿严重程度量表定义为从轻度视网膜病变过渡到无明显黄斑水肿)风险的早期生物标志物。我们将在4000名患有糖尿病的退伍军人的视网膜图像中比较这一生物标志物，这些退伍军人目前没有DR，其中约10%的人在不少于两年后出现视网膜病变，而其余的人没有。

DESCRIPTION (provided by applicant): Background: We hypothesize that retinal vessel derived biomarkers, obtained using our automated, precise, fast, novel tool for measuring retinal vessels in retinal images can identify veterans at increased risk for diabetic retinopathy and hypertension, before any overt signs of retinopathy or increased blood pressure have become apparent. Population studies have shown that changes in arterial and venous diameter are associated with future development of these complications. Purpose: Determine the potential utility of retinal vessel derived biomarkers, from color fundus photographs, as a non-invasive independent risk factor for diabetic retinopathy (DR) and hypertension in veterans with diabetes. Methods: Aim 1. We will evaluate automatically derived retinal vessel parameters (arterial and retinal vessel width and branch relationships) as an early biomarker for future development of hypertension no less than 2 years later, with normal current normal blood pressure. We will compare this biomarker in retinal images from 500 veterans with diabetes, all of whom did not have hypertension at the time of imaging, for those who were and were not diagnosed with hypertension no more than 3 years later. Aim 2. To evaluate automatically derived retinal vessel parameters as an early biomarker for the risk for development of diabetic retinopathy (defined as transition from less than moderate retinopathy AND no apparent macular edema according to the International Clinical Diabetic Retinopathy and Diabetic Macular Edema Severity Scale) in at risk veterans with diabetes. We will compare this biomarker in retinal images from a population of 4000 veterans with diabetes, currently without DR, ~10% of who developed retinopathy no less than two years later while the remainder did not.