To determine whether venous beading (VB) in two or more quadrants is an appropriate grading criterion for severe nonproliferative diabetic retinopathy (NPDR).
A hospital-based, retrospective, cross-sectional study. A total of 806 patients admitted with diabetic retinopathy (DR) from January 2014 to April 2017 were included in this study. DR severity was graded by the international grading criterion. The status of VB, intraretinal microvascular abnormalities (IRMA), capillary nonperfusion, arteriovenous nicking, and diabetic macular edema was evaluated based on fundus fluorescein angiography.
The prevalence of VB in eyes with proliferative diabetic retinopathy (PDR), severe NPDR, and moderate NPDR was 41.3% (327/791), 5.9% (31/526), and 0% (0/295), respectively (p < 0.001). Moreover, the proportion of VB in two or more quadrants was even lower (27.1% for PDR and 2.1% for severe NPDR, p < 0.001), and among the total of 225 eyes with VB in two or more quadrants, 214 eyes (95.1%) were graded as PDR. Furthermore, VB formation was significantly correlated with capillary nonperfusion, duration of diabetes (both p < 0.001), and smoking (p < 0.05). After adjusting for age, sex, and other possible factors, VB (OR = 7.479, p < 0.001) and IRMA (OR = 2.433, p < 0.001) were determined as independent risk factors for developing PDR.
Our study suggested that VB in two or more quadrants might not be a sensitive grading criterion for severe NPDR among a Chinese population with type 2 diabetes. Nevertheless, VB has a great specificity to define an advanced form of DR.
Early Treatment Diabetic Retinopathy Study Research Group (1991) Grading diabetic retinopathy from stereoscopic color fundus photographs—an extension of the modified Airlie House classification. ETDRS report number 10. Ophthalmology 98(5 Suppl):786–806
Early Treatment Diabetic Retinopathy Study Research Group (1991) Early photocoagulation for diabetic retinopathy. ETDRS report number 9. Ophthalmology 98(5 Suppl):766–785
American Academy of Ophthalmology Retina/Vitreous Panel (2016) Preferred practice pattern guidelines. Diabetic retinopathy, San Francisco, CA(American Academy of Ophthalmology):Available at: http://www.aao.org/ppp. Accessed 20 Sep 2014
Early Treatment Diabetic Retinopathy Study Research Group (1991) Classification of diabetic retinopathy from fluorescein angiograms. ETDRS report number 11. Ophthalmology 98(5 Suppl):807–822
Sato Y, Kamata A, Matsui M (1993) Clinical study of venous abnormalities in diabetic retinopathy. Jpn J Ophthalmol 37(2):136–142 PubMed
Wat N, Wong RLM, Wong IYH (2016) Associations between diabetic retinopathy and systemic risk factors. Hong Kong Med J 22(6):589–599 PubMed
- Venous beading in two or more quadrants might not be a sensitive grading criterion for severe nonproliferative diabetic retinopathy
- Springer Berlin Heidelberg
Graefe's Archive for Clinical and Experimental Ophthalmology
Incorporating German Journal of Ophthalmology
Print ISSN: 0721-832X
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