Please use this identifier to cite or link to this item:
Title: Quantitative Assessment of Early Diabetic Retinopathy Using Fractal Analysis
Authors: Cheung, N.
Donaghue, K.C.
Liew, G.
Rogers, S.L.
Wang, J.J.
Lim, S.-W.
Jenkins, A.J.
Hsu, W. 
Lee, M.L. 
Wong, T.Y. 
Issue Date: 2009
Citation: Cheung, N., Donaghue, K.C., Liew, G., Rogers, S.L., Wang, J.J., Lim, S.-W., Jenkins, A.J., Hsu, W., Lee, M.L., Wong, T.Y. (2009). Quantitative Assessment of Early Diabetic Retinopathy Using Fractal Analysis. Diabetes Care 32 (1) : 106-110. ScholarBank@NUS Repository.
Abstract: Objective - Fractal analysis can quantify the geometric complexity of the retinal vascular branching pattern and may therefore offer a new method to quantify early diabetic microvascular damage. In this study, we examined the relationship between retinal fractal dimension and retinopathy in young individuals with type 1 diabetes. Research design and methods - We conducted a cross-sectional study of 729 patients with type 1 diabetes (aged 12-20 years) who had seven-field stereoscopic retinal photographs taken of both eyes. From these photographs, retinopathy was graded according to the modified Airlie House classification, and fractal dimension was quantified using a computer-based program following a standardized protocol. Results - In this study, 137 patients (18.8%) had diabetic retinopathy signs; of these, 105 had mild retinopathy. Median (interquartile range) retinal fractal dimension was 1.46214 (1.45023-1.47217). After adjustment for age, sex, diabetes duration, A1C, blood pressure, and total cholesterol, increasing retinal vascular fractal dimension was significantly associated with increasing odds of retinopathy (odds ratio 3.92 [95% CI 2.02-7.61] for fourth versus first quartile of fractal dimension). In multivariate analysis, each 0.01 increase in retinal vascular fractal dimension was associated with a nearly 40% increased odds of retinopathy (1.37 [1.21- 1.56]). This association remained after additional adjustment for retinal vascular caliber. Conclusions - Greater retinal fractal dimension, representing increased geometric complexity of the retinal vasculature, is independently associated with early diabetic retinopathy signs in type 1 diabetes. Fractal analysis of fundus photographs may allow quantitative measurement of early diabetic microvascular damage. © 2009 by the American Diabetes Association.
Source Title: Diabetes Care
ISSN: 01495992
DOI: 10.2337/dc08-1233
Appears in Collections:Staff Publications

Show full item record
Files in This Item:
There are no files associated with this item.


checked on Aug 9, 2022


checked on Aug 9, 2022

Page view(s)

checked on Aug 4, 2022

Google ScholarTM



Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.