Retinal venular tortuosity and fractal dimension predict incident retinopathy in adults with type 2 diabetes: the Edinburgh Type 2 – published online 30/01/2021

Rachel B. Forster, Emmanuel Sandoval Garcia, Anniek J. Sluiman, Sheila M. Grecian, Stela McLachlan, Tom J. MacGillivray, Mark W. J. Strachan, Jackie F. Price, on behalf of the Edinburgh Type 2 Diabetes Study (ET2DS) investigators

Diabetic retinopathy is a common complication of diabetes and can have a major impact on quality of life. In this issue, Forster et al (https://doi.org/10.1007/s00125-021-05388-5) report that recent developments have allowed for detailed analysis of the retinal vessels in the back of the eye. This gives hope of identifying early changes that can predetermine local vascular disease. Through follow-up of the Edinburgh Type 2 Diabetes Study, the authors aimed to identify associations between several retinal vessel measurements and the development of diabetic retinopathy. They identified that increased venular tortuosity (curvature of the small veins and how much the vessels twist) and decreased fractal dimension (complexity of the vessel system) were both associated with later development of diabetic retinopathy. Further analysis found venular tortuosity to be a possible biomarker candidate for future risk prediction models, which, according to the authors, could be used to help identify risk of diabetic retinopathy prior to disease onset.

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