Comparative analysis of retinal vascular structural parameters in populations with different glucose metabolism status based on color fundus photography and artificial intelligence

ObjectiveMeasure and analyze retinal vascular parameters in individuals with varying glucose metabolism, explore preclinical retinal microstructure changes related to diabetic retinopathy (DR), and assess glucose metabolism’s impact on retinal structure.MethodsThe study employed a cross-sectional de...

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Main Authors: Naimei Chen, Zhentao Zhu, Di Gong, Xinrong Xu, Xinya Hu, Weihua Yang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-02-01
Series:Frontiers in Cell and Developmental Biology
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Online Access:https://www.frontiersin.org/articles/10.3389/fcell.2025.1550176/full
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author Naimei Chen
Naimei Chen
Zhentao Zhu
Di Gong
Xinrong Xu
Xinya Hu
Weihua Yang
author_facet Naimei Chen
Naimei Chen
Zhentao Zhu
Di Gong
Xinrong Xu
Xinya Hu
Weihua Yang
author_sort Naimei Chen
collection DOAJ
description ObjectiveMeasure and analyze retinal vascular parameters in individuals with varying glucose metabolism, explore preclinical retinal microstructure changes related to diabetic retinopathy (DR), and assess glucose metabolism’s impact on retinal structure.MethodsThe study employed a cross-sectional design encompassing a 4-year period from 2020 to 2024. Fundus photographs from 320 individuals (2020–2024) were categorized into non-diabetes, pre-diabetes, type 2 diabetes mellitus (T2DM) without DR, and T2DM with mild-to-moderate non-proliferative DR (NPDR) groups. An artificial intelligence (AI)-based automatic measurement system was used to quantify retinal blood vessels in the fundus color photographic images, enabling inter-group parameter comparison and analysis of significant differences.ResultsBetween January 2020 and June 2024, fundus color photographs were collected from 320 individuals and categorized into four groups: non-diabetes (n = 54), pre-diabetes (n = 71), T2DM without overt DR (n = 144), and T2DM with mild-to-moderate NPDR (n = 51). In pairwise comparisons among individuals with pre-diabetes, T2DM without DR, and T2DM with mild-to-moderate NPDR. Fasting blood glucose (FBG), glycated hemoglobin (HbA1c), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were significantly different (P < 0.05). Within the T2DM population, FBG, HbA1c, age, SBP, and DBP were significant predictors for mild-to-moderate NPDR (P < 0.05). Average venous branching number (branch_avg_v) was significantly different among pre-diabetes, T2DM without DR, and T2DM with mild-to-moderate NPDR groups. In patients with T2DM with mild-to-moderate NPDR, Average length of arteries (length_avg_a) and average length of veins (length_avg_v) increased, whereas branch_avg_v, average venous branching angle (angle_avg_v), average venous branching asymmetry (asymmetry_avg_v),overall length density (vessel_length_density), and vessel area density (vessel_density) decreased significantly (P < 0.05). Logistic regression analysis identified length_avg_a, branch_avg_v, angle_avg_v, asymmetry_avg_v, vessel_length_density, and vessel_density as independent predictors of mild-to-moderate NPDR in patients with T2DM. Receiver Operating Characteristic (ROC) curve analysis demonstrated that length_avg_a, length_avg_v, branch_avg_v, angle_avg_v, asymmetry_avg_v, vessel_length_density, and vessel_density had diagnostic value for mild-to-moderate NPDR (P < 0.05).ConclusionIn individuals diagnosed with T2DM, specific retinal vascular parameters, such as branch_avg_v and vessel_density, demonstrate a significant correlation with mild-to-moderate NPDR. These parameters hold promise as preclinical biomarkers for detecting vascular abnormalities associated with DR.
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spelling doaj-art-ba3a49b79b5e405abdc707f5eb8b09602025-02-03T06:33:38ZengFrontiers Media S.A.Frontiers in Cell and Developmental Biology2296-634X2025-02-011310.3389/fcell.2025.15501761550176Comparative analysis of retinal vascular structural parameters in populations with different glucose metabolism status based on color fundus photography and artificial intelligenceNaimei Chen0Naimei Chen1Zhentao Zhu2Di Gong3Xinrong Xu4Xinya Hu5Weihua Yang6Department of Ophthalmology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, ChinaDepartment of Ophthalmology, Huaian Hospital of Huaian City, Huaian, ChinaDepartment of Ophthalmology, Huaian Hospital of Huaian City, Huaian, ChinaShenzhen Eye Hospital, Shenzhen Eye Medical Center, Southern Medical University, Shenzhen, ChinaDepartment of Ophthalmology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, ChinaShenzhen Eye Hospital, Shenzhen Eye Medical Center, Southern Medical University, Shenzhen, ChinaShenzhen Eye Hospital, Shenzhen Eye Medical Center, Southern Medical University, Shenzhen, ChinaObjectiveMeasure and analyze retinal vascular parameters in individuals with varying glucose metabolism, explore preclinical retinal microstructure changes related to diabetic retinopathy (DR), and assess glucose metabolism’s impact on retinal structure.MethodsThe study employed a cross-sectional design encompassing a 4-year period from 2020 to 2024. Fundus photographs from 320 individuals (2020–2024) were categorized into non-diabetes, pre-diabetes, type 2 diabetes mellitus (T2DM) without DR, and T2DM with mild-to-moderate non-proliferative DR (NPDR) groups. An artificial intelligence (AI)-based automatic measurement system was used to quantify retinal blood vessels in the fundus color photographic images, enabling inter-group parameter comparison and analysis of significant differences.ResultsBetween January 2020 and June 2024, fundus color photographs were collected from 320 individuals and categorized into four groups: non-diabetes (n = 54), pre-diabetes (n = 71), T2DM without overt DR (n = 144), and T2DM with mild-to-moderate NPDR (n = 51). In pairwise comparisons among individuals with pre-diabetes, T2DM without DR, and T2DM with mild-to-moderate NPDR. Fasting blood glucose (FBG), glycated hemoglobin (HbA1c), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were significantly different (P < 0.05). Within the T2DM population, FBG, HbA1c, age, SBP, and DBP were significant predictors for mild-to-moderate NPDR (P < 0.05). Average venous branching number (branch_avg_v) was significantly different among pre-diabetes, T2DM without DR, and T2DM with mild-to-moderate NPDR groups. In patients with T2DM with mild-to-moderate NPDR, Average length of arteries (length_avg_a) and average length of veins (length_avg_v) increased, whereas branch_avg_v, average venous branching angle (angle_avg_v), average venous branching asymmetry (asymmetry_avg_v),overall length density (vessel_length_density), and vessel area density (vessel_density) decreased significantly (P < 0.05). Logistic regression analysis identified length_avg_a, branch_avg_v, angle_avg_v, asymmetry_avg_v, vessel_length_density, and vessel_density as independent predictors of mild-to-moderate NPDR in patients with T2DM. Receiver Operating Characteristic (ROC) curve analysis demonstrated that length_avg_a, length_avg_v, branch_avg_v, angle_avg_v, asymmetry_avg_v, vessel_length_density, and vessel_density had diagnostic value for mild-to-moderate NPDR (P < 0.05).ConclusionIn individuals diagnosed with T2DM, specific retinal vascular parameters, such as branch_avg_v and vessel_density, demonstrate a significant correlation with mild-to-moderate NPDR. These parameters hold promise as preclinical biomarkers for detecting vascular abnormalities associated with DR.https://www.frontiersin.org/articles/10.3389/fcell.2025.1550176/fullcolor fundus photographyretinal vascular parametersbiomarkersglucose metabolism statusartificial intelligence
spellingShingle Naimei Chen
Naimei Chen
Zhentao Zhu
Di Gong
Xinrong Xu
Xinya Hu
Weihua Yang
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
color fundus photography
retinal vascular parameters
biomarkers
glucose metabolism status
artificial intelligence
title Comparative analysis of retinal vascular structural parameters in populations with different glucose metabolism status based on color fundus photography and artificial intelligence
title_full Comparative analysis of retinal vascular structural parameters in populations with different glucose metabolism status based on color fundus photography and artificial intelligence
title_fullStr Comparative analysis of retinal vascular structural parameters in populations with different glucose metabolism status based on color fundus photography and artificial intelligence
title_full_unstemmed Comparative analysis of retinal vascular structural parameters in populations with different glucose metabolism status based on color fundus photography and artificial intelligence
title_short Comparative analysis of retinal vascular structural parameters in populations with different glucose metabolism status based on color fundus photography and artificial intelligence
title_sort comparative analysis of retinal vascular structural parameters in populations with different glucose metabolism status based on color fundus photography and artificial intelligence
topic color fundus photography
retinal vascular parameters
biomarkers
glucose metabolism status
artificial intelligence
url https://www.frontiersin.org/articles/10.3389/fcell.2025.1550176/full
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