Evidence map›Paper›PMID 40593439›Full record

ArticleOphthalmology and therapy2025

Microaneurysm Counting as a Biomarker for the Hyperperfusion Stage of Nonproliferative Diabetic Retinopathy.

Luís Mendes, Ana Rocha, Marta Lopes, Ana Almeida, Nicole Duarte, Débora Reste-Ferreira, António Martinho, Pedro Pereira, Inês Marques, Conceição Lobo and 1 more

Abstract read
In one paragraph

Article in Ophthalmology and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Luís MendesAIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.ORCID http://orcid.org/0000-0002-3432-3604
Ana RochaAIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.ORCID http://orcid.org/0009-0000-9014-0362
Marta LopesAIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.ORCID http://orcid.org/0000-0002-5403-8499
Ana AlmeidaAIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.ORCID http://orcid.org/0000-0002-9873-8729
Nicole DuarteAIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.ORCID http://orcid.org/0000-0001-5645-0957
Débora Reste-FerreiraAIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.ORCID http://orcid.org/0000-0002-8769-1355
António MartinhoAIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.ORCID http://orcid.org/0000-0001-8447-9255
Pedro PereiraRetmarker S.A, METEDA company, Rome, Italy.
Inês MarquesAIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.ORCID http://orcid.org/0000-0001-9170-6997
Conceição LoboAIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.ORCID http://orcid.org/0000-0001-5831-7711
José Cunha-VazAIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal. cunhavaz@aibili.pt.ORCID http://orcid.org/0000-0002-0947-9850

Funding

NA by NextGenerationEU (PRR - Financiamento Base - Centros de Tecnologia e Inovação - Investimento RE-C05-i02 - Missão Interface nº 03/C05-i02/2022).NA This work was supported by AIBILI
6 · The paper itself

Abstract

introductionThis study aimed to investigate the utility of microaneurysm (MA) counting as a tool for characterizing the hyperperfusion stage of nonproliferative diabetic retinopathy (NPDR) and to examine the hypothesis that MAs can serve as a surrogate biomarker for the presence of intraretinal microvascular abnormalities (IRMAs).

methodsForty-nine (n = 49) eyes with type 2 diabetes mellitus with NPDR were included in this analysis: 12 with Early Treatment Diabetic Retinopathy Study (ETDRS) levels 43 and 37 with levels 47-53. Automated MA detection was performed using the RetmarkerDR software (Retmarker SA, Meteda Group, Italy), alongside manual detection, both done in the central retina (field 2). Based on MA counts, microaneurysm turnover (MAT) was computed. IRMAs were manually counted based on swept-source optical coherence tomography (SS-OCT) angiography on PLEX® Elite 9000 (ZEISS, Dublin, CA, USA). The statistically significant differences between ETDRS groups were studied by comparing Mann-Whitney U test p values (significance value < 0.05). The correlation between the presence of MAs and IRMAs and MAT and IRMAs was examined using Spearman correlation analysis.

resultsThere was an observed increase in the number of IRMAs, MAs, and MAT values as NPDR progressed, independently of the counting method used. Specifically, this increase was noted when transitioning from ETDRS groups characterized by the predominance of the hypoperfusion stage (ETDRS 43) to those associated with the hyperperfusion stage (ETDRS 47-53). When MAs were counted manually, a moderate correlation was identified between the number of MAs and the presence of IRMAs (ρ = 0.40; p value = 0.005). Additionally, a similar correlation was found between MAT and the presence of IRMAs (ρ = 0.43; p value = 0.002).

conclusionsThis study underscores the potential relevance of MAs as a pivotal indicator of the hyperperfusion stage of NPDR and supports their role as surrogate biomarkers for IRMAs. These results suggest a role for MA counting in the assessment and management of diabetic eye disease.

Indexed as

DiabetesFundus photographyIntraretinal microvascular abnormalitiesMicroaneurysmsRetinopathyWide-field optical coherence tomography angiography

Identifiers

PMID40593439
PMCPMC12271039

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.