ArticleEye (London, England)2026
Evaluation of photoreceptor integrity in diabetic retinopathy using high-resolution optical coherence tomography.
Article in Eye (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
backgroundThe relative ellipsoid zone reflectivity (rEZR) is a promising imaging biomarker for photoreceptor integrity, but its variation across diabetic retinopathy (DR) stages remains unclear. This study investigates rEZR changes across different DR severities using high-resolution optical coherence tomography (OCT) imaging.
methodsFor this exploratory cross-sectional study, 64 eyes of 44 patients were included (17 eyes: no DR, 33 eyes: non-proliferative DR (NPDR), 14 eyes: proliferative DR (PDR)). Imaging was performed using high-resolution spectral-domain OCT (SPECTRALIS HighRes OCT, Heidelberg Engineering, axial resolution: 3 μm). rEZR (ratio between ellipsoid zone and external limiting membrane reflectivity) was measured at the foveola, within the Early Treatment Diabetic Retinopathy Study ETDRS grid (central 1 mm, inner ring, outer ring) and peripapillary. Linear mixed models assessed the association between rEZR, DR stage and visual acuity.
resultsIn the outer macular ring, mean rEZR was significantly lower in PDR compared to no DR (p = 0.005) and NPDR (p = 0.045). In the total area, mean rEZR was significantly lower in PDR compared to no DR (p = 0.016) and NPDR (p = 0.032). Peripapillary mean rEZR was significantly lower in NPDR compared to no DR (p = 0.013) and in PDR compared to no DR (p = 0.033). No significant group differences were observed in the foveola, central 1 mm or inner macular ring.
conclusionOur data suggest that more advanced stages of DR are associated with a decrease in photoreceptor integrity, with statistically significant group differences predominantly observed in the outer macular regions and peripapillary.
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