Retinal Ischemic Perivascular Lesions are Associated with Multifactorial Disease Burden and Severity of Diabetic Retinopathy

March 1, 2026Ophthalmology ScienceOpen Access

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Key Points

This research aims to quantify retinal ischemic perivascular lesions (RIPLs) as potential biomarkers for the severity of diabetic retinopathy.
Conducted a cross-sectional study with patients having diabetes mellitus and varying severity of diabetic retinopathy.
Used optical coherence tomography to quantify RIPLs based on established criteria.
Rated RIPL counts with two independent graders and assessed intergrader reliability with the intraclass correlation coefficient.
Analyzed the association between RIPL counts and diabetic retinopathy severity using multinomial logistic regression.
Utilized receiver operating characteristic analysis to gauge diagnostic performance of RIPLs.
RIPL counts were 1.18±2.46 in no DR, 3.69±4.91 in nonproliferative DR, and 10.10±10.44 in proliferative DR.
Greater RIPL counts correlated with increased odds of higher DR severity, with specific odds ratios indicating significance.
RIPLs showed moderate predictive ability for vision-threatening DR, achieving an area under the curve of 0.779.
Causal mediation analysis suggested RIPLs mediated 30% of hypertension's impact on DR severity, highlighting their role.

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Cross-sectional study quantifies retinal ischemic lesions linked to diabetic retinopathy severity, suggesting clinical implications.

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Zhuang et al. (2026) studied this question.

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