Previous work has shown that cone spacing analysis can be more sensitive and less prone to errors than density analysis when tracking disease progression or response to treatment in eyes with retinal degeneration. Overall, cone density alone appears to be intrinsically unable to provide valuable information on the early pathological changes of the cone mosaic in patients with type 1 diabetes mellitus. However, several studies have demonstrated moderate to high variability within cone density even within the healthy population, making it difficult to detect small deviations from normal in controlled comparative studies. In previous work, cone photoreceptor involvement in a cohort of eleven adult patients with a history of type 1 diabetes mellitus (DM1) in the past 9 years to 21 years has been examined and the decreased cone density within the central retina has been correlated with increasing duration of diabetes, the presence of diabetic retinopathy on fundoscopy and poor glycometabolic control. Adaptive optics (AO) retinal imaging has been shown to resolve non-invasively alterations of the photoreceptor mosaic in patients with diabetes mellitus. As innovative optical technologies are at disposal of clinicians, new approaches of early detection of pathological tissue changes can emerge. Currently, diagnosis of DR is made when the damage has already happened at a macroscopic scale, due to limits of current functional and imaging instruments to evaluate structural impairments of cellular components of the neuro-retinal tissue. People with diabetes mellitus are at higher risk of vision loss than the general population the prevalence of this complication relates to the type and duration of diabetes.Įarly diagnosis of DR is required to preserve vision and avoid serious complications. It represents one of the leading causes of visual impairment among adults in the western world and its incidence is increasing in other parts of the world, primarily India and China. This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors.ĭiabetic retinopathy (DR) is a chronic progressive sight-threatening disease of the retinal microvasculature and neuronal cells associated with prolonged hyperglycaemia. There are no patents, products in development or marketed products to declare. Giuseppe Lombardo is employed by Vision Engineering Italy srl. The specific role of this author is articulated in the ‘author contributions’ section.Ĭompeting interests: The authors have the followiing interests. Vision Engineering Italy srl funder provided support in the form of salaries for author GL, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: All relevant data are within the paper and its Supporting Information files.įunding: Research for this work was supported by the Italian Ministry of Health (5x1000 funding), by the National Framework Program for Research and Innovation PON (grant n. Received: DecemAccepted: FebruPublished: March 10, 2016Ĭopyright: © 2016 Lombardo et al. PLoS ONE 11(3):Įditor: Knut Stieger, Justus-Liebig-University Giessen, GERMANY Citation: Lombardo M, Parravano M, Serrao S, Ziccardi L, Giannini D, Lombardo G (2016) Investigation of Adaptive Optics Imaging Biomarkers for Detecting Pathological Changes of the Cone Mosaic in Patients with Type 1 Diabetes Mellitus.
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