Relationships Between Retinal Vascular Characteristics and Renal Function in Patients With Type 2 Diabetes Mellitus

PURPOSE: To develop a deep learning-based method to achieve vessel segmentation and measurement on fundus images, and explore the quantitative relationships between retinal vascular characteristics and the clinical indicators of renal function. METHODS: We recruited patients with type 2 diabetes mellitus with different stages of diabetic retinopathy (DR), collecting their fundus photographs and results of renal function tests. A deep learning framework for retinal vessel segmentation and measurement was developed. The correlation between the renal function indicators and the severity of DR were explored, then the correlation coefficients between indicators of renal function and retinal vascular characteristics were analyzed. RESULTS: We included 418 patients (eyes) with type 2 diabetes mellitus. The albumin to creatinine ratio, blood uric acid, blood creatinine, blood albumin, and estimated glomerular filtration rate were significantly correlated with the progression of DR (P < 0.05); no correlation existed in other metrics (P > 0.05). The fractal dimension was found to significantly correlate with most of the clinical parameters of renal function (P < 0.05). CONCLUSIONS: The albumin to creatinine ratio, blood uric acid, blood creatinine, blood albumin, and estimated glomerular filtration rate have significant correlation with the progression of moderate to proliferative DR. Through deep learning-based vessel segmentation and measurement, the fractal dimension was found to significantly correlate with most clinical parameters of renal function. TRANSLATIONAL RELEVANCE: Deep learning-based vessel segmentation and measurement on color fundus photographs could explore the relationships between retinal characteristics and renal function, facilitating earlier detection and intervention of type 2 diabetes mellitus complications.