Diabetes is one of the fastest-growing health challenges in the world. More than half a billion people are currently living with the disease, and that number continues to rise.
While many people are aware that diabetes can affect blood sugar levels, fewer realize that it can also damage the eyes, nerves, kidneys, heart, and brain.
One of the most serious complications of diabetes is damage to the retina, the light-sensitive tissue at the back of the eye that allows us to see.
The retina converts light into signals that travel to the brain, helping us recognize faces, read, drive, and perform everyday activities. When diabetes damages this delicate tissue, vision can gradually worsen and may eventually be lost.
Researchers are particularly concerned about a condition known as diabetic retinal neurodegeneration, or DRN. In this condition, nerve cells within the retina begin to deteriorate and die.
Scientists believe DRN may occur before many of the visible blood vessel changes traditionally associated with diabetic eye disease. Unfortunately, DRN is often discovered only after symptoms appear, when some of the damage is already permanent.
A new study offers hope that this situation could change. Researchers led by Huangdong Li at the Guangdong Provincial Clinical Research Center for Ocular Diseases in Guangzhou, China, have developed an artificial intelligence system that may be able to identify people at high risk of retinal degeneration years before symptoms develop.
The research was published in the journal PLOS Medicine. The scientists wanted to determine whether signals in the blood could reveal early signs of retinal nerve damage long before vision problems become noticeable.
To investigate this question, the team collected blood samples from 1,492 people with type 2 diabetes who did not yet have diabetic retinal neurodegeneration. They then followed many of these participants over a six-year period and conducted detailed eye scans on 1,218 of them to monitor changes in retinal health.
The researchers also compared their findings with data from 502 people with diabetes enrolled in the United Kingdom Biobank, a major health research project.
By analyzing the blood samples, the team identified 71 different proteins that appeared to be linked to future retinal degeneration. Proteins are molecules that perform countless functions inside the body. Some help control inflammation, while others support cell maintenance, repair, and communication.
Using machine learning, a type of artificial intelligence that can identify complex patterns in large datasets, the scientists combined information from these proteins to create a predictive tool called Pro-DRN.
The results were impressive. According to the researchers, Pro-DRN improved prediction accuracy by 26% compared with the best-performing previous model. This means the system may be significantly better at identifying which patients are most likely to develop retinal degeneration in the future.
The potential benefits are substantial. If doctors can identify high-risk patients before symptoms appear, they may be able to monitor them more closely, recommend earlier interventions, and potentially prevent severe vision loss.
Researchers also note that retinal degeneration may provide important clues about other forms of nerve damage caused by diabetes. Some scientists consider the retina a “window” into the health of the nervous system. Changes in retinal nerve cells may reflect similar processes occurring elsewhere in the body, including the brain and peripheral nerves.
Because of this, better prediction of retinal degeneration could eventually help researchers understand risks for cognitive decline, dementia, and diabetic nerve damage affecting the hands and feet.
The research team has already made the Pro-DRN model available online so that healthcare professionals can evaluate patient risk using blood protein data.
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Source: Guangdong Provincial Clinical Research Center for Ocular Diseases.
