Microaneurysms (MA) are the hallmark of diabetic retinopathy, and are the earliest clinically recognisable features of the condition. They have, however, been found in patients without diabetes [1] and this raises the question whether the presence of a few MAs, in the absence of any other retinal lesion, are of any importance in diabetic patients. This is further emphasised by the fact that although MAs are most commonly seen in the perifoveal area, they are only rarely the cause of visual impairment. To determine the importance of MAs and particularly whether they have a predictive value for the progression of diabetic retinopathy we examined the photographs of patients in the United Kingdom Prospective Diabetes Study (UKPDS), a large multicentre randomised controlled clinical study of different treatments in newly diagnosed Type II diabetic patients. This paper presents the result of that study. Details of the UKPDS, patient recruitment and randomisation have been reported [2] . In brief, patients in whom Type II (non-insulin-dependent) diabetes mellitus had been newly di- Abstract Aims/hypothesis. To determine whether microaneurysms, in the absence of other lesions, have a predictive role in the progression of diabetic retinopathy in Type II (non-insulin-dependent) diabetes mellitus. Methods. Retinal photographs taken at diagnosis in patients participating in the United Kingdom Prospective Diabetes Study, and thereafter at 3 yearly intervals, were assessed using a modified Early Treatment of Diabetic Retinopathy grading system for lesions of diabetic retinopathy and end points of vitreous haemorrhage and photocoagulation. The number of microaneurysms in each eye was recorded. Results. The changes between diagnosis and later photographs were analysed in 2424 patients at 6 years, 1236 at 9 years and 414 at 12 years. Of the 2424 patients studied in the 6 year cohort 1809 had ei-
Recent studies indicated that MAs are the hallmark of diabetic retinopathy REF .
Microaneurysms in the development of diabetic retinopathy (UKPDS 42)
Diabetologia
Diabetologia
Medicine