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Noninvasive retinal oxygen metabolism and hemodynamics of 215 eyes from 73 age\u2010matched healthy subjects, 90 diabetic patients without DR, 40 NPDR, and 12 DR with postpanretinal photocoagulation were measured with a custom\u2010built multimodal retinal imaging device. Diabetic patients underwent biochemical examinations. Two logistic regression models were developed to predict NPDR using retinal and biochemical metrics, respectively. The predictive model 1 using retinal metrics incorporated male gender, insulin treatment condition, diastolic duration, resistance index, and oxygen extraction fraction presented a similar predictive power with model 2 using biochemical metrics incorporated diabetic duration, diastolic blood pressure, and glycated hemoglobin A1c (area under curve: 0.73 vs. 0.70; sensitivity: 76% vs. 68%; specificity: 64% vs. 62%). These results suggest that retinal oxygen metabolic and hemodynamic biomarkers may replace biochemical parameters to predict the occurrence of NPDR <jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/jbio202300567-gra-0001.png\" xlink:title=\"image\"\/>.<\/jats:p>","DOI":"10.1002\/jbio.202300567","type":"journal-article","created":{"date-parts":[[2024,3,26]],"date-time":"2024-03-26T01:50:02Z","timestamp":1711417802000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The retinal oxygen metabolism and hemodynamics as a substitute for biochemical tests to predict nonproliferative diabetic retinopathy"],"prefix":"10.1002","volume":"17","author":[{"given":"Chuanqing","family":"Zhou","sequence":"first","affiliation":[{"name":"College of Medical Instruments Shanghai University of Medicine and Health Sciences  Shanghai 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