{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T07:57:14Z","timestamp":1785571034886,"version":"3.56.0"},"reference-count":49,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Diabetes Invest"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To evaluate photoreceptor changes and their correlation with microvascular alterations in different stages of diabetic retinopathy (DR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirty\u2010two treatment\u2010na\u00efve DR patients (50 eyes) without clinically significant macular edema were graded into mild, moderate, and severe non\u2010proliferative DR (NPDR) and proliferative DR (PDR). The macula was imaged using adaptive optics scanning laser ophthalmoscopy (AO\u2010SLO) at five subsections. Mean\/minimum photoreceptor density, cell regularity, dispersion, spacing, and dark areas were recorded. Central macular thickness (CMT) and macular leakage index (MLI) were measured.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The percentage of dark areas increased gradually with DR severity: 1.86\u2009\u00b1\u20091.52 (mild NPDR), 3.32\u2009\u00b1\u20091.45 (moderate NPDR), 4.22\u2009\u00b1\u20092.11 (severe NPDR), and 5.92\u2009\u00b1\u20093.06 (PDR) (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.007). MLI also progressively increased (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.01): 0.31\u2009\u00b1\u20090.60%, 3.47\u2009\u00b1\u20094.70%, 6.92\u2009\u00b1\u20095.44%, and 8.98\u2009\u00b1\u20093.58%, respectively. MLI showed a positive correlation with the percentage of dark areas (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.36,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.01). No significant changes were observed in photoreceptor density, regularity, dispersion, spacing, CMT, or visual acuity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dark areas observed by AO\u2010SLO suggest photoreceptor abnormalities, indicating decreased waveguiding ability and localized dysfunction as DR progresses. The positive correlation between dark areas and macular vascular leakage implies early dysfunction of the retinal neurovascular unit (NVU) in DR, warranting further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jdi.70353","type":"journal-article","created":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T05:15:21Z","timestamp":1781327721000},"page":"1348-1357","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The positive correlation between the progressive photoreceptor damage and the increased macular leakage indicating the severity of diabetic retinopathy"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5758-7602","authenticated-orcid":false,"given":"Qi","family":"Fang","sequence":"first","affiliation":[{"name":"Shaanxi Eye Hospital, Xi'an Key Laboratory of Digital Medical Technology of Ophthalmologic Imaging Xi'an People's Hospital (Xi'an Fourth 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