A study published in Molecular and Cellular Pediatrics showed the peripapillary microvasculature to be a superior indicator of retinal damage progression in diabetic retinopathy (DR). To assess inner retinal layer damage and microvasculature changes in the peripapillary area, researchers categorized patients into four groups: control (group 1), type 2 diabetes without DR (group 2), mild to moderate non-proliferative DR (NPDR; group 3), and severe NPDR (group 4). They identified an average pRNFL thicknesses of 96.2±7.1 in group 1, 94.1± 9.6 in group 2, 92.0±9.9 in group 3, and 90.3± 12.4 μm in group 4 ( P=0.003). Vessel density (VD) of the outer ring was 18.9±0.6 in group 1, 18.4± 0.8 in group 2, 17.9±1.1 in group 3, and 17.3± 1.6 mm−1 in group 4 ( P<0.001). Multivariate analysis showed that VD of the outer ring significantly correlated with DR severity (P<0.001). The findings highlight the potential of peripapillary VD as a better indicator of DR progression than the peripapillary retinal nerve fiber layer structure.