Retinopathy and retinal function in insulin-dependent diabetes mellitus.

Abstract

SUMMARY Sixty-six insulin-dependent diabetic patients with normal visual acuity were studied (132 eyes). on these patients at 10 years showed the gradual appearance of yellow-blue defects, which in some cases preceded the development of retinopathy.Kinnear et al.3 studied colour vision in 800 diabetics. With the 100-hue test the mean error score in patients without retinopathy was significantly greater than normal. There was a further increase in the error score in diabetics with retinopathy. This increase was statistically significant only in patients over 30 years of age. They found that changes in the 100-hue test were of no value in predicting the development of retinopathy.Arden4 found no abnormality in contrast sensitivity in 18 diabetic patients without retinopathy. Of 47 patients with retinopathy and normal visual acuity over 50% had abnormal grating scores. Foulds and McClure2 found the mean grating score was significantly greater than normal in 12 diabetic patients without retinopathy. The increase was apparent on all plates. Baiteryakova et al.5 studied 60 diabetic patients and showed a reduction in the electro-oculogram which could be present before the development of retinopathy. These findings were confirmed by Flicker6 in his study of 93 diabetic patients.To decide the role of retinal function tests in the assessment of diabetic retinopathy we carried out tests of retinal form, colour, and light sense on 132 eyes with normal visual acuity in 66 female insulindependent diabetics aged between 20 and 40 years. Patients and methodsSixty-six female well controlled insulin-dependent diabetic patients with normal corrected visual acuity were assessed. They had a full ophthalmological examination, including retinal photography and fluorescein angiography. The mean age was 27-7 years, SEM 0-4 year. The mean duration of diabetes mellitus was 8-7 years, SEM 0-5 year. The mean insulin dose was 43-6 international units, SEM 1-2. Twenty-four (36-4%) were smokers and 10 (15-2%) were taking anovulants.Retinal contrast sensitivity was determined with a book of Arden gratings' under standard daylight illumination in a Veri Vide cabinet. A total score greater than 82 was taken as abnormal.Colour discrimination was tested by the Farnsworth-Munsell 100-hue test8 under the same conditions. A total score greater than 100 was taken as abnormal.

A multifocal electroretinogram model predicting the development of diabetic retinopathy

“…The RPE is electrically polarized, and this trans-epithelial potential comprises the major component of the corneo-retinal potential, which can be measured non-invasively as the EOG. It has been reported that the light peak response (measured as the Arden ratio) is relatively insensitive to diabetes and is not correlated with diabetic retinopathy (Moloney and Drury, 1982;Shirao and Kawasaki, 1998). However, it has also been reported that the fast oscillation ratio of the EOG differed significantly among groups of subjects who were nondiabetic, diabetic without retinopathy, and diabetic with mild retinopathy despite the fact that they had normal Arden ratios (Schneck, et al, 2001).…”

Blue-light filtering intraocular lens in patients with diabetes: Contrast sensitivity and chromatic discrimination

“…1,7,42,43 Spatial resolution in diabetic patients has been assessed by means of the CSF. 1,8,44,45 However, some discrepancy must exist to correlate the contrast sensitivity changes with the presence or severity of the retinopathy. 21,22,46 Trick et al 7 found that contrast sensitivity deficits were detected more frequently in diabetes, occurring in 24.3% of diabetic patients without retinopathy and 45% of diabetic patients who had background retinopathy.…”

Mesopic foveal contrast sensitivity is impaired in diabetic patients without retinopathy

“…Since the first reports in 1982 and 1983 of reduced contrast sensitivity (CS) function in patients with diabetic retinopathy [1,2], CS has been studied extensively to determine its effectiveness as a test for diagnosing early and advanced Presented at the ARVO meeting, May 2008.…”