Srividya Neriyanuri1,2, Shahina Pardhan2, Laxmi Gella3, Sakshyar Saumya Pal4, Suganeswari Ganesan4, Tarun Sharma4, Rajiv Raman2,4. 1. Vision Research Foundation, Sankara Nethralaya Eye Hospital, Chennai, India. 2. Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK. 3. Elite School of Optometry, Chennai, India. 4. Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya Eye Hospital, Chennai, India.
Abstract
PURPOSE: To explore any relationship between the markers of early retinal neuronal damage and peripheral diabetic neuropathy in subjects with no diabetic retinopathy (DR). METHODS: A cross-sectional study in which type 2 diabetic subjects (n=743) without DR were studied. Visual functions including visual acuity, contrast sensitivity, colour vision, retinal sensitivity using microperimeter and retinal thicknesses by spectral domain optical coherence tomography were measured. Vibration perception thresholds of greater than or equal to 20 µV, measured by sensitometer using a biothesiometer probe, were defined as having peripheral diabetic neuropathy. Statistical analyses were performed using independent t-test, multivariate logistic regression and Pearson's correlation. RESULTS: Of 743 subjects who had no DR, 24.9% had diabetic neuropathy. Independent comparisons among subjects who had diabetic neuropathy compared with those who did not showed statistically significant retinal nerve fibre layer thinning (p=0.01), reduced contrast sensitivity (p=0.0001), reduced retinal sensitivity (p=0.03), impaired colour vision (p=0.04) and reduced visual acuity (p=0.0001). Multivariate analysis showed significant association between the mean retinal sensitivity (measured using a microperimeter) and diabetic neuropathy (adjusted OR (95% CI): 0.76 (0.60 to 0.95), p=0.01). CONCLUSIONS: Significant association of neuroretinal dysfunction with the presence of diabetic neuropathy was noted among subjects with no DR. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
PURPOSE: To explore any relationship between the markers of early retinal neuronal damage and peripheral diabetic neuropathy in subjects with no diabetic retinopathy (DR). METHODS: A cross-sectional study in which type 2 diabetic subjects (n=743) without DR were studied. Visual functions including visual acuity, contrast sensitivity, colour vision, retinal sensitivity using microperimeter and retinal thicknesses by spectral domain optical coherence tomography were measured. Vibration perception thresholds of greater than or equal to 20 µV, measured by sensitometer using a biothesiometer probe, were defined as having peripheral diabetic neuropathy. Statistical analyses were performed using independent t-test, multivariate logistic regression and Pearson's correlation. RESULTS: Of 743 subjects who had no DR, 24.9% had diabetic neuropathy. Independent comparisons among subjects who had diabetic neuropathy compared with those who did not showed statistically significant retinal nerve fibre layer thinning (p=0.01), reduced contrast sensitivity (p=0.0001), reduced retinal sensitivity (p=0.03), impaired colour vision (p=0.04) and reduced visual acuity (p=0.0001). Multivariate analysis showed significant association between the mean retinal sensitivity (measured using a microperimeter) and diabetic neuropathy (adjusted OR (95% CI): 0.76 (0.60 to 0.95), p=0.01). CONCLUSIONS: Significant association of neuroretinal dysfunction with the presence of diabetic neuropathy was noted among subjects with no DR. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Authors: Sare Safi; Anoushiravan Rahimi; Afsaneh Raeesi; Hamid Safi; Mohammad Aghazadeh Amiri; Mojtaba Malek; Mehdi Yaseri; Mohammad Haeri; Frank A Middleton; Eduardo Solessio; Hamid Ahmadieh Journal: BMJ Open Diabetes Res Care Date: 2017-08-08