Retinal sensitivity in subjects with type 2 diabetes mellitus: Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study (SN-DREAMS II, Report No. 4)

• Published in: British journal of ophthalmology Vol. 100; no. 6; pp. 808 - 813
• Main Authors: Gella, Laxmi, Raman, Rajiv, Kulothungan, Vaitheeswaran, Saumya Pal, Swakshyar, Ganesan, Suganeswari, Sharma, Tarun
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.06.2016
• Subjects: Adult; Aged; Aged, 80 and over; Contrast Sensitivity - physiology; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - physiopathology; Diabetic Retinopathy - complications; Diabetic Retinopathy - epidemiology; Diabetic Retinopathy - physiopathology; Female; Follow-Up Studies; Humans; India - epidemiology; Macular Edema - epidemiology; Macular Edema - etiology; Macular Edema - physiopathology; Male; Middle Aged; Population Surveillance - methods; Prevalence; Retina - diagnostic imaging; Retina - physiopathology; Retrospective Studies; Risk Factors; Tomography, Optical Coherence; Retina
• ISSN: 0007-1161; 1468-2079
• DOI: 10.1136/bjophthalmol-2015-307064

AimTo evaluate retinal sensitivity (RS) in subjects with diabetes in a population-based study and to elucidate associated risk factors for abnormal RS.MethodsA subset of 357 subjects from Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study-II was included in this study. All subjects underwent detailed ophthalmic evaluation including microperimetry and spectral domain optical coherence tomography.ResultsThe prevalence of abnormal mean retinal sensitivity (MRS) was 89.1%. MRS was significantly reduced in subjects with diabetes but no retinopathy when compared with non-diabetic subjects. MRS was reduced in moderate non-proliferative diabetic retinopathy (DR) and macular oedema (ME) at 8° (p=0.04, p=0.01, respectively) and in ME at 10° (p=0.009) and 12° (p=0.036) compared with no DR. Significant negative correlation was found between MRS and best corrected visual acuity, duration of diabetes, glycosylated haemoglobin and central foveal thickness. Increased retinal thickness remained a significant risk factor (OR, 1.02; p=0.044) for abnormal MRS. Altered inner retinal layers and foveal contour were associated with reduced MRS among subjects with DR and presence of epiretinal membrane, altered foveal contour and altered retinal pigment epithelium were associated with reduced MRS.ConclusionsReduced RS in those subjects with diabetes but no retinopathy suggests the early neuronal damage in type 2 diabetes mellitus.