Accommodative disorders in non‐presbyopic subjects with type 1 diabetes without retinopathy: A comparative, cross‐sectional study

• Published in: Ophthalmic & physiological optics Vol. 43; no. 5; pp. 954 - 963
• Main Authors: Silva‐Viguera, María‐Carmen, Bautista‐Llamas, María‐José
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.09.2023
• Subjects: accommodation; Accommodation, Ocular; accommodative anomalies; Adolescent; Adult; Child; Cross-Sectional Studies; Diabetes; diabetes mellitus; Diabetes mellitus (insulin dependent); Diabetes Mellitus, Type 1 - complications; diabetic complications; Eye diseases; Hemoglobin; Humans; Retinal Diseases; Retinopathy; Statistical analysis; type 1 diabetes; visual disorders; Young Adult; diabetic complications; accommodation; visual disorders; type 1 diabetes; diabetes mellitus; accommodative anomalies
• ISSN: 0275-5408; 1475-1313; 1475-1313
• DOI: 10.1111/opo.13164

Purpose The purpose of this study was to assess accommodative function in non‐presbyopic individuals diagnosed with type 1 diabetes (T1D) without any signs of retinopathy, to determine the existence of possible accommodative disorders related to this disease, and to determine the influence of T1D duration and glycosylated haemoglobin values on accommodative function. Methods This comparative, cross‐sectional study included 60 participants between 11 and 39 years old, 30 with T1D and 30 controls, with no previous eye surgery, ocular disease or medication that could affect the results of the visual examination. Amplitude of accommodation (AA), negative and positive relative accommodation (NRA and PRA), accommodative response (AR) and accommodative facility (AF) were assessed using the tests that showed the highest repeatability. Participants were classified based on normative values into ‘insufficiency, excess or normal results’, and a diagnosis of accommodative disorders (accommodative insufficiency, accommodative infacility and accommodative excess) was made. Results Participants with T1D had statistically significant lower AA and AF and higher NRA values than the controls. Furthermore, AA was significantly and inversely correlated with age and the duration of diabetes; however, AF and NRA were only correlated with disease duration. In the classification by accommodative variables, a higher percentage of ‘insufficiency values’ was observed in the T1D group (50%) than in the control group (6%; p < 0.001). In terms of accommodative disorders, accommodative infacility was the most prevalent (15%), followed by accommodative insufficiency (10%). Conclusions Our findings indicate that T1D affects most accommodative parameters, with accommodative insufficiency being associated with this disease.