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Zhang T, Ying H, Wang H, Zhao F, Pan Q, Zhan Q, Zhang F, An Q, Liu T, Hu Y, Zhang Y. Visual motion sensitivity as an indicator of diabetic retinopathy in type 2 diabetes mellitus. Front Neurosci 2024; 18:1412241. [PMID: 39156633 PMCID: PMC11327050 DOI: 10.3389/fnins.2024.1412241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 07/24/2024] [Indexed: 08/20/2024] Open
Abstract
Objectives This current study is based on a set of visual motion sensitivity tests, investigating the correlation between visual motion sensitivity and diabetic retinopathy (DR) in type 2 diabetes mellitus (T2DM), thereby furnishing a scientific rationale for preventing and controlling DR. Methods This research was conducted by a combination of questionnaire collection and on-site investigation that involved 542 T2DM recruited from a community. The visual motion sensitivity determined the visual motion perception of the participants across three spatial frequencies (low, medium, and high) for both the first- and second-order contrast. The logistic regression model was adopted to investigate the relationship between visual motion sensitivity and DR prevalence. Besides, the Pearson correlation analysis was used to analyze the factors influencing visual motion sensitivity and restricted cubic spline (RCS) functions to assess the dose-response relationship between visual motion sensitivity and glycated hemoglobin. Results Among 542 subjects, there are 162 cases of DR, with a prevalence rate of 29.89%. After adjusting factors of age, gender, glycated hemoglobin, duration of diabetes, BMI, and hypertension, we found that the decline in first- and second-order high spatial frequency sensitivity increased the risk for DR [odds ratio (OR): 1.519 (1.065, 2.168), 1.249 (1.068, 1.460)]. The decline in perceptual ability of second-order low, medium, and high spatial frequency sensitivity is a risk factor for moderate to severe DR [OR: 1.556 (1.116, 2.168), 1.388 (1.066, 1.806), 1.476 (1.139, 1.912)]. The first-order and the second-order high spatial frequency sensitivity are significantly positively correlated with glycated hemoglobin (r = 0.105, p = 0.015 and r = 0.119, p = 0.005, respectively). Conclusion Visual motion sensitivity especially for the second-order high spatial frequency stimuli emerges as a significant predictor of DR in T2DM, offering a sensitive diagnostic tool for early detection.
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Affiliation(s)
- Tianlin Zhang
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Haojiang Ying
- Department of Psychology, Soochow University, Suzhou, China
| | - Huiqun Wang
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Fouxi Zhao
- Guizhou Center for Disease Control and Prevention, Guiyang, China
| | - Qiying Pan
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Qingqing Zhan
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Fuyan Zhang
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Qinyu An
- Medical College, Guizhou University, Guiyang, China
| | - Tao Liu
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
- Guizhou Center for Disease Control and Prevention, Guiyang, China
| | - Yuandong Hu
- Guizhou Center for Disease Control and Prevention, Guiyang, China
| | - Yang Zhang
- Department of Psychology, Soochow University, Suzhou, China
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Ahmed Y, Reddy M, Mederos J, McDermott KC, Varma DK, Ludwig CA, Ahmed IK, Khaderi KR. Democratizing Health Care in the Metaverse: How Video Games can Monitor Eye Conditions Using the Vision Performance Index: A Pilot Study. OPHTHALMOLOGY SCIENCE 2024; 4:100349. [PMID: 37869021 PMCID: PMC10587622 DOI: 10.1016/j.xops.2023.100349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 05/23/2023] [Accepted: 05/30/2023] [Indexed: 10/24/2023]
Abstract
Objective In a world where digital media is deeply engrained into our everyday lives, there lies an opportunity to leverage interactions with technology for health and wellness. The Vision Performance Index (VPI) leverages natural human-technology interaction to evaluate visual function using visual, cognitive, and motor psychometric data over 5 domains: field of view, accuracy, multitracking, endurance, and detection. The purpose of this study was to describe a novel method of evaluating holistic visual function through video game-derived VPI score data in patients with specific ocular pathology. Design Prospective comparative analysis. Participants Patients with dry eye, glaucoma, cataract, diabetic retinopathy (DR), age-related macular degeneration, and healthy individuals. Methods The Vizzario Inc software development kit was integrated into 2 video game applications, Balloon Pop and Picture Perfect, which allowed for generation of VPI scores. Study participants were instructed to play rounds of each video game, from which a VPI score was compiled. Main Outcome Measures The primary outcome was VPI overall score in each comparison group. Vision Performance Index component, subcomponent scores, and psychophysical inputs were also compared. Results Vision Performance Index scores were generated from 93 patients with macular degeneration (n = 10), cataract (n = 10), DR (n = 15), dry eye (n = 15), glaucoma (n = 16), and no ocular disease (n = 27). The VPI overall score was not significantly different across comparison groups. The VPI subcomponent "reaction accuracy" score was significantly greater in DR patients (106 ± 13.2) versus controls (96.9 ± 11.5), P = 0.0220. The VPI subcomponent "color detection" score was significantly lower in patients with DR (96.8 ± 2.5; p=0.0217) and glaucoma (98.5 ± 6.3; P = 0.0093) compared with controls (101 ± 11). Psychophysical measures were statistically significantly different from controls: proportion correct (lower in DR, age-related macular degeneration), contrast errors (higher in cataract, DR), and saturation errors (higher in dry eye). Conclusions Vision Performance Index scores can be generated from interactions of an ocular disease population with video games. The VPI may offer utility in monitoring select ocular diseases through evaluation of subcomponent and psychophysical input scores; however, future larger-scale studies must evaluate the validity of this tool. Financial Disclosures Proprietary or commercial disclosure may be found after the references.
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Affiliation(s)
- Yusuf Ahmed
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Mohan Reddy
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California
- Vizzario, Inc, Venice, California
| | - Jacob Mederos
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California
- Vizzario, Inc, Venice, California
| | - Kyle C. McDermott
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California
- Vizzario, Inc, Venice, California
| | - Devesh K. Varma
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Prism Eye Institute, Oakville, Ontario, Canada
| | - Cassie A. Ludwig
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California
- Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Iqbal K. Ahmed
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Prism Eye Institute, Oakville, Ontario, Canada
- Moran Eye Centre, University of Utah School of Medicine, Salt Lake City, Utah
| | - Khizer R. Khaderi
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California
- Vizzario, Inc, Venice, California
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Jones PJ, Lavery L, Davies MJ, Webb D, Rowlands AV. Hotspots: Adherence in home foot temperature monitoring interventions for at-risk feet with diabetes-A narrative review. Diabet Med 2023; 40:e15189. [PMID: 37489103 DOI: 10.1111/dme.15189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/18/2023] [Accepted: 07/21/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Home foot temperature monitoring (HFTM) is recommended for those at moderate to high ulcer risk. Where a > 2.2°C difference in temperature between feet (hotspot) is detected, it is suggested that individuals (1) notify a healthcare professional (HCP); (2) reduce daily steps by 50%. We assess adherence to this and HFTM upon detecting a recurrent hotspot. METHODS PubMed and Google Scholar were searched until 9 June 2023 for English-language peer-reviewed HFTM studies which reported adherence to HFTM, daily step reduction or HCP hotspot notification. The search returned 1030 results excluding duplicates of which 28 were shortlisted and 11 included. RESULTS Typical adherence among HFTM study participants for >3 days per week was 61%-93% or >80% of study duration was 55.6%-83.1%. Monitoring foot temperatures >50% of the study duration was associated with decreased ulcer risk (Odds Ratio: 0.50, p < 0.001) in one study (n = 173), but no additional risk reduction was found for >80% adherence. Voluntary dropout was 5.2% (Smart mats); 8.1% (sock sensor) and 4.8%-35.8% (infrared thermometers). Only 16.9%-52.5% of participants notified an HCP upon hotspot detection. Objective evidence of adherence to 50% reduction in daily steps upon hotspot detection was limited to one study where the average step reduction was a pedometer-measured 51.2%. CONCLUSIONS Ulcer risk reduction through HFTM is poorly understood given only half of the participants notify HCPs of recurrent hotspots and the number of reducing daily steps is largely unknown. HFTM adherence and dropout are variable and more research is needed to determine factors affecting adherence and those likely to adhere.
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Affiliation(s)
- Petra J Jones
- Leicester Diabetes Centre, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Lawrence Lavery
- Department of Plastic Surgery, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Melanie J Davies
- Leicester Diabetes Centre, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
- NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - David Webb
- Leicester Diabetes Centre, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Alex V Rowlands
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
- NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, Division of Health Sciences, University of South Australia, Adelaide, Australia
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Tsai LT, Chen CC, Hou CH, Liao KM. Achromatic and chromatic contrast discrimination in patients with type 2 diabetes. Sci Rep 2023; 13:7420. [PMID: 37156848 PMCID: PMC10167204 DOI: 10.1038/s41598-023-34407-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 04/28/2023] [Indexed: 05/10/2023] Open
Abstract
Effects of type 2 diabetes on achromatic and chromatic contrast sensitivity (CS) are still controversial. In this study, we aimed to investigate CS in patients without diabetic retinopathy (no-DR) and in those with non-proliferative DR (NPDR) and proliferative DR (PDR) using psychophysical methods with transient and sustained achromatic stimuli and color patches. Achromatic CS was measured with the pulsed pedestal (PP) paradigm (7, 12, and 19 cd/m2) and pedestal-△-pedestal (P-△-P) paradigm (11.4, 18, and 28.5 cd/m2). A chromatic discrimination paradigm that assesses protan, deutan, and tritan color vision was adopted. Forty-two patients (no-DR n = 24, NPDR n = 12, PDR = 6; male n = 22, mean age = 58.1 y/o) and 38 controls (male n = 18, mean age = 53.4 y/o) participated. In patients, mean thresholds were higher than in controls and linear trends were significant in most conditions. For the PP paradigm, differences were significant in the PDR and NPDR groups in the 7 and 12 cd/m2 condition. For the P-△-P paradigm, differences were only significant in the PDR group in the 11 cd/m2 condition. Chromatic contrast loss was significant in the PDR group along the protan, deutan and tritan axes. The results suggest independent involvements of achromatic and chromatic CS in diabetic patients.
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Affiliation(s)
- Li-Ting Tsai
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Ophthalmology, National Taiwan University Hospital, Taiwan College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chien-Chung Chen
- Department of Psychology, National Taiwan University, Taipei, Taiwan
| | - Chiun-Ho Hou
- Department of Ophthalmology, National Taiwan University Hospital, Taiwan College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Kuo-Meng Liao
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Zhong-Xiao Branch, Taipei City Hospital, Taipei, Taiwan.
- Department of Endocrine and Metabolism, Zhong-Xiao Branch, Taipei City Hospital, No. 87, Tongde Rd., Nangang Dist., Taipei, 11556, Taiwan.
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MicroRNA-150 (miR-150) and Diabetic Retinopathy: Is miR-150 Only a Biomarker or Does It Contribute to Disease Progression? Int J Mol Sci 2022; 23:ijms232012099. [PMID: 36292956 PMCID: PMC9603433 DOI: 10.3390/ijms232012099] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 10/05/2022] [Accepted: 10/06/2022] [Indexed: 11/18/2022] Open
Abstract
Diabetic retinopathy (DR) is a chronic disease associated with diabetes mellitus and is a leading cause of visual impairment among the working population in the US. Clinically, DR has been diagnosed and treated as a vascular complication, but it adversely impacts both neural retina and retinal vasculature. Degeneration of retinal neurons and microvasculature manifests in the diabetic retina and early stages of DR. Retinal photoreceptors undergo apoptosis shortly after the onset of diabetes, which contributes to the retinal dysfunction and microvascular complications leading to vision impairment. Chronic inflammation is a hallmark of diabetes and a contributor to cell apoptosis, and retinal photoreceptors are a major source of intraocular inflammation that contributes to vascular abnormalities in diabetes. As the levels of microRNAs (miRs) are changed in the plasma and vitreous of diabetic patients, miRs have been suggested as biomarkers to determine the progression of diabetic ocular diseases, including DR. However, few miRs have been thoroughly investigated as contributors to the pathogenesis of DR. Among these miRs, miR-150 is downregulated in diabetic patients and is an endogenous suppressor of inflammation, apoptosis, and pathological angiogenesis. In this review, how miR-150 and its downstream targets contribute to diabetes-associated retinal degeneration and pathological angiogenesis in DR are discussed. Currently, there is no effective treatment to stop or reverse diabetes-caused neural and vascular degeneration in the retina. Understanding the molecular mechanism of the pathogenesis of DR may shed light for the future development of more effective treatments for DR and other diabetes-associated ocular diseases.
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Énzsöly A, Hajdú RI, Turóczi Z, Szalai I, Tátrai E, Pálya F, Nagy ZZ, Mátyás C, Oláh A, Radovits T, Szabó K, Dékány B, Szabó A, Kusnyerik Á, Soltész P, Veres DS, Somogyi A, Somfai GM, Lukáts Á. The Predictive Role of Thyroid Hormone Levels for Early Diabetic Retinal Changes in Experimental Rat and Human Diabetes. Invest Ophthalmol Vis Sci 2021; 62:20. [PMID: 34010957 PMCID: PMC8142702 DOI: 10.1167/iovs.62.6.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose In diabetic subjects, early visual functional alterations such as color vision deficiencies (CVDs) are known to precede clinically apparent diabetic retinopathy. Prominent photoreceptor outer segment degeneration and an increase in the number of retinal dual cones (co-expressing S- and M-opsins simultaneously) have been described in diabetic rat models, suggesting a connection with the development of CVDs. As cone opsin expression is controlled by thyroid hormones, we investigated the diabetic retina in association with thyroid hormone alterations. Methods In rat models of type 1 and 2 diabetes, dual cones were labeled by immunohistochemistry, and their numbers were analyzed in relation to free triiodothyronine (fT3) and free thyroxine (fT4) levels. Quantification of dual cones was also performed in human postmortem retinas. Additionally, a cross-sectional case–control study was performed where thyroid hormone levels were measured and color vision was assessed with Lanthony desaturated D15 discs. Results A higher number of dual cones was detectable in diabetic rats, correlating with fT4 levels. Dual cones were also present in postmortem human retinas, with higher numbers in the three diabetic retinas. As expected, age was strongly associated with CVDs in human patients, and the presence of diabetes also increased the risk. However, the current study failed to detect any effect of thyroid hormones on the development of CVDs. Conclusions Our results point toward the involvement of thyroid homeostasis in the opsin expression changes in diabetic rats and human samples. The evaluation of the possible clinical consequences warrants further research.
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Affiliation(s)
- Anna Énzsöly
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Rozina I Hajdú
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary.,Department of Anatomy, Histology and Embryology, Semmelweis University, Budapest, Hungary
| | - Zsolt Turóczi
- 2nd Department of Internal Medicine, Semmelweis University, Budapest, Hungary
| | - Irén Szalai
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Erika Tátrai
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Fanni Pálya
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Zoltán Z Nagy
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Csaba Mátyás
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Attila Oláh
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Tamás Radovits
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Klaudia Szabó
- Department of Anatomy, Histology and Embryology, Semmelweis University, Budapest, Hungary
| | - Bulcsú Dékány
- Department of Anatomy, Histology and Embryology, Semmelweis University, Budapest, Hungary
| | - Arnold Szabó
- Department of Anatomy, Histology and Embryology, Semmelweis University, Budapest, Hungary
| | - Ákos Kusnyerik
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Petra Soltész
- 2nd Department of Internal Medicine, Semmelweis University, Budapest, Hungary
| | - Dániel S Veres
- Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary
| | - Anikó Somogyi
- 2nd Department of Internal Medicine, Semmelweis University, Budapest, Hungary
| | - Gábor M Somfai
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary.,Eye Clinic, Stadtspital Waid and Triemli, Zürich, Switzerland.,Werner H. Spross Foundation for the Advancement of Research and Teaching in Ophthalmology, Zürich, Switzerland
| | - Ákos Lukáts
- Department of Anatomy, Histology and Embryology, Semmelweis University, Budapest, Hungary
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Evaluation of the neuronal and microvascular components of the macula in patients with diabetic retinopathy. Doc Ophthalmol 2021; 143:193-205. [PMID: 33861362 DOI: 10.1007/s10633-021-09834-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To investigate whether abnormal retinal microcirculation correlates with retinal neuronal changes in untreated diabetic eyes without macular edema. METHODS This study enrolled 29 diabetic patients without diabetic retinopathy (DR), 18 patients with mild non-proliferative diabetic retinopathy (NPDR), 15 patients with moderate NPDR, 14 patients with severe NPDR, 27 patients with proliferative diabetic retinopathy (PDR), and 25 healthy control subjects. Pattern electroretinography (PERG) and optical coherence tomography angiography (OCT-A) tests were performed. RESULTS Differences in the mean values for the area, acircularity index, and perimeter of foveal avascular zone were statistically significant between the healthy control group and the diabetic patients (P < 0.05 for all). P50 and N95 amplitudes were statistically significantly lower in the PDR group compared to diabetic patients without DR, control, and moderate NPDR groups (P < 0.05 for all). The whole retina vessel densities in superficial and deep capillary plexus were lower in the PDR group compared to the diabetic patients without DR and control group (P < 0.05 for all). There were statistically significant positive correlations between the amplitudes of the P50 and N95 waves with the vessel densities. CONCLUSION The existence of significant correlations between PERG and OCT-A parameters in diabetic patients has shown that vascular and neuronal changes in the macula affect each other in diabetic patients.
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ANATOMICAL AND FUNCTIONAL TESTING IN DIABETIC PATIENTS WITHOUT RETINOPATHY: Results of Optical Coherence Tomography Angiography and Visual Acuity Under Varying Contrast and Luminance Conditions. Retina 2020; 39:2022-2031. [PMID: 30015764 DOI: 10.1097/iae.0000000000002258] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess early retinal microvascular and functional changes in diabetic patients without clinical evidence of diabetic retinopathy with optical coherence tomography angiography and central visual analyzer. METHODS This was an observational case-control study of diabetic patients without diabetic retinopathy and nondiabetic controls. Patients underwent optical coherence tomography angiography imaging and visual acuity testing using the central visual analyzer. The foveal avascular zone area and the capillary density in the superficial and deep capillary plexuses were measured manually by a masked grader. RESULTS Sixty eyes from 35 diabetic patients were included in the study group, and 45 eyes from 31 nondiabetic patients were included in the control group. The foveal avascular zone area was not significantly different between the diabetic group and controls (both P > 0.05). The mean capillary density in the deep capillary plexus was significantly lower in diabetic eyes compared with control eyes (P = 0.04). The mean visual acuity in all central visual analyzer modules was significantly decreased in diabetic patients compared with controls (all P < 0.05). CONCLUSION Optical coherence tomography angiography was able to detect retinal microvascular changes in the deep capillary plexus, and the central visual analyzer showed signs of decreased visual acuity under conditions simulating suboptimal contrast and glare in diabetic patients without diabetic retinopathy.
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Zafar S, Sachdeva M, Frankfort BJ, Channa R. Retinal Neurodegeneration as an Early Manifestation of Diabetic Eye Disease and Potential Neuroprotective Therapies. Curr Diab Rep 2019; 19:17. [PMID: 30806815 PMCID: PMC7192364 DOI: 10.1007/s11892-019-1134-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW Diabetic retinopathy (DR) is a major cause of visual impairment and blindness throughout the world. Microvascular changes have long been regarded central to disease pathogenesis. In recent years, however, retinal neurodegeneration is increasingly being hypothesized to occur prior to the vascular changes classically associated with DR and contribute to disease pathogenesis. RECENT FINDINGS There is growing structural and functional evidence from human and animal studies that suggests retinal neurodegeneration to be an early component of DR. Identification of new therapeutic targets is an ongoing area of research with several different molecules undergoing testing in animal models for their neuroprotective properties and for possible use in humans. Retinal neurodegeneration may play a central role in DR pathogenesis. As new therapies are developed, it will be important to develop criteria for clinically defining retinal neurodegeneration. A standardization of the methods for monitoring neurodegeneration along with more sensitive means of detecting preclinical damage is also needed.
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Affiliation(s)
- Sidra Zafar
- Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD 21287, USA
| | - Mira Sachdeva
- Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD 21287, USA
| | | | - Roomasa Channa
- Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD 21287, USA
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA
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Ao M, Li X, Qiu W, Hou Z, Su J, Wang W. The impact of age-related cataracts on colour perception, postoperative recovery and related spectra derived from test of hue perception. BMC Ophthalmol 2019; 19:56. [PMID: 30786855 PMCID: PMC6383292 DOI: 10.1186/s12886-019-1057-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 01/29/2019] [Indexed: 11/10/2022] Open
Abstract
Background Cataract patients were always excluded from studies on ageing of colour vision; thus, effect of age-related cataracts on deterioration of colour perception has not been analysed. In present study, impacts of age-related cataracts on colour discrimination, postoperative recovery and related spectra were investigated. Methods In this cohort study, thirty age-related cataract patients scheduled for binocular surgery and 30 elderly volunteers were enrolled. Colour discrimination under photopic (1000 lx) and mesopic (40 lx) conditions was evaluated with Farnsworth-Munsell 100-hue test. The total error score (TES) and partial error score (PES) were calculated. Results Preoperatively, the TES in the patient group was 129.7 ± 59.5 at 1000 lx and 194.6 ± 74.5 at 40 lx, exhibiting worse discrimination than the volunteer group (TES1000lux = 71.5 ± 37.5 and TES40lux = 113.1 ± 38.8, p ≤ 0.001). Inferior perception were detected in the yellow to green-yellow (Y-GY), green-yellow to green (GY-G), green to blue-green (G-BG) and blue-green to blue (BG-B) colour bands (p ≤ 0.003), corresponding to the 470 nm–580 nm range of the visible light spectrum. Under mesopic conditions, the impact expanded to all colour bands except for yellow-red to yellow (YR-Y). Postoperatively, the TES in the patient group were 80.4 ± 62.4 at 1000 lx and 112.0 ± 85.2 at 40 lx, which were lower than those of the preoperative phase (p ≤ 0.001) but similar to those of the volunteer group (p ≥ 0.505). Postoperative improvement occurred in the Y-GY, GY-G and G-BG colour bands (490 nm to 580 nm) at 1000 lx (p ≤ 0.001) and shifted to the Y-GY, GY-G, G-BG and BG-B colour bands (470 nm to 580 nm) at 40 lx (p ≤ 0.001). Deterioration of hue perception for decrement of illumination was detected in the red to yellow-red (R-YR), Y-GY, G-BG, BG-B, blue to purple-blue (B-PB) and red-purple to red (RP-R) colour bands (450 nm to 500 nm) in the volunteer group (p ≤ 0.002) and the R-YR, G-BG, BG-B, B-PB, PB-P and red-purple to red (RP-R) colour bands (from the short-wavelength end to 500 nm) in the patient group preoperatively (p ≤ 0.001). Conclusions Phacoemulsification could effectively rebuild colour perception in patients with age-related cataract. The postoperative benefits were most significant in colour bands corresponding with spectrum from 470 nm to 580 nm. Electronic supplementary material The online version of this article (10.1186/s12886-019-1057-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mingxin Ao
- Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Number Forty-Nine North Garden Road Haidian District, Beijing, 86100191, China
| | - Xuemin Li
- Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Number Forty-Nine North Garden Road Haidian District, Beijing, 86100191, China
| | - Weiqiang Qiu
- Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Number Forty-Nine North Garden Road Haidian District, Beijing, 86100191, China
| | - Zhiqiang Hou
- Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Number Forty-Nine North Garden Road Haidian District, Beijing, 86100191, China
| | - Jie Su
- Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Number Forty-Nine North Garden Road Haidian District, Beijing, 86100191, China
| | - Wei Wang
- Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Number Forty-Nine North Garden Road Haidian District, Beijing, 86100191, China. .,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Number Forty-Nine North Garden Road Haidian District, Beijing, 86100191, China.
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Early detection of diabetic retinopathy. Surv Ophthalmol 2018; 63:601-608. [DOI: 10.1016/j.survophthal.2018.04.003] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 04/07/2018] [Accepted: 04/09/2018] [Indexed: 12/15/2022]
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Szabó K, Énzsöly A, Dékány B, Szabó A, Hajdú RI, Radovits T, Mátyás C, Oláh A, Laurik LK, Somfai GM, Merkely B, Szél Á, Lukáts Á. Histological Evaluation of Diabetic Neurodegeneration in the Retina of Zucker Diabetic Fatty (ZDF) Rats. Sci Rep 2017; 7:8891. [PMID: 28827737 PMCID: PMC5566374 DOI: 10.1038/s41598-017-09068-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 07/21/2017] [Indexed: 01/24/2023] Open
Abstract
In diabetes, retinal dysfunctions exist prior to clinically detectable vasculopathy, however the pathology behind these functional deficits is still not fully established. Previously, our group published a detailed study on the retinal histopathology of type 1 diabetic (T1D) rat model, where specific alterations were detected. Although the majority of human diabetic patients have type 2 diabetes (T2D), similar studies on T2D models are practically absent. To fill this gap, we examined Zucker Diabetic Fatty (ZDF) rats - a model for T2D - by immunohistochemistry at the age of 32 weeks. Glial reactivity was observed in all diabetic specimens, accompanied by an increase in the number of microglia cells. Prominent outer segment degeneration was detectable with changes in cone opsin expression pattern, without a decrease in the number of labelled elements. The immunoreactivity of AII amacrine cells was markedly decreased and changes were detectable in the number and staining of some other amacrine cell subtypes, while most other cells examined did not show any major alterations. Overall, the retinal histology of ZDF rats shows a surprising similarity to T1D rats indicating that despite the different evolution of the disease, the neuroretinal cells affected are the same in both subtypes of diabetes.
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Affiliation(s)
- Klaudia Szabó
- Department of Anatomy, Histology and Embryology, Semmelweis University, Budapest, H-1085, Hungary
| | - Anna Énzsöly
- Department of Anatomy, Histology and Embryology, Semmelweis University, Budapest, H-1085, Hungary
- Department of Ophthalmology, Semmelweis University, Budapest, H-1085, Hungary
| | - Bulcsú Dékány
- Department of Anatomy, Histology and Embryology, Semmelweis University, Budapest, H-1085, Hungary
| | - Arnold Szabó
- Department of Anatomy, Histology and Embryology, Semmelweis University, Budapest, H-1085, Hungary
| | - Rozina I Hajdú
- Department of Anatomy, Histology and Embryology, Semmelweis University, Budapest, H-1085, Hungary
| | - Tamás Radovits
- Heart and Vascular Center, Semmelweis University, Budapest, H-1085, Hungary
| | - Csaba Mátyás
- Heart and Vascular Center, Semmelweis University, Budapest, H-1085, Hungary
| | - Attila Oláh
- Heart and Vascular Center, Semmelweis University, Budapest, H-1085, Hungary
| | - Lenke K Laurik
- Department of Ophthalmology, Semmelweis University, Budapest, H-1085, Hungary
| | - Gábor M Somfai
- Department of Ophthalmology, Semmelweis University, Budapest, H-1085, Hungary
| | - Béla Merkely
- Heart and Vascular Center, Semmelweis University, Budapest, H-1085, Hungary
| | - Ágoston Szél
- Department of Anatomy, Histology and Embryology, Semmelweis University, Budapest, H-1085, Hungary
| | - Ákos Lukáts
- Department of Anatomy, Histology and Embryology, Semmelweis University, Budapest, H-1085, Hungary.
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Tan NC, Yip WF, Kallakuri S, Sankari U, Koh YLE. Factors associated with impaired color vision without retinopathy amongst people with type 2 diabetes mellitus: a cross-sectional study. BMC Endocr Disord 2017; 17:29. [PMID: 28577364 PMCID: PMC5457622 DOI: 10.1186/s12902-017-0181-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 05/29/2017] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Patients with type 2 diabetes mellitus (T2DM) may develop color vision impairment. This study aimed to determine the prevalence and factors associated with impaired color vision in patients with T2DM but without diabetic retinopathy. METHODS Enrolment criteria included multi-ethnic Asian participants, age 21 to 80 years, with known T2DM for a minimum of 2 years. Their diagnoses were affirmed from oral glucose tolerance test results and they were screened for impaired color vision using the Farnsworth D-15 instrument. Demographic characteristics were described and clinical data for the preceding 2 years were analyzed using logistic regression. RESULTS Twenty-two percent of 849 eligible participants had impaired color vision with higher involvement of the right eye. Impaired blue-yellow color-vision(Tritanomaly) was the commonest impaired color vision. Participants with impaired color vision were significantly associated with age and lower education; longer duration of T2DM (median 6 years vs 4 years); higher HbA1c level and HDL-Cholesterol in 2nd year; lower mean total cholesterol, mean LDL-Cholesterol and mean triglyceride in 2nd year. They also have poorer vision beyond 6/12 in the affected eye. Logistic regression showed that impaired color vision was associated with older patients (OR=1.04), increased duration of T2DM (OR=1.07); prescription of Tolbutamide (OR=3.79) and lower mean systolic blood pressure (OR=0.98). CONCLUSION Almost one in four participants with T2DM had impaired color vision, largely with tritanomaly. Color vision screening may be considered for participants who develop T2DM for 6 years or longer, but this requires further cost-effectiveness evaluation.
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Affiliation(s)
- N. C. Tan
- SingHealth Polyclinics, 167, Jalan Bukit Merah, Tower 5, #15-10, 150167 Singapore, Singapore
- Duke NUS Medical School, Singapore, Singapore
| | - W. F. Yip
- Singapore Eye Research Institute, Singapore, Singapore
| | - S. Kallakuri
- Optometry Centre, Singapore Polytechnic, Singapore, Singapore
| | - U. Sankari
- SingHealth Polyclinics, 167, Jalan Bukit Merah, Tower 5, #15-10, 150167 Singapore, Singapore
| | - Y. L. E. Koh
- SingHealth Polyclinics, 167, Jalan Bukit Merah, Tower 5, #15-10, 150167 Singapore, Singapore
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15
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Ansar M, Santos-Cortez RLP, Saqib MAN, Zulfiqar F, Lee K, Ashraf NM, Ullah E, Wang X, Sajid S, Khan FS, Amin-ud-Din M, Smith JD, Shendure J, Bamshad MJ, Nickerson DA, Hameed A, Riazuddin S, Ahmed ZM, Ahmad W, Leal SM. Mutation of ATF6 causes autosomal recessive achromatopsia. Hum Genet 2015; 134:941-50. [PMID: 26063662 PMCID: PMC4529463 DOI: 10.1007/s00439-015-1571-4] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 05/19/2015] [Indexed: 02/07/2023]
Abstract
Achromatopsia (ACHM) is an early-onset retinal dystrophy characterized by photophobia, nystagmus, color blindness and severely reduced visual acuity. Currently mutations in five genes CNGA3, CNGB3, GNAT2, PDE6C and PDE6H have been implicated in ACHM. We performed homozygosity mapping and linkage analysis in a consanguineous Pakistani ACHM family and mapped the locus to a 15.12-Mb region on chromosome 1q23.1-q24.3 with a maximum LOD score of 3.6. A DNA sample from an affected family member underwent exome sequencing. Within the ATF6 gene, a single-base insertion variant c.355_356dupG (p.Glu119Glyfs*8) was identified, which completely segregates with the ACHM phenotype within the family. The frameshift variant was absent in public variant databases, in 130 exomes from unrelated Pakistani individuals, and in 235 ethnically matched controls. The variant is predicted to result in a truncated protein that lacks the DNA binding and transmembrane domains and therefore affects the function of ATF6 as a transcription factor that initiates the unfolded protein response during endoplasmic reticulum (ER) stress. Immunolabeling with anti-ATF6 antibodies showed localization throughout the mouse neuronal retina, including retinal pigment epithelium, photoreceptor cells, inner nuclear layer, inner and outer plexiform layers, with a more prominent signal in retinal ganglion cells. In contrast to cytoplasmic expression of wild-type protein, in heterologous cells ATF6 protein with the p.Glu119Glyfs*8 variant is mainly confined to the nucleus. Our results imply that response to ER stress as mediated by the ATF6 pathway is essential for color vision in humans.
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Affiliation(s)
- Muhammad Ansar
- />Department of Molecular and Human Genetics, Center for Statistical Genetics, Baylor College of Medicine, 1 Baylor Plaza 700D, Houston, TX 77030 USA
- />Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, 45320 Pakistan
| | - Regie Lyn P. Santos-Cortez
- />Department of Molecular and Human Genetics, Center for Statistical Genetics, Baylor College of Medicine, 1 Baylor Plaza 700D, Houston, TX 77030 USA
| | - Muhammad Arif Nadeem Saqib
- />Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, 45320 Pakistan
| | - Fareeha Zulfiqar
- />Department of Otorhinolaryngology Head and Neck Surgery, School of Medicine, University of Maryland, Baltimore, MD 21203 USA
| | - Kwanghyuk Lee
- />Department of Molecular and Human Genetics, Center for Statistical Genetics, Baylor College of Medicine, 1 Baylor Plaza 700D, Houston, TX 77030 USA
| | - Naeem Mahmood Ashraf
- />Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, 45320 Pakistan
| | - Ehsan Ullah
- />Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, 45320 Pakistan
| | - Xin Wang
- />Department of Molecular and Human Genetics, Center for Statistical Genetics, Baylor College of Medicine, 1 Baylor Plaza 700D, Houston, TX 77030 USA
| | - Sundus Sajid
- />Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, 45320 Pakistan
| | - Falak Sher Khan
- />Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, 45320 Pakistan
| | | | - University of Washington Center for Mendelian Genomics
- />Department of Molecular and Human Genetics, Center for Statistical Genetics, Baylor College of Medicine, 1 Baylor Plaza 700D, Houston, TX 77030 USA
- />Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, 45320 Pakistan
- />Department of Otorhinolaryngology Head and Neck Surgery, School of Medicine, University of Maryland, Baltimore, MD 21203 USA
- />University of Education, Dera Ghazi Khan Campus, Lahore, 32200 Pakistan
- />Department of Genome Sciences, University of Washington, Seattle, WA 98195 USA
- />Institute of Biomedical and Genetic Engineering, Islamabad, 44000 Pakistan
| | - Joshua D. Smith
- />Department of Genome Sciences, University of Washington, Seattle, WA 98195 USA
| | - Jay Shendure
- />Department of Genome Sciences, University of Washington, Seattle, WA 98195 USA
| | - Michael J. Bamshad
- />Department of Genome Sciences, University of Washington, Seattle, WA 98195 USA
| | - Deborah A. Nickerson
- />Department of Genome Sciences, University of Washington, Seattle, WA 98195 USA
| | - Abdul Hameed
- />Institute of Biomedical and Genetic Engineering, Islamabad, 44000 Pakistan
| | - Saima Riazuddin
- />Department of Otorhinolaryngology Head and Neck Surgery, School of Medicine, University of Maryland, Baltimore, MD 21203 USA
| | - Zubair M. Ahmed
- />Department of Otorhinolaryngology Head and Neck Surgery, School of Medicine, University of Maryland, Baltimore, MD 21203 USA
| | - Wasim Ahmad
- />Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, 45320 Pakistan
| | - Suzanne M. Leal
- />Department of Molecular and Human Genetics, Center for Statistical Genetics, Baylor College of Medicine, 1 Baylor Plaza 700D, Houston, TX 77030 USA
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Gella L, Raman R, Kulothungan V, Pal SS, Ganesan S, Sharma T. Impairment of Colour Vision in Diabetes with No Retinopathy: Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study (SNDREAMS- II, Report 3). PLoS One 2015; 10:e0129391. [PMID: 26053017 PMCID: PMC4460124 DOI: 10.1371/journal.pone.0129391] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 05/07/2015] [Indexed: 01/28/2023] Open
Abstract
PURPOSE To assess impairment of colour vision in type 2 diabetics with no diabetic retinopathy and elucidate associated risk factors in a population-based cross-sectional study. METHODS This is part of Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular-genetics Study (SN-DREAMS II) which was conducted between 2007-2010. FM 100 hue-test was performed in 253 subjects with no clinical evidence of diabetic retinopathy. All subjects underwent detailed ophthalmic evaluation including cataract grading using LOCS III and 45° 4-field stereoscopic fundus photography. Various ocular and systemic risk factors for impairment of colour vision (ICV) were assessed in subjects with diabetes but no retinopathy. P value of < 0.05 was considered statistically significant. RESULTS The mean age of the study sample was 57.08 ± 9.21 (range: 44-86 years). Gender adjusted prevalence of ICV among subjects with diabetes with no retinopathy was 39.5% (CI: 33.5-45.5). The mean total error score in the study sample was 197.77 ± 100 (range: 19-583). The risk factors for ICV in the study were women OR: 1.79 (1.00-3.18), increased resting heart rate OR: 1.04 (1.01-1.07) and increased intraocular pressure OR: 1.12 (1.00-1.24). Significant protective factor was serum high-density lipoprotein OR: 0.96 (0.93-0.99). CONCLUSIONS Acquired ICV is an early indicator of neurodegenerative changes in the retina. ICV found in diabetic subjects without retinopathy may be of non-vascular etiology.
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Affiliation(s)
- Laxmi Gella
- Elite School of Optometry, Chennai, Tamil Nadu, India
- Birla Institute of Technology and Science, Pilani, India
| | - Rajiv Raman
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | | | - Swakshyar Saumya Pal
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Suganeswari Ganesan
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Tarun Sharma
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
- * E-mail:
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Shoji T, Sato H, Chihara E, Sakurai Y. Are middle-age blood pressure levels related to color vision impairment? The Okubo Color Study. Am J Hypertens 2015; 28:98-105. [PMID: 24898378 DOI: 10.1093/ajh/hpu097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND We sought to investigate the association between blood pressure levels and prevalence of acquired color vision impairment in middle-aged Japanese men. METHODS Participants underwent color vision testing, ophthalmological examination, standardized interview, physical record examination, and venous blood examination. Cardiovascular disease risk factors were determined based on blood and physical examination results and the interview. Logistic regression analysis was performed after adjusting for body mass index, systemic dyslipidemia, diabetes, cataract, glaucoma, smoking status, and drinking status. RESULTS Of 1,042 men, 872 were eligible for the study, 130 failed the Lanthony 15-hue desaturated panel (D-15 DS) diagnosed as acquired color vision impairment 15-hue, and 31 failed the Farnsworth-Munsell 100-hue test diagnosed as acquired color vision impairment 100-hue. Diastolic blood pressure was significantly correlated with both acquired color vision impairment in 100-hue patients (adjusted odds ratio (OR) for 10-mm Hg increases = 1.42; 95% confidence interval (CI) = 1.00-2.02) and acquired color vision impairment in 15-hue patients (adjusted OR for 10-mm Hg increases = 1.25; 95% CI = 1.04-1.51). The multiple-adjusted ORs for acquired color vision impairment 100-hue patients and acquired color vision impairment 15-hue patients were 7.13 (95% CI = 1.72-27.88) and 4.37 (95% CI = 1.69-11.03), respectively, for the highest blood pressure category (systolic blood pressure ≥ 160 and diastolic blood pressure ≥ 100 mm Hg) compared with those for the lowest blood pressure category (systolic blood pressure <120 and diastolic blood pressure <80 mm Hg). Tests for trends were significant (P < 0.05) in both analyses. CONCLUSIONS Hypertension in middle-aged men may negatively modify vision-associated neuronal function.
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Affiliation(s)
- Takuhei Shoji
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan; Department of Preventive Medicine and Public Health, National Defense Medical College, Tokorozawa, Saitama, Japan;
| | - Hiroki Sato
- Department of Preventive Medicine and Public Health, National Defense Medical College, Tokorozawa, Saitama, Japan
| | | | - Yutaka Sakurai
- Department of Preventive Medicine and Public Health, National Defense Medical College, Tokorozawa, Saitama, Japan
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Chihara E. Myopia and diabetes mellitus as modificatory factors of glaucomatous optic neuropathy. Jpn J Ophthalmol 2013; 58:16-25. [PMID: 23942995 DOI: 10.1007/s10384-013-0267-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2013] [Accepted: 06/19/2013] [Indexed: 12/16/2022]
Abstract
Myopic deformation of the eye and metabolic alterations of the nerve tissue of patients with diabetes may modify glaucomatous optic neuropathy (GON). Blockage of axonal transport of neurotrophic factors (NTFs) is the event crucial to understanding the factors that affect GON. The primary, but not sole, blockage site is at the lamina cribrosa (LC). Other than this primary site of damage at the LC, 7 other factors may explain atypical nerve fiber layer (NFL) defects and the vulnerability of the nerve fibers in eyes with high myopia and glaucoma: a second point of blockage at the edge of the posterior scleral foramen; ectatic strain on the NFL; ectasia and distortion of the LC; association of a hypoplastic optic disc; thin and weak collagen fibers; peripapillary chorioretinal atrophy; and myopic neuropathy. Among diabetic patients, diabetic neuropathy in the retinal NFL is present initially, and increased resistance to aqueous outflow leads to ocular hypertension. Superimposition of GON on diabetic neuropathy and ocular hypertension in patients with diabetes may enhance their susceptibility to nerve damage. Results of a meta-analysis study suggested a positive association between diabetes mellitus and glaucoma whereas other reports suggested that leakage of vascular endothelial growth factor, a survival mechanism of ischemic neural tissue, and enhanced stiffness of the LC as a result of diabetic glycation may protect neurons from apoptosis. Thus, modification of GON as a result of diabetes remains controversial.
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Affiliation(s)
- Etsuo Chihara
- Sensho-Kai Eye Institute, Minamiyama 50-1, Iseda, Uji, Kyoto, 611-0043, Japan,
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