Color vision and neuroretinal function in diabetes
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We investigate how type 2 diabetes (T2DM) and diabetic retinopathy (DR) affect color vision (CV) and mfERG implicit time (IT), whether CV and IT are correlated, and whether CV and IT abnormality classifications agree.
Adams desaturated D-15 color test, mfERG, and fundus photographs were examined in 37 controls, 22 T2DM patients without DR (NoRet group), and 25 T2DM patients with DR (Ret group). Color confusion score (CCS) was calculated. ITs were averaged within the central 7 hexagons (central IT; ≤4.5°) and outside this area (peripheral IT; ≥4.5°). DR was within (DRIN) or outside (DROUT) of the central 7 hexagons. Group differences, percentages of abnormalities, correlations, and agreement were determined.
CCS was greater in the NoRet (P = 0.002) and Ret (P < 0.0001) groups than in control group. CCS was abnormal in 3, 41, and 48 % of eyes in the control, NoRet, and Ret groups, respectively. Ret group CV abnormalities were more frequent in DRIN than in DROUT subgroups (71 vs. 18 %, respectively; P < 0.0001). CCS and IT were correlated only in the Ret group, in both retinal zones (P ≤ 0.028). Only in the Ret group did CCS and peripheral IT abnormality classifications agree (72 %; P < 0.05).
CV is affected in patients with T2DM, even without DR. Central DR increases the likelihood of a CV deficit compared with non-central DR. mfERG IT averaged across central or peripheral retinal locations is less frequently abnormal than CV in the absence of DR, and these two measures are correlated only when DR is present.
KeywordsColor vision Adams desaturated D-15 Multifocal mfERG Diabetes Diabetic retinopathy
This research was funded by NIH EY021811 (MES) and NIH EY02271 (AJA). The authors thank Ken Huie for implementing the software for scoring the Adams desaturated D-15 data.
Conflict of interest
I certify that there is no actual or potential conflict of interest in relation to this article.
- 1.Centers for Disease Control and Prevention (2011) National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, AtlantaGoogle Scholar
- 3.American Diabetes Association (2013) The cost of diabetes. http://www.diabetes.org/advocate/resources/cost-of-diabetes.html. Accessed 12 Feb 2014
- 9.Ziegler D, Papanas N, Zhivov A, Allgeier S, Winter K, Ziegler I, Bruggemann J, Strom A, Peschel S, Kohler B, Stachs O, Guthoff RF, Roden M (2014) Early detection of nerve fiber loss by corneal confocal microscopy and skin biopsy in recently diagnosed type 2 diabetes. Diabetes 63(7):2454–2463. doi: 10.2337/db13-1819 CrossRefPubMedGoogle Scholar
- 11.Adams AJ, Haegerstrom-Portnoy G (1987) Color Deficiency. In: Amos JF (ed) Diagnosis and management in vision care, vol 1. Butterworth-Heinemann, Stoneham, pp 671–709Google Scholar
- 13.Dhamdhere KP, Bearse MA Jr, Wolff BE, Harrison WW, Cardenas M, Barez S, Schneck ME, Adams AJ (2011) Associations between contrast sensitivity and multifocal electroretinograms in Type2 diabetes. Paper presented at the ARVO, Fort Lauderdale, Florida, 05/02/2011Google Scholar
- 17.Rodgers M, Hodges R, Hawkins J, Hollingworth W, Duffy S, McKibbin M, Mansfield M, Harbord R, Sterne J, Glasziou P, Whiting P, Westwood M (2009) Colour vision testing for diabetic retinopathy: a systematic review of diagnostic accuracy and economic evaluation. Health Technol Assess 13(60):1–160. doi: 10.3310/hta13600 CrossRefPubMedGoogle Scholar
- 20.Adams AJ et al (1982) Chromaticity and luminosity changes in glaucoma and diabetes. Doc Ophthalmol Proc Ser 33:413–418Google Scholar
- 21.Barca L, Vaccari G (1977) On the impairment of color discrimination in diabetic retinopathy, a report of 24 cases. Atti Fond G Ronchi 32:635–640Google Scholar
- 22.Birch JM, Chisholm I, Kinnear P, Marre M, Pinckers AJLG, Pokorny J, Smith VC, Verriest G (1979) Acquired color vision defects. In: Pokory J, Smith VC, Verriest G, Pinckers AJLG (eds) Congenital and Acquired Color Vision Defects. Grune and Stratton Inc, New York, pp 282–284Google Scholar
- 24.Lakowski R, Aspinall PA, Kinnear PR (1973) Association between colour vision losses and diabetes melitus. Ophthalmic Res 4:145–159Google Scholar
- 26.Zanen J (1953) [Introduction to the study of acquired central retinal dyschromatopsias]. Bull Soc Belge Ophtalmol 103:3–144; discussion, 144–148Google Scholar
- 29.Harrison WW, Bearse MA Jr, Ng JS, Jewell NP, Barez S, Burger D, Schneck ME, Adams AJ (2011) Multifocal electroretinograms predict onset of diabetic retinopathy in adult patients with diabetes. Invest Ophthalmol Vis Sci 52(2):772–777. doi: 10.1167/iovs.10-5931 CrossRefPubMedCentralPubMedGoogle Scholar
- 31.Harrison WW, Bearse MA Jr, Schneck ME, Wolff BE, Jewell NP, Barez S, Mick AB, Dolan BJ, Adams AJ (2011) Prediction, by retinal location, of the onset of diabetic edema in patients with nonproliferative diabetic retinopathy. Invest Ophthalmol Vis Sci 52(9):6825–6831. doi: 10.1167/iovs.11-7533 CrossRefPubMedCentralPubMedGoogle Scholar
- 35.Adams AJ, Rodic R (1982) Use of desaturated and saturated versions of the D-15 test in glaucoma and glaucoma-suspect patients. In: Verriest G (ed) Colour vision deficiencies IV. Doc Ophthalmol Proc Series, vol 33. The Hague: Dr W Junk, pp 419–424Google Scholar
- 37.Hood DCLJ (1997) A technique for measuring individual multifocal ERG records: non-invasive assessment of the visual system. Trends Opt Photon 11:33–41Google Scholar