title: Early selective neuroretinal disorder in prepubertal type 1 (insulin-dependent) diabetic children without microvascular abnormalities.
abstract: The duration of diabetes before puberty is not considered relevant to the future development of complications. To evaluate the effects of diabetes on the neural retina, we analysed macular function by steady-state focal electroretinography in 20 prepubescent diabetic children without vascular retinopathy and in 39 sex- and age-matched normal children. The mean (+/- SD) response related to retinal cellular elements between the photoreceptors and ganglion cells was significantly lower in diabetic children than in the control group (0.38 +/- 0.12 vs. 0.51 +/- 0.13 microV; unpaired t-test = 3; P = 0.005). Similarly, ganglion cell function showed a significant impairment in diabetic children with respect to the control group (0.4 +/- 0.13 vs. 0.53 +/- 0.09 microV; unpaired t-test = 5.4; P = 0.0001), whereas the photoreceptors appeared unaffected. Metabolic control and disease duration were not correlated with functional deficits. Our results suggest that before puberty, early diabetes may have a selective effect on the neural retina prior to the appearance of microvascular changes. A focal electroretinogram could identify diabetic children with neurosensory disorders who may have a higher risk of developing microvascular retinopathy.
authors.affiliation: Institute of Internal Medicine, Catholic University, Rome, Italy.
authors.forename: A V
authors.initials: AV
authors.lastname: Greco
authors.forename: M A
authors.initials: MA
authors.lastname: Di Leo
authors.forename: S
authors.initials: S
authors.lastname: Caputo
authors.forename: B
authors.initials: B
authors.lastname: Falsini
authors.forename: V
authors.initials: V
authors.lastname: Porciatti
authors.forename: G
authors.initials: G
authors.lastname: Marietti
authors.forename: G
authors.initials: G
authors.lastname: Ghirlanda
mesh_terms: D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D003930:Diabetic Retinopathy / Q000175:diagnosis* / Q000503:physiopathology; D004596:Electroretinography; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010786:Photoreceptor Cells / Q000502:physiology / Q000503:physiopathology*; D011627:Puberty; D012016:Reference Values; D012165:Retinal Ganglion Cells / Q000502:physiology*