title: Visual function in young IDDM patients over 8 years of age. A 4-year longitudinal study.
abstract: OBJECTIVE
  To carry out a longitudinal study of visual functions in young patients over the age of 8 years with IDDM and to assess the impact of metabolic control on the presence of diabetic retinopathy.
  
  
  METHODS
  There were 37 young IDDM patients from the Paediatric and Adolescent Clinic at the University Hospital of Wales studied annually for 4 years, with a control group of 24 healthy subjects observed over a 2-year period. Assessment of visual functions included visual acuity, color vision, and contrast sensitivity. Ophthalmoscopy and retinal photography were used to determine the presence or absence of diabetic retinopathy. In addition, pubertal status and metabolic control (glycosylated hemoglobin) were determined at each visit.
  
  
  RESULTS
  Patients with IDDM demonstrate abnormal color vision and contrast sensitivity compared with the control group (P < 0.05), but visual acuity was unaffected. Visual functions were not significantly different between those IDDM patients with and without retinopathy. After 4 years, diabetic retinopathy was present in 43% of the group and was related to diabetes duration and metabolic control (P < 0.05).
  
  
  CONCLUSIONS
  Visual function testing could not distinguish between those IDDM patients with and without retinopathy, but the color vision and contrast sensitivity in those with IDDM were significantly impaired compared with the control group. The presence of retinopathy was related to the duration of diabetes and metabolic control. It is important to ensure that good glycemic control and regular attendance for retinopathy screening is encouraged in the adolescent patients.
authors.affiliation: Department of Optometry and Vision Sciences, University of Wales, Cardiff, U.K. north@cardiff.ac.uk
authors.forename: R V
authors.initials: RV
authors.lastname: North
authors.forename: U
authors.initials: U
authors.lastname: Farrell
authors.forename: D
authors.initials: D
authors.lastname: Banford
authors.forename: C
authors.initials: C
authors.lastname: Jones
authors.forename: J W
authors.initials: JW
authors.lastname: Gregory
authors.forename: G
authors.initials: G
authors.lastname: Butler
authors.forename: D R
authors.initials: DR
authors.lastname: Owens
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis* / Q000378:metabolism; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis* / Q000378:metabolism; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D012016:Reference Values; D013997:Time Factors; D014785:Vision, Ocular / Q000502:physiology*
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin