Adolescents with Type 2 diabetes: early indications of focal retinal neuropathy, retinal thinning, and venular dilation.
OBJECTIVE
The eye provides a unique window into the neural and vascular health of a patient with diabetes. The present study is the first of its kind to examine the neural retinal function, structure, and retinal vascular health in adolescents with Type 2 diabetes.


METHODS
Focal neural responses from 103 discrete retinal regions of the eye were tested using multifocal electroretinography. Optical coherence tomography was utilized to measure retinal thickness. Digital fundus photographs were examined for the presence of retinopathy and to measure vascular caliber using retinal vessel analysis. Fifteen adolescents diagnosed with Type 2 diabetes, aged 13 to 21 years with a mean diabetes duration of 2.1 +/- 1.3 years, were tested. Twenty-six age-matched control subjects were also tested.


RESULTS
Multifocal electroretinograms of the Type 2 diabetic group were significantly (P = 0.03) delayed by 0.49 milliseconds. The diabetic group also showed significant (both; P < or = 0.03) retinal thinning (10.3 microm) and significant venular dilation (16.2 microm).


CONCLUSIONS
The present study shows early indications of focal retinal neuropathy, retinal thinning, and venular dilation in adolescents with Type 2 diabetes. Early detection of functional and structural changes will hopefully aid in the prevention of permanent damage or further functional loss.
Bronson-Castain
Kevin W
KW
Graduate Program in Vision Science, School of Optometry, University of California, Berkeley, California 94602-2020, USA. kbc@berkeley.edu
Bearse
Marcus A
MA
Neuville
Jessica
J
Jonasdottir
Soffia
S
King-Hooper
Barbara
B
Barez
Shirin
S
Schneck
Marilyn E
ME
Adams
Anthony J
AJ
D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis*; D003929:Diabetic Neuropathies / Q000175:diagnosis*; D003930:Diabetic Retinopathy / Q000175:diagnosis*; D004108:Dilatation, Pathologic; D004596:Electroretinography; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D012160:Retina / Q000473:pathology*; D012169:Retinal Vein / Q000473:pathology*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
D001786:Blood Glucose; D006442:Glycated Hemoglobin