title: Fixation characteristics among subjects with diabetes: SN-DREAMS II, Report No. 5.
abstract: OBJECTIVE
  To evaluate fixation and scotoma characteristics among subjects with diabetes in a population-based study.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  A subset of 357 subjects was recruited from follow-up cohort of Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study I.
  
  
  METHODS
  All subjects underwent detailed ophthalmic evaluation including microperimetry and spectral domain optical coherence tomography. Fixation parameters such as stability of fixation, fixation location, and presence of scotoma were evaluated. A p value less than 0.05 was considered statistically significant.
  
  
  RESULTS
  The mean age of the study sample was 56.86 ± 8.63 years. Relatively unstable fixation was observed in 73 and poor central fixation in 25 subjects. Among subjects with poor central fixation, 72% (18 subjects) had relatively unstable fixation. Poor central and relatively unstable fixation were significantly associated with best corrected visual acuity (BCVA; p = 0.002 and p = 0.017, respectively). Prevalence rate of scotoma was 24.4%, which was highly prevalent in females (p = 0.035) and among subjects with reduced BCVA (p < 0.001), reduced contrast sensitivity (p < 0.001), cataract (p < 0.001), impaired retinal sensitivity (p < 0.001), and presence of sight-threatening diabetic retinopathy (STDR; p < 0.001). Presence of scotoma was significantly associated with abnormal foveal contour (p = 0.046) and altered inner retinal layers (p < 0.001).
  
  
  CONCLUSIONS
  We report that fixation characteristics are independent of ocular characteristics except for BCVA. Female sex, reduced visual acuity and contrast sensitivity, cataract, and STDR were significantly associated with presence of scotoma.
authors.affiliation: Elite School of Optometry, St. Thomas Mount, Tamil Nadu; Birla Institutes of Technology and Science, Pilani.
authors.forename: Laxmi
authors.initials: L
authors.lastname: Gella
authors.affiliation: Shri Bhagwan Mahavir Vitreoretinal Services, Tamil Nadu, India.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Raman
authors.affiliation: Shri Bhagwan Mahavir Vitreoretinal Services, Tamil Nadu, India.
authors.forename: Swakshyar Saumya
authors.initials: SS
authors.lastname: Pal
authors.affiliation: Shri Bhagwan Mahavir Vitreoretinal Services, Tamil Nadu, India.
authors.forename: Suganeswari
authors.initials: S
authors.lastname: Ganesan
authors.affiliation: Shri Bhagwan Mahavir Vitreoretinal Services, Tamil Nadu, India. Electronic address: drtaruns@gmail.com.
authors.forename: Tarun
authors.initials: T
authors.lastname: Sharma
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015350:Contrast Sensitivity / Q000502:physiology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003930:Diabetic Retinopathy / Q000503:physiopathology*; D005260:Female; D005403:Fixation, Ocular / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012607:Scotoma / Q000503:physiopathology*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology