Pupillary responses in non-proliferative diabetic retinopathy.
The goal of this study was to determine the extent of rod-, cone-, and melanopsin-mediated pupillary light reflex (PLR) abnormalities in diabetic patients who have non-proliferative diabetic retinopathy (NPDR). Fifty diabetic subjects who have different stages of NPDR and 25 age-equivalent, non-diabetic controls participated. PLRs were measured in response to full-field, brief-flash stimuli under conditions that target the rod, cone, and intrinsically-photosensitive (melanopsin) retinal ganglion cell pathways. Pupil responses were compared among the subjects groups using age-corrected linear mixed models. Compared to control, the mean baseline pupil diameters were significantly smaller for all patient groups in the dark (all p < 0.001) and for the moderate-severe NPDR group in the light (p = 0.003). Pairwise comparisons indicated: (1) the mean melanopsin-mediated PLR was significantly reduced in the mild and moderate-severe groups (both p < 0.001); (2) the mean cone-mediated PLR was reduced significantly in the moderate-severe group (p = 0.008); (3) no significant differences in the mean rod-mediated responses. The data indicate abnormalities in NPDR patients under conditions that separately assess pupil function driven by different photoreceptor classes. The results provide evidence for compromised neural function in these patients and provide a promising approach for quantifying their neural abnormalities.
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, 1855 W. Taylor St., Chicago, IL 60612, USA.
Jason C
JC
Park
Center for Clinical and Translational Sciences, University of Illinois at Chicago, 914 S Wood Street, Chicago, IL 60612, USA.
Yi-Fan
YF
Chen
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, 1855 W. Taylor St., Chicago, IL 60612, USA.
Norman P
NP
Blair
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, 1855 W. Taylor St., Chicago, IL 60612, USA.
Felix Y
FY
Chau
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, 1855 W. Taylor St., Chicago, IL 60612, USA.
Jennifer I
JI
Lim
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, 1855 W. Taylor St., Chicago, IL 60612, USA.
Yannek I
YI
Leiderman
Department of Ophthalmology, University of Southern California, 1450 San Pablo St, Los Angeles, CA 90033, USA.
Mahnaz
M
Shahidi
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, 1855 W. Taylor St., Chicago, IL 60612, USA.
J Jason
JJ
McAnany
D000328:Adult; D000368:Aged; D015415:Biomarkers; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000378:metabolism* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008027:Light; D008297:Male; D008875:Middle Aged; D010775:Photic Stimulation; D012025:Reflex, Pupillary; D017949:Retinal Cone Photoreceptor Cells / Q000378:metabolism; D017948:Retinal Rod Photoreceptor Cells / Q000378:metabolism; D017299:Rod Opsins / Q000378:metabolism; D000099210:Melanopsin
D015415:Biomarkers; D017299:Rod Opsins; D000099210:Melanopsin