Retinopathy in subjects with pre-diabetes and electrophysiological studies in diabetes patients with and without retinopathy

University dissertation from Dept of Ophthalmology

Abstract: Diabetes is increasing worldwide and hence the risk developing complications where retinopathy is the theme of this study. The aim of the study was to evaluate the presence of (vascular) retinopathy in subjects with the pre-diabetes stage, impaired fasting glucose (IFG), and the development of retinopathy in these subjects during five years. In the second part of the study diabetes patients with different duration of diabetes and grade of (vascular) retinopathy was examined with electrophysiological methods to investigate if there are alterations detectable in diabetes patients. Results: Retinopathy was present in 10% of subjects with impaired fasting glucose. The retinopathy was associated with higher diastolic and systolic blood pressure, weight and body mass index (BMI). The 5-year incidence of developing retinopathy was 6.9%. In the second part of the study electrophysiological alterations was found in full- field ERG and multi focal ERG in newly onset type 2 diabetes patients even before any vascular retinopathy was detectable on fundus photography. Alterations were also verified before visual detoriation in patients with ischemic maculopathy and long duration of diabetes. Conclusion: Blood pressure appears to be a major concern in the development of retinopathy in subjects with impaired fasting glucose, IFG. The incidence of retinopathy was, however low in these subjects who had received recommendations regarding diet and lifestyle. The full-field and multifocal electroretinography demonstrate early alterations of the retinal function identified before any retinopathy is visible on fundus photography. In future electrophysiological examinations may be valuable to follow these alterations in the natural course of the disease and to evaluate effect of treatment including the neuroretina.

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