Visual Deficits in Type 2 Diabetes Mellitus Without Retinopathy: From Retinal Structure to Higher-Level Visual Functions.

IF 2.6 3区医学 Q2 OPHTHALMOLOGY

Translational Vision Science & Technology Pub Date : 2025-03-03 DOI:10.1167/tvst.14.3.10

Sha Luo, Lin Xia, Yue Wang, Yong Tang, Jiong Dong, Rong Liu, Lixia Feng

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引用次数: 0

Abstract

Purpose: The purpose of this study was to evaluate deficits at varying levels of visual system in diabetes without clinical retinopathy (NoDR) and to explore the optimal method for detecting early diabetic visual disorders among functional and retinal structural assessments included.

Methods: This cross-sectional study examined eyes by the Early Treatment of Diabetic Retinopathy Study (ETDRS) charts, visual psychophysical tests, optical coherence tomography (OCT), and OCT angiography (OCTA). Visual psychophysical metrics included grating acuity (GA), and contrast sensitivity to first-order motion stimuli (1stM), second-order contrast-modulated stationary stimuli (2ndS), and second-order motion stimuli (2ndM). Generalized linear mixed effect (GLME) models were applied to assess group effects and linear relationships between measurements. The receiver operating characteristic (ROC) analysis was utilized to identify the optimal classifier for detecting NoDR.

Results: Fifty-three eyes of 33 patients with NoDR and 40 eyes of 27 healthy controls were included. The NoDR group showed significant reductions in various visual functions, including ETDRS acuity, GA, 2ndS, and 2ndM (P values < 0.001), and microvascular changes in foveal vascular density (FD-300), the acircularity index (AI) of the foveal avascular zone, and the parafoveal superficial capillary plexus density (P values < 0.05). GLME models revealed these retinal variations were not significantly correlated with early diabetic visual function abnormalities. ROC analysis demonstrated the integration of GA and FD-300 (area under the curve [AUC] = 0.911) is the most effective classifier for detecting early diabetic visual dysfunctions.

Conclusions: In addition to retinal defects, both low- and higher-order visual function disorders along the visual pathway exist in patients with NoDR. Combining functional and structural measurements may provide more accurate assessments for detecting early diabetic visual disorders.

Translational relevance: Sophisticated visual psychophysical measurements, including grating acuity and second-order function, could be applied for detecting early diabetic visual disorders.

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无视网膜病变的2型糖尿病的视力缺陷：从视网膜结构到高级视觉功能。

目的：本研究的目的是评估无临床视网膜病变（NoDR）的糖尿病患者不同程度的视觉系统缺陷，并探讨在功能和视网膜结构评估中发现早期糖尿病视力障碍的最佳方法。方法：本横断面研究通过糖尿病视网膜病变早期治疗研究（ETDRS）图表、视觉心理物理测试、光学相干断层扫描（OCT）和OCT血管造影（OCTA）检查眼睛。视觉心理物理指标包括光栅敏锐度（GA）和对一阶运动刺激（1stM）、二阶对比调制静止刺激（2ds）和二阶运动刺激（2ndM）的对比敏感度。采用广义线性混合效应（GLME）模型评估群体效应和测量之间的线性关系。利用受试者工作特征（ROC）分析来确定检测NoDR的最佳分类器。结果：纳入33例NoDR患者53只眼和27例健康对照40只眼。NoDR组ETDRS、GA、2ds、2ndM等各项视觉功能均显著降低（P值< 0.001），中央凹血管密度（FD-300）、中央凹无血管区循环指数（AI）、中央凹旁浅毛细血管丛密度微血管改变（P值< 0.05）。GLME模型显示，这些视网膜变异与早期糖尿病视觉功能异常无显著相关性。ROC分析表明，GA和FD-300（曲线下面积[AUC] = 0.911）的结合是检测早期糖尿病视觉功能障碍最有效的分类器。结论：除了视网膜缺陷外，NoDR患者还存在沿视觉通路的低阶和高阶视觉功能障碍。结合功能和结构测量可以为早期糖尿病视力障碍的检测提供更准确的评估。翻译相关性：复杂的视觉心理物理测量，包括光栅敏锐度和二阶函数，可用于检测早期糖尿病视力障碍。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Translational Vision Science & Technology Engineering-Biomedical Engineering

CiteScore

5.70

自引率

3.30%

发文量

346

审稿时长

25 weeks

期刊介绍： Translational Vision Science & Technology (TVST), an official journal of the Association for Research in Vision and Ophthalmology (ARVO), an international organization whose purpose is to advance research worldwide into understanding the visual system and preventing, treating and curing its disorders, is an online, open access, peer-reviewed journal emphasizing multidisciplinary research that bridges the gap between basic research and clinical care. A highly qualified and diverse group of Associate Editors and Editorial Board Members is led by Editor-in-Chief Marco Zarbin, MD, PhD, FARVO. The journal covers a broad spectrum of work, including but not limited to: Applications of stem cell technology for regenerative medicine, Development of new animal models of human diseases, Tissue bioengineering, Chemical engineering to improve virus-based gene delivery, Nanotechnology for drug delivery, Design and synthesis of artificial extracellular matrices, Development of a true microsurgical operating environment, Refining data analysis algorithms to improve in vivo imaging technology, Results of Phase 1 clinical trials, Reverse translational ("bedside to bench") research. TVST seeks manuscripts from scientists and clinicians with diverse backgrounds ranging from basic chemistry to ophthalmic surgery that will advance or change the way we understand and/or treat vision-threatening diseases. TVST encourages the use of color, multimedia, hyperlinks, program code and other digital enhancements.