Are We Overlooking the Neurodegeneration in the Early Stage of Type 1 Diabetes Mellitus without Visual Impairment or Diabetic Retinopathy: Is It Probably Occurred before Retinal Vasculature Dysfunction?

PURPOSE: Using electrophysiology (ERG) to investigate the early alterations of retinal function in diabetic children and adolescents without diabetic retinopathy (DR) or visual impairment (VI).

METHODS

We recorded and compared the data of full-field flicker ERGs between 59 normal subjects and 60 children and adolescents with type 1 diabetes mellitus (T1DM) from the Children's Hospital of Fudan University in Shanghai.

RESULTS

In both groups, patients with diabetes and healthy controls were matched for age, gender, weight, height, BMI, intraocular pressure (IOP), and best-corrected visual acuity (BCVA). Among the parameters of the outcomes of ERG, the implicit time in eyes in DM patients was significantly prolonged compared to normal eyes (p = .008, 16 Td-s; p = .000, 32 Td-s). In the case group, we found significantly positive correlation between implicit time and BMI (p < .05), as well as implicit time and axial length (AL).

CONCLUSIONS

The study reveals that the dysfunction of retina in DM children can be detected with ERGs. It also shows that hyperglycemia has an impact on the occurrence of neurodegeneration in the early stage of DM.