Vol 6, No 1 (2017)
Research paper
Published online: 2017-06-20

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The evaluation of ocular changes in prediabetic individuals

Anna Sokołowska-Oracz12, Paweł Piątkiewicz1
Pubmed: 12376491
Clin Diabetol 2017;6(1):8-16.

Abstract

Background. Prediabetes is the major risk factor for type 2 diabetes, but the prediabetic state itself is also associated with classical macrovascular and microvascular complications. Studies indicate that other ocular abnormalities can develop during the stage of prediabetes; however, data on the occurrence of ocular changes are limited. The aim of our study was to evaluate ocular changes in prediabetic individuals.

Material and methods. Sixty subjects (40 women, 20 men) aged 37–78, with impaired fasting glucose and/or impaired glucose tolerance, were enrolled in the study and compared with 30 volunteers (20 women, 10 men) without prediabetes, aged 39–75. Both groups of patients underwent a complete physical examination, biochemical tests and ophthalmic examination: visual acuity testing, colour vision and letter contrast sensitivity tests, anterior and posterior segment evalua­tion, intraocular pressure measurement, fundus photographs and optical coherence tomography. Prediabetic patients underwent examinations twice: on the 1st visit and on the 2nd visit after 9-month period.

Results. Ophthalmic examination revealed in prediabetic individuals as compared to healthy controls increased prevalence of cataract (31.67% vs. 6.67%; p < 0.05), corneal surface disorders (21.67% vs. 3.33%; p < 0.05), posterior vitreous detachments (76.67% vs. 55%; p < 0.05), arterial narrowing (81.67% vs. 63.33%; p < 0.05) and hypertension angiopathy (70% vs. 36.67%; p < 0.05). There were also differences between prediabetic and control groups in prevalence rate of retinopathy (8.33% vs. 3.33%; NS) and acquired colour vision impairment (8.33% vs. 0%, NS). When compared visit 1 to visit 2, statistically significant differences were observed in fasting plasma glucose level (106.9 vs. 104.1 mg/dL; p < 0.05) and HbA1c (5.80% vs. 5.99%; p < 0.05). There were no statistically significant differences in ocular changes; however, increased prevalence of retinopathy signs was noted during the examination after 9-month period (8.33% vs. 12.73%; NS).

Conclusion. Prediabetic subjects present increased prevalence of ocular disorders as compared to healthy population. Results of this study indicate that prediabetic state is the independent risk factor of these complications; although, many patients with prediabetes have other features of metabolic syndrome. The regular ophthalmic monitoring seems to be essential at the stage of prediabetes in order to detect ocular abnormalities and identify individuals at risk of other diabetic complications.

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