PurposeTo elucidate the relationship between disorganization of retinal inner layers (DRILs) and retinal function in diabetic patients without diabetic retinopathy (DR) and with nonproliferative DR, but without diabetic macular edema (DME).MethodsFifty-seven participants with diabetes mellitus (DM) and 18 healthy controls underwent comprehensive ophthalmic examination, fundus photography, and spectral-domain optical coherence tomography. Scans of the fovea were evaluated for the presence of DRIL. Retinal function was evaluated using Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity, the quick contrast sensitivity function (qCSF) on the AST Sentio Platform, short-wavelength automated perimetry (SWAP), standard automated perimetry (SAP), and frequency doubling perimetry (FDP). ANOVA and Kruskal-Wallis were used to compare retinal function in subjects with and without DRIL. Tukey-Kramer test and Wilcoxon were used for post hoc analysis.ResultsDRIL was identified in 9 of 57 diabetic subjects. DRIL subjects had higher body mass index and longer diabetes duration compared to diabetic subjects without DRIL (P = 0.03 and P = 0.009, respectively). Subjects with DRIL had reduced ETDRS visual acuity (P = 0.003), contrast sensitivity function (P = 0.0003), and SAP performance (PSD, P < 0.0001) compared to controls and diabetic subjects without DRIL. Structural analysis revealed inner retinal thinning, and some outer retinal thinning, associated with DRIL.ConclusionsDiabetic subjects with DRIL have reduced retinal function compared to those without DRIL, and defective retinal lamination may be an early cellular consequence of diabetes responsible for this in some patients. Following further longitudinal studies, DRIL may be a readily available and reliable structural biomarker for reduced retinal function in early diabetic neuroretinal disease.

Background Ethnic concordance between physicians and patients improves compliance and therapeutic benefit. Current literature shows a lack of diversity within ophthalmology. Thus, we aimed to develop a longitudinal mentorship program between first year ophthalmology residents (PGY2s) and first year medical students (M1s) coming from minority communities underrepresented in medicine (URM) to provide early exposure to the field. Methods M1 members of URM organizations were recruited and paired with PGY2 ophthalmology residents in a mentorship program between 2017 and 2019. All participants were surveyed twice annually. Results All 2017 M1s stated increased interest in ophthalmology, felt “satisfied” or “very satisfied” with the program, and completed all requirements. At the year-end, the mean educational value of the program for 2017 M1s was rated 4.33/5, and interest in ophthalmology 4.67/5. Quality of the clinical experiences for 2017 PGY2s 3.5/5, and the overall effectiveness of the program 3.5/5. At the year-end, the average educational value of the program for 2018 M1s was 4.4/5, and interest in ophthalmology 4.0/5. Quality of the clinical experiences for 2018 PGY2s was 3.1/5, and the overall effectiveness of the program was 3.4/5. Conclusion Our “pipeline” program represents an ongoing effort to increase URM interest in ophthalmology. Continued assessment to identify areas for growth and improvement can optimize the program to aid other programs in initiating efforts to tackle this important issue.