Autofluorescence of the crystalline lens in early and late onset diabetes.

Abstract

Blue/green autofluorescence (excitation around 420 to 430 nm, emission around 520 nm) ofthe crystalline lens has been studied by an in vivo photographic method in two populations of diabetics and controls. The populations consisted of a geographically based survivor group of 161 mixed early and late onset diabetics (and 133 non-diabetic controls) and a second group of 104 early onset insulin dependent diabetics (and 138 non-diabetic controls), the latter all with non-cataractous lenses.Powerful associations (p<10-6) were found between the presence ofdiabetes and increased lenticular autofluorescence in both populations. Among the mixed diabetics diabetic type was a significant factor after accounting for the effects of age and diabetic duration. In the early onset group (clear lenses) a powerful association existed between autofluorescence and diabetic duration (p=0000011) after allowing for the effect of age, while in a subgroup of late onset diabetics with clear lenses this effect was modest (p=0.015). In the early onset diabetic group diabetic retinopathy (p=00064) was associated with increased lenticular autofluorescence after allowing for the effects of age and diabetic duration. In addition a powerful interaction between diabetic duration and the presence of diabetic retinopathy (p<10-6) was found in this subgroup. Among the geographically based population of diabetics, increased nuclear brunescence was powerfully associated (p<10 6) with increased autofluorescence after allowing for the effects of age, diabetic duration, and type of diabetes. This association was not found in the non-diabetic population. Nonenzymatic glycosylation oflens proteins should be considered as a possible mechanism of production of the fluorogen with emission around 520 nm.

Simultaneous Noninvasive Clinical Measurement of Lens Autofluorescence and Rayleigh Scattering Using a Fluorescence Biomicroscope

“…23,[45][46][47][48][49] Furthermore, within the diabetes patient population, lens fluorescence is also correlated with the development of the diabetes-related pathologies of cataract and retinopathy [50][51][52] and with systemic pathologies.…”

Effect of Glycemic Control on Refractive Changes in Diabetic Patients With Hyperglycemia

“…Over an extended period of time, low grade myopia may develop secondary to an increase in lens thickness and change in the curvature of the lens surface in metabolically stable adult diabetic patients. [1][2][3][4] Transient refractive changes associated with changing plasma glucose concentrations are well recognized features of DM. It has been reported that hyperglycemia may lead to the development of myopia, while hypoglycemia may result in the development of hyperopia.…”

Cumulative glycaemia as measured by lens fluorometry: association with retinopathy in type 2 diabetes

“…A previous study also found associations between retinopathy and lens fluorescence in eyes with clear lenses in both early-and late-onset diabetes [4]. However, it was not population-based and did not include information about metabolic control or use a referenced method of retinopathy grading.…”

“…Lens fluorescence has been shown to increase with age [3], duration of diabetes [3,4], glycaemia [5] and smoking [6]. The presence of retinopathy in a clinic-based population of patients with variable diabetes duration and type has been found to be associated with higher levels of fluorescence measured by a method not correcting for intrinsic light absorption [4].…”

“…The presence of retinopathy in a clinic-based population of patients with variable diabetes duration and type has been found to be associated with higher levels of fluorescence measured by a method not correcting for intrinsic light absorption [4]. The aim of the present study was to investigate if retinopathy is associated with lens fluorescence in a population-based study of primarily newly diagnosed individuals with type 2 diabetes.…”