Delayed Visual Evoked Response is Linked to Vascular Endothelial Growth Factor and Autonomic Dysfunction in Type 2 Diabetes Mellitus

Abstract

Aims: In this study, we aimed to assess the link between visual evoked potentials (VEP), angiogenic marker (VEGF) and autonomic function tests in type-2 diabetes mellitus (T2DM). Methods: Age-matched 86 male subjects (44 type-2 diabetics on treatment and 42 normal healthy volunteers) were recruited for this study. Body mass index (BMI), basal cardiovascular parameters, spectral analysis of heart rate variability (HRV), were assessed. Fasting blood glucose, insulin, HOMA-IR and VEGF were estimated. The independent association of the P100 latency of VEP with VEGF was determined by multiple regression analysis. Results: LF-HF ratio a marker of sympathovagal balance, increased significantly (p=0.0287) in diabetic group compared to the control group. Comparison of visual evoked potentials between controls and diabetic groups showed significant increase in latency of P100 of both the eyes (right eye p<0.0001, left eye p=0.0003) among the cases. There was significant increase (p=0.0091) in VEGF in diabetic subjects when compared to control. Also positive and significant correlation of P100 latency of VEP with VEGF is seen in diabetics. Conclusions: There is delayed latency of VEP and increased VEGF in type 2 diabetic people. The correlation between VEP and VEGF could indicate the probable role of angiogenesis leading to reduced integrity of the neural pathways in T2DM.

Assessment of Visual Evoked Potential to Detect Visual Pathway Dysfunction in Gestational Diabetes Mellitus: A Longitudinal Case-Control Study With Post-partum Follow-up

“…AGE accumulation in the brain also creates an environment of increased inflammation and oxidative stress by acting through RAGE [24]. Such changes have the potential to induce demyelinating damages in the visual pathway, causing prolonged P100 latency [25]. Increased AGE levels increase the expression of vascular endothelial growth factor (VEGF) in retinal endothelial cells [26].…”

“…Increased AGE levels increase the expression of vascular endothelial growth factor (VEGF) in retinal endothelial cells [26]. VEGF increases the permeability of retinal blood vessels and causes the release of inflammatory cytokines, inducing metabolic changes in the retinal environment that can be manifested as prolonged P100 latency [25]. More studies are required to ascertain the exact pathophysiological mechanism of change in VEP during GDM.…”