The Gaze Fixation Assessed by Microperimetry: A Useful Tool for the Monitoring of the Cognitive Function in Patients with Type 2 Diabetes

Ortiz-Zúñiga, Ángel M.; Simó‐Servat, Olga; Rojano-Toimil, Alba; Sebastián, Julia Vázquez-De; Castellano-Tejedor, Carmina; Hernández, Cristina; Simó, Rafael; Ciudin, Andreea

doi:10.3390/jpm11080698

Cited by 7 publications

(8 citation statements)

References 18 publications

(27 reference statements)

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“…Some studies have found that fixation stability is related to the cognitive function of patients. 15,16 Fixation stability contributes to the complex network of white matter, superior colliculus, parietal, and frontal cortex, while macular sensitivity depends on the conduction of various links in the visual pathway. 17 Zhu et al 18 have found a significant correlation between mean sensitivity and HbA1c in patients with DR, and time in range (the percentage of time that the target glucose is in the range of 3.9-10.0 mmol/L over 24 hours, as one of the markers of continuous blood glucose testing) of glucose was significant positively correlated with mean sensitivity.…”

Section: Discussionmentioning

confidence: 99%

Association of macular structure with microperimetry sensitivity following vitrectomy for proliferate diabetic retinopathy

Wang,

Shao,

Gong

et al. 2024

Retina

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Purpose: To evaluate macular sensitivity using microperimetry in patients with proliferate diabetic retinopathy following vitrectomy and to investigate the relationship between the sensitivity and foveal microstructures with optical coherence tomography/angiography. Methods: Eighty-four eyes of 84 patients with proliferative diabetic retinopathy, who were indicated for vitrectomy, had no intraocular surgery history 3 months preoperatively, and were able to ensure fundus examination after the vitrectomy, were included. A logMAR best-corrected visual acuity, macular sensitivity of microperimetry, macular retinal thickness, and macular vessel perfusion using optical coherence tomography/angiography were examined at 1 week, 1 month, and 3 months postoperatively. Results: The logMAR best-corrected visual acuity and mean macular sensitivity of patients with proliferative diabetic retinopathy improved postoperatively (P < 0.05). There was a significant correlation between best-corrected visual acuity and mean sensitivity (P < 0.05). Postoperative mean macular sensitivity was significantly correlated with outer retinal thickness in the 0 to 6 mm macular area (P < 0.05) and also significantly correlated with deep capillary plexus perfusion (P < 0.05). Fixation stability and mean macular sensitivity did not show any correlation with glycated hemoglobin, triglyceride, serum total cholesterol, carbamide, and creatinine and duration of diabetes mellitus (P > 0.05). Conclusion: Postoperative mean macular sensitivity was significantly correlated with outer retinal thickness and deep capillary plexus perfusion for patients with proliferative diabetic retinopathy. The authors found that the visual performance of patients can be evaluated by the outer retinal thickness and deep capillary plexus perfusion, so optical coherence tomography/angiography examination can be an important prognostic factor for visual performance in patients. Clinical Trial Registration: This trial is registered with the Chinese Clinical Trial Registry (http://www.chictr.org.cn; Registration No.: ChiCTR2100043399).

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Section: Discussionmentioning

confidence: 99%

Association of macular structure with microperimetry sensitivity following vitrectomy for proliferate diabetic retinopathy

Wang,

Shao,

Gong

et al. 2024

Retina

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“…The device automatically calculates the reliability index, which assesses the accuracy of the test. Furthermore, according to our previous results [ 10 , 13 ] we evaluated as part of GF: the bivariate contour ellipse area, as the preferred retinal loci to calculate fixation stability (BCEA): BCEA63% (1 standard deviation) and BCEA95% (2 standard deviations) areas. The BCEA is measured as a bivariate contour ellipse, expressed in “º 2 ”.…”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, by adding the GF parameters to the RS the probability to identify cognitive impairment significantly increased in an independent manner, with a sensitivity of 72.7% and sensibility of 87.9% [ 12 ], converting the retinal microperimetry into a potential useful tool for the screening of MCI in patients with T2D > 65 years. Additionally, we have recently evaluated the usefulness of retinal microperimetry as a monitoring tool for the cognitive function in patients > 65 years with T2D [ 13 ]. The annual worsening in cognitive function went in parallel with worsening of GF, suggesting this parameter can be a reliable and subtler tool for the monitoring of the cognitive function in patients with T2D.…”

Section: Introductionmentioning

confidence: 99%

Retinal sensitivity and gaze fixation evaluated by microperimetry in subjects with type 2 diabetes: two independent parameters that explore different neuronal circuits

Ortiz-Zúñiga

Rojano-Toimil

Rahnama

et al. 2023

J Endocrinol Invest

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Background and aims Retinal sensitivity (RS) and gaze fixation (GF) assessed by retinal microperimetry are useful and complementary tools for identifying mild cognitive impairment (MCI) in patients with type 2 diabetes (T2D). The hypothesis is that RS and GF examine different neural circuits: RS depends only on the visual pathway while GF reflects white matter complex connectivity networks. The aim of the study is to shed light to this issue by examining the relationship of these two parameters with visual evoked potentials (VEP), the current gold standard to examine the visual pathway. Materials and methods Consecutive T2D patients > 65 years were recruited from the outpatient clinic. Retinal microperimetry (MAIA 3rd generation) and visual evoked potentials (VEP) (Nicolet Viking ED). RS (dB), GF (BCEA63%, BCEA95%) (MAIA) and VEP (Latency P100ms, Amplitude75–100 uV) were analyzed. Results Thirty three patients (45% women, 72.1 ± 4.6 years) were included. VEP parameters significantly correlated with RS but not with GF. Conclusions These results confirm that RS but not GF depends on the visual pathway, reinforcing the concept that they are complementary diagnostic tools. Used together can further increase the value of microperimetry as screening test for identifying T2D population with cognitive impairment.

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“…Furthermore, we have recently evaluated the usefulness of retinal microperimetry as a monitoring tool for the cognitive function in patients >65 years with T2D ( 36 ). We found that the worsening in cognitive function went in parallel with worsening of gaze fixation, suggesting this parameter can be a reliable and more subtle tool for the monitoring of the cognitive function in patients with type 2 diabetes.…”

Section: New Emerging Methods For Screening and Monitoring Of Cogniti...mentioning

confidence: 99%

New methods for the diagnosis and monitoring of cognitive function in patients with type 2 diabetes

Ciudin

Simó

2022

Front. Endocrinol.

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The presence of type 2 diabetes acts as an accelerator of cognitive impairment (mild cognitive impairment and later dementia), with a significant impact on the management of the disease and its complications. Therefore, it is recommended to perform an annual evaluation of cognitive function in patients with diabetes older than 65 years. Current guidelines still recommend the use of the Minimental State Evaluation Test (MMSE) as screening test, but it has a modest sensitivity and specificity for identifying mild cognitive impairment. This represents an important gap because patients with mild cognitive impairment are at risk of progressing to dementia. The neurocognitive diagnosis is based on complex neuropsychological tests, which require specifically trained personnel and are time consuming, making its routine incorporation into daily clinical practice unfeasible. Therefore, at present there are no reliable biomarkers to identify patients with type 2 diabetes at increased risk of developing cognitive impairment. Since the brain and the retina have a common embryological origin, our Research Group, has worked over the last 10 years evaluating the usefulness of the retina as a “window” to the brain. We provided evidence that retinal microperimetry is a simple, feasible and useful tool for screening and monitoring cognitive function in patients with type 2 diabetes. We propose a review of actual tests recommended for screening of cognitive impairment as well as an update of new emerging methods, such as retinal microperimetry.

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The Gaze Fixation Assessed by Microperimetry: A Useful Tool for the Monitoring of the Cognitive Function in Patients with Type 2 Diabetes

Cited by 7 publications

References 18 publications

Association of macular structure with microperimetry sensitivity following vitrectomy for proliferate diabetic retinopathy

Association of macular structure with microperimetry sensitivity following vitrectomy for proliferate diabetic retinopathy

Retinal sensitivity and gaze fixation evaluated by microperimetry in subjects with type 2 diabetes: two independent parameters that explore different neuronal circuits

New methods for the diagnosis and monitoring of cognitive function in patients with type 2 diabetes

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