Visual Psychophysics in Diabetic Retinopathy

Midena, Edoardo; Vujosevic, Stela

doi:10.1007/978-1-60761-150-9_6

Cited by 7 publications

(7 citation statements)

References 103 publications

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“…The hypothesis according to which neurodegeneration precedes the vascular one is confirmed by some electrophysiological and psychophysical studies, which show that the alterations are present even before the microvascular damage becomes ophthalmoscopically or angiographically visible. Such retinal function alterations mainly consist in contrast sensitivity loss, altered color perception, and failure of retinal recovery time [5, 6]. Moreover, it has been observed that in diabetic mice the oscillatory potentials of the electroretinogram (ERG) have increased peak latencies and/or reduced amplitudes, suggesting a compromised inner retinal function secondary to neuronal transmission alterations or to the combined loss of amacrine and ganglion cells [7].…”

Section: Introductionmentioning

confidence: 99%

Retinal Layers Changes in Human Preclinical and Early Clinical Diabetic Retinopathy Support Early Retinal Neuronal and Müller Cells Alterations

Vujosevic

Midena

2013

Journal of Diabetes Research

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Purpose. To evaluate the changes in thickness of individual inner and outer macular and peripapillary retinal layers in diabetes. Methods. 124 subjects (124 eyes) were enrolled: 74 diabetics and 50 controls. Macular edema, proliferative diabetic retinopathy (DR), any intraocular treatment and refractive error >6 diopters were the main exclusion criteria. Full ophthalmic examination, stereoscopic fundus photography, and spectral domain-OCT were performed. After automatic retinal segmentation (layering) in 5 layers, the thickness of each layer was calculated, and values compared among groups. Results. Thirty patients had no DR, 44 patients had non proliferative DR. A significant increase of inner plexiform and nuclear layers was found in DR eyes versus controls (P < 0.001). A significant decrease (P < 0.01) of retinal nerve fiber layer (RNFL) and at specific sites of retinal ganglion cell layer (P = 0.02) was documented in the macula. In the peripapillary area there were no differences between diabetics and controls. Conclusions. Decreased RNFL thickness and increased INL/OPL thickness in diabetics without DR or with initial DR suggest early alterations in the inner retina. On the contrary, the outer retina seems not to be affected at early stages of DM. Automatic intraretinal layering by SD-OCT may be a useful tool to diagnose and monitor early intraretinal changes in DR.

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Section: Introductionmentioning

confidence: 99%

Retinal Layers Changes in Human Preclinical and Early Clinical Diabetic Retinopathy Support Early Retinal Neuronal and Müller Cells Alterations

Vujosevic

Midena

2013

Journal of Diabetes Research

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179

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“…It is well established that visual function can be decreased in diabetic patients even without any clinical sign of diabetic retinopathy [79]. Decreased foveal function may be evaluated with contrast sensitivity, threshold Amsler grid, and more recently with microperimetry [79].…”

Section: Metamorphopsia In Diabetic Retinopathymentioning

confidence: 99%

“…Decreased foveal function may be evaluated with contrast sensitivity, threshold Amsler grid, and more recently with microperimetry [79]. The presence of metamorphopsia was evaluated by Wall et al [25] using 4 different types of Amsler grids (low-intensity grids) in diabetic patients without and with background diabetic retinopathy.…”

Section: Metamorphopsia In Diabetic Retinopathymentioning

confidence: 99%

Metamorphopsia: An Overlooked Visual Symptom

2015

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Metamorphopsia is a common symptom in different macular disorders. Micropsia and macropsia are special types of metamorphopsia. Recent theories suggest that both retinal and cortical mechanisms are involved in the development and changes of metamorphopsia. Different functional tests have been proposed for the evaluation of metamorphopsia: from the Amsler grid to the hand-held mobile devices for home monitoring. This review addresses some new insights into the pathophysiology of metamorphopsia and different available tests for the evaluation of this symptom in most common macular disorders. The importance of quantification of metamorphopsia in macular diseases is confirmed by the most recent therapeutic approaches.

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“…Such retinal changes in function mainly consist of sensitivity loss, altered color perception, and failure of retinal recovery time [35,36] . Moreover, it has been observed that in diabetic mice the oscillatory potentials of the electroretinogram have increased peak latencies and/or reduced amplitudes, suggesting a compromised inner retinal function secondary to altered neuronal transmission or to the combined loss of amacrine and ganglion cells [37] .…”

Section: Neuronal Cell Degenerationmentioning

confidence: 99%

Emerging Insights into Pathogenesis

Midena

Pilotto

2017

Developments in Ophthalmology

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Diabetic retinopathy (DR) is a frequent complication of diabetes mellitus (DM). Persistent hyperglycemia leads to the activation of multiple cellular pathways involved in the pathogenesis of DR, resulting in increased inflammation, oxidative stress, and vascular dysfunction. DR has been considered a "chronic, low-grade inflammatory disease of the retina". However, an increasing body of evidence suggests that inflammation and neurodegeneration both occur in human diabetes even before the development of clinical signs of DR. One of the first signs of inflammation in DM is the activation of retinal glia cells (RGC). RGC include microglia and macroglial cells (Müller cells and astrocytes). Activated RGC release cytotoxic substances responsible for the recruitment of leukocytes, blood-retinal barrier breakdown, direct glial dysfunction, and neuronal cell death. Recently, many inflammatory mediators, growth factors, and other molecules have been investigated in human vitreous and aqueous humor samples to better understand, in vivo, the multiple pathways and mechanisms leading to the pathogenesis of DR and its complications, such as diabetic macular edema, with potential for more tailored treatment. Moreover, non-invasive techniques, like optical coherence tomography, have allowed to detect new findings in the retinal layers, such as the hyperreflective intraretinal spots, which have been hypothesized to represent an in vivo marker of microglial activation, and early neural cell loss, confirming the hypothesis that neurodegeneration occurs early both in type 1 and 2 diabetes. These new emerging insights foster a better understanding of the pathogenesis of DR, which can no longer be considered as a pure retinal vascular complication of DM.

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Visual Psychophysics in Diabetic Retinopathy

Cited by 7 publications

References 103 publications

Retinal Layers Changes in Human Preclinical and Early Clinical Diabetic Retinopathy Support Early Retinal Neuronal and Müller Cells Alterations

Retinal Layers Changes in Human Preclinical and Early Clinical Diabetic Retinopathy Support Early Retinal Neuronal and Müller Cells Alterations

Metamorphopsia: An Overlooked Visual Symptom

Emerging Insights into Pathogenesis

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