Daley M L, Watzke R C, Riddle M C
Division of Neurosurgery, School of Medicine, Oregon Health Sciences University, Portland 97201.
Diabetes Care. 1987 Nov-Dec;10(6):777-81. doi: 10.2337/diacare.10.6.777.
Existing methods for early detection of ocular injury from diabetes have serious limitations. We describe a new method, measuring visual flicker discrimination of the blue-sensitive mechanism of vision. This method is noninvasive, quantitative, and capable of distinguishing two types of impairment. Blue-flicker discrimination was measured in 10 adults with type I (insulin-dependent) diabetes for less than 5 yr. Although no evidence of diabetic changes was detected by careful ophthalmic examination by an experienced ophthalmologist, 12 of 19 eyes (63%) had flicker discrimination scores considered abnormal in comparison with those of a control group, and 8 of 10 subjects (80%) had at least 1 eye with abnormal performance. In all but 2 abnormal eyes the deficit of blue-flicker discrimination was of the "absorptive" type, suggesting increased absorbance or scattering of blue light in the optical media. These data show that a functional impairment of vision can be measured very early in the course of type I diabetes, before visible retinopathy is present, and suggest this test procedure may have both investigative and clinical applications.
现有的糖尿病性眼损伤早期检测方法存在严重局限性。我们描述了一种新方法，即测量视觉对蓝光敏感机制的闪烁辨别能力。该方法是非侵入性的、定量的，并且能够区分两种类型的损伤。对10名患I型（胰岛素依赖型）糖尿病不到5年的成年人进行了蓝光闪烁辨别能力测量。尽管经验丰富的眼科医生通过仔细的眼科检查未发现糖尿病性改变的证据，但与对照组相比，19只眼中有12只眼（63%）的闪烁辨别分数被认为异常，10名受试者中有8名（80%）至少有1只眼表现异常。除2只异常眼外，所有异常眼中蓝光闪烁辨别能力的缺陷均为“吸收性”类型，这表明光介质中蓝光的吸光度或散射增加。这些数据表明，在I型糖尿病病程早期，在出现可见的视网膜病变之前，就可以测量到视力的功能性损伤，并且表明该测试程序可能具有研究和临床应用价值。
