Bangstad H J, Brinchmann-Hansen O, Hultgren S, Dahl-Jørgensen K, Hanssen K F
Aker Diabetes Research Centre, Aker University Hospital, Oslo, Norway.
Acta Ophthalmol (Copenh). 1994 Dec;72(6):668-73. doi: 10.1111/j.1755-3768.1994.tb04677.x.
We compared neurosensorial visual function by psychophysical tests (macular recovery time and contrast sensitivity) in two well matched groups of young Type 1 (insulin-dependent) diabetic patients with micro- and normoalbuminuria, respectively. The patients had normal visual acuity (> or = 1.0) and either no retinopathy or non-proliferative retinopathy. Thirty patients with microalbuminuria (albumin excretion > or = 15 micrograms/min in a least two out of three timed overnight urine samples) were matched (age, diabetes duration, mean one-year HbA1c, gender) with normoalbuminuric (n = 27) patients. Retinopathy (50 degree colour fundus photography) was assessed by counting microaneurysms and hemorrhages as 'red spots'. Contrast sensitivity was examined for the spatial frequencies of 1.5, 3, 6, 12 and 18 cycles per degree (cpd). Macular recovery time (nyctometry) refers to the time-related (2 min) ability of the retina to regain visual acuity following exposure to bright light (photostress). Contrast sensitivity score was reduced in patients with microalbuminuria compared to those without; 18 cpd (mean and 95% confidence intervals): [4.2 (3.8-4.7) vs 5.0 (4.6-5.4), p = 0.03]. Macular recovery performance was not significantly reduced: [21.0 arbitrary units (17.5-24.6) vs 26.0 (22.6-30.7), p = 0.12]. We conclude that impaired contrast sensitivity independent of background retinopathy is shown in a group of young Type 1 (insulin-dependent) diabetic patients with low-grade microalbuminuria compared to a group of patients with normoalbuminuria.
我们通过心理物理学测试（黄斑恢复时间和对比敏感度），对两组匹配良好的年轻1型（胰岛素依赖型）糖尿病患者的神经感觉视觉功能进行了比较，这两组患者分别患有微量白蛋白尿和正常白蛋白尿。患者视力正常（≥1.0），且无视网膜病变或非增殖性视网膜病变。30例微量白蛋白尿患者（在至少两份定时夜间尿样中白蛋白排泄量≥15微克/分钟）与正常白蛋白尿患者（n = 27）进行匹配（年龄、糖尿病病程、平均一年糖化血红蛋白、性别）。通过将微动脉瘤和出血计数为“红点”来评估视网膜病变（50度彩色眼底摄影）。检测了1.5、3、6、12和18周/度（cpd）空间频率下的对比敏感度。黄斑恢复时间（暗适应测量）是指视网膜在暴露于强光（光应激）后恢复视力的时间相关（2分钟）能力。与无微量白蛋白尿的患者相比，微量白蛋白尿患者的对比敏感度评分降低；18 cpd（均值和95%置信区间）：[4.2（3.8 - 4.7）对5.0（4.6 - 5.4），p = 0.03]。黄斑恢复表现未显著降低：[21.0任意单位（17.5 - 24.6）对26.0（22.6 - 30.7），p = 0.12]。我们得出结论，与一组正常白蛋白尿患者相比，一组患有低度微量白蛋白尿的年轻1型（胰岛素依赖型）糖尿病患者表现出与背景视网膜病变无关的对比敏感度受损。
