Dosso A A, Yenice-Ustun F, Sommerhalder J, Golay A, Morel Y, Leuenberger P M
University Eye Clinic, Geneva, Switzerland.
Arch Ophthalmol. 1998 Oct;116(10):1316-20. doi: 10.1001/archopht.116.10.1316.
To evaluate contrast sensitivity in insulin-resistant obese patients and in aretinopathic diabetic patients.
Contrast sensitivity was measured at 3 letter sizes (44 x 44, 9 x 9, and 5 x 5 mm) in mesopic (5 candela [cd]/m2) and low photopic (85 cd/m2) vision in 20 dyslipidemic obese patients with insulin resistance, 20 age-matched patients with type 2 diabetes mellitus, and 20 aged-matched healthy control subjects.
Significant loss of contrast sensitivity at all 3 letter sizes was observed in low photopic vision (at 44 x 44-mm letter size, control vs obese, P<.002, and control vs diabetic, P<.005; at 9 x 9-mm letter size, control vs obese, P<.02, and control vs diabetic, P<.001; and at 5 x 5-mm letter size, control vs obese, P<.05, and control vs diabetic, P<.005) and mesopic vision (at 44 x 44-mm letter size, control vs diabetic, P<.005; at 9 x 9-mm letter size, control vs obese, P<.005, and control vs diabetic, P<.01; and at 5 x 5-mm letter size, control vs obese, P<.005, and control vs diabetic, P<.001) in insulin-resistant obese and diabetic patients.
The results suggest that an early neurosensory dysfunction may occur without visible vascular involvement and without overt hyperglycemia.
评估胰岛素抵抗肥胖患者和视网膜病变糖尿病患者的对比敏感度。
对20例伴有胰岛素抵抗的血脂异常肥胖患者、20例年龄匹配的2型糖尿病患者以及20例年龄匹配的健康对照者,在中亮度(5坎德拉[cd]/m²)和低明视觉(85 cd/m²)条件下,测量3种字母大小(44×44、9×9和5×5毫米)的对比敏感度。
在低明视觉(在44×44毫米字母大小下,对照组与肥胖组相比,P<0.002,对照组与糖尿病组相比,P<0.005;在9×9毫米字母大小下,对照组与肥胖组相比,P<0.02,对照组与糖尿病组相比,P<0.001;在5×5毫米字母大小下,对照组与肥胖组相比,P<0.05,对照组与糖尿病组相比,P<0.005)和中亮度视觉(在44×44毫米字母大小下,对照组与糖尿病组相比,P<0.005;在9×9毫米字母大小下,对照组与肥胖组相比,P<0.005,对照组与糖尿病组相比,P<0.01;在5×5毫米字母大小下,对照组与肥胖组相比,P<0.005,对照组与糖尿病组相比,P<0.001)中,胰岛素抵抗肥胖患者和糖尿病患者在所有3种字母大小下均出现了显著的对比敏感度损失。
结果表明,在无明显血管受累且无明显高血糖的情况下,可能会发生早期神经感觉功能障碍。