Introduction:
Vision loss is a major complication of diabetes mellitus (DM). Studies have showed that favorable serum lipid profile has been related to a significantly lower risk in peripheral neuropathy; however, its relationship with diabetic lesions in the visual pathway is unknown. Visual evoked response (VER), a sensitive and objective ophthalmic and neurological measurement, has been used frequently in type I DM patients to assess the functional abnormality in visual pathway. In this study, we apply VER to evaluate the effect of serum lipid level and glucose level on the visual pathway in type II diabetic patients.Asian Americans have been known to have higher prevalence of diabetes and diabetic visual disturbances than their non-Hispanic white counterparts. We use VER to examine the ethnic-specific effect of serum lipid level and glucose level on visual abnormalities in Asian American (AA) and Caucasian type II diabetic patients.
Purpose:
To use the VER to analyze the relationship between visual function and serum lipids in Asian American and Caucasian type II diabetic patients with good vision.
Methods:
Subjects: 32 patients, 64 eyes, 16 AA and 16 Caucasian age-matched pairs. VER (ISCEV protocol, LKC UTAS System). Inclusion criteria: 20/20-20/60 vision, lipid profiles, FBS, HBA1c, dilated funduscopic exam. Analysis was done with retrospective chart review, Fisher’s exact test, and student’s t-test.
Results:
Conclusions:
This pilot study is the first to suggest that serum lipids show a significant effect on VER in diabetics. Moreover, we found that VER exhibits differential susceptibility to unfavorable serum lipid profile between Asian and Caucasian diabetic patients. Interestingly, in our study, elevated LDL has no added effect on VER in diabetics while lower HDL affects Caucasian diabetics greatly. Further large-scale studies are needed to delineate the effect of serum lipids on the visual system.
Keywords: diabetic retinopathy • lipids • electrophysiology: clinical