Abstract
Purpose :
Type 1 Diabetes Mellitus (T1D) is an autoimmune disease that can affect ocular health over the lifetime of affected individuals. Pilot cohort study examined trends in vegetarians vs. non-vegetarians lipofuscin accumulation in the retinal-pigmented epithelium (RPE) of T1D subjects using fundus auto-fluorescence (FAF) imaging. Results were compared to those from our previous studies of lipofuscin concentration in vegetarian vs. non-vegetarian in non T1D subjects.
Methods :
FAF imaging was performed on 14 subjects using a Canon CR-2 Plus AF retinal camera fitted with an exciter (535-585 nm wide band) and barrier filter (605-715nm). All monochromatic images were captured without the use of mydriatic agents at an angle of 45° and corrected for auto-exposure (Adobe Photoshop V 7.02). Auto-fluorescence (AF) measurement was a 35.5 mm2 rectangle in the ganglion cell complex (GCC) for lipofuscin accumulation. Standardized scores were obtained by leveling AF at the optic nerve to correct for baseline fluorescence. Mean, SD, and T-tests were used to compare AF in vegetarians vs. non-vegetarians to determine significant changes in lipofuscin levels.
Results :
Fourteen subjects (14 eyes, 50% females, 100% of Caucasian decent) were analyzed. Dietary mix was 50% vegetarians and 50% non-vegetarians (self-reported as eating meat for more than ½ their life). AF scores between vegetarian and non-vegetarian T1D subjects were significantly different (p<0.05), as seen in Table 1. The average levels of AF for each age-matched dietary group are included in Table 2.
Conclusions :
In this small pilot cohort study, our results showed that younger T1D vegetarians (mean age=20) had mean lipofuscin levels comparable to that of older healthy vegetarians (mean age = 47.23) more than double their age. This trend suggests an accelerated increase in lipofuscin levels at a younger age in subjects with T1D compared to healthy subjects. We noted that non-T1D vegetarians (mean age=22.57) had lipofuscin levels of 81.31 that were similar to the vegetarian T1D subjects (mean age=20) lipofuscin levels of 84.84, as seen in Table 3. Vegetarian T1D subjects also had significantly lower lipofuscin levels than non-vegetarian T1D subjects. These results support our previous studies that found a trend of lower lipofuscin levels with vegetarian diet compared to non-vegetarian diet in healthy subjects. Further studies will be done with larger sample sizes.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.