Characterizing the spatial distribution of color vision deficiencies in diabetes and prediabetes

2型糖尿病是美国劳动年龄人群失明的主要原因。糖尿病导致视力丧失 眼病，包括糖尿病视网膜病变和浮肿。糖尿病眼病可以出现在任何视网膜上 并损害内视网膜和外视网膜。除了血糖控制之外，没有其他治疗方法 早期糖尿病眼病。早期诊断和检测的方法，特别是在特定地点的情况下， 这很重要，因为它们可以帮助医生和患者主动延缓视网膜病变和视力丧失。当前 临床检查，如多焦视网膜电图(MfERG)、眼部相干断层扫描(OCT)和彩色 视力评估已被广泛证明在早期糖尿病中会发生改变。然而，这方面的工作很少。 以表征糖尿病视网膜的局限性色觉缺陷，目前尚不清楚 哪些细胞与色觉丧失有关。为了解决这些差距，拟议中的研究将测试 患者使用定制的色度微视野来精确量化视觉上的颜色辨别 菲尔德。在目标1中，糖尿病患者和糖尿病前期患者的颜色阈值将显示不同于 视力正常的对照组受试者，其损害程度和检测变异与HbA1c相关 级别。除了蓝-黄通道的预期减少外，还假设红-绿 路径也将显示不足，解决S是否单独失去锥体的争议 是糖尿病患者色觉缺陷的根本原因。在目标2中，增加了共同注册的结构和功能 MfERG、OCT和眼底照相的测量将显示空间局部性损失与 对于受损的区域，为未来旨在早期发现的纵向研究奠定基础 糖尿病和糖尿病前期的受影响地区。预测哪些地区受影响最严重的能力可能 构成了该病诊断和治疗方面的重大进步，并有可能创造新的结局 未来研究和试验的要点。糖尿病在美国和世界范围内已经达到流行的程度， 更好地了解这种疾病的影响可能会改善这些患者的生活。

Type 2 Diabetes is a leading cause of blindness in working-aged Americans. Vision loss comes from diabetic eye disease which includes diabetic retinopathy and edema. Diabetic eye disease can appear at any retinal location and damages both the inner and outer retina. There are no treatments outside of glycemic control for early diabetic eye disease. Methods for early diagnosis and detection, especially if location-specific, are important as they can help doctors and patients to be proactive in delaying retinopathy and vision loss. Current clinical tests such as multifocal electroretinograms (mfERG), ocular coherence tomography (OCT), and color vision assessment have been widely shown to be altered in early diabetes. However, there has been little work to characterize localized color vision deficiencies across the diabetic retina, and it remains unclear exactly which cells are implicated in color vision losses. To address these gaps, the proposed research will test patients using a custom chromatic microperimeter to precisely quantify color discrimination across the visual field. In Aim 1, color thresholds from patients with diabetes and prediabetes will be shown to differ from normally sighted control subjects, with the degree of impairment and variation in testing correlated with HbA1c levels. In addition to expected reductions in the blue-yellow pathway, it is hypothesized that the red-green pathway will show a deficiency as well, addressing the controversy concerning whether S-cone loss alone underlies the color vision deficits in diabetes. In Aim 2, additional co-registered structural and functional measures from mfERG, OCT, and fundus photography will reveal that spatially localized losses are associated with regions of damage, laying the foundation for future longitudinal studies aimed at the early detection of affected regions in diabetes and prediabetes. The ability to predict which areas are most affected could constitute a significant advance in diagnosis and management of this disease and potentially create new end points for future studies and trials. Diabetes has reached epidemic proportions in the US and worldwide and better understanding the effects of the disease could lead to improvements in the lives of these patients.