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

2型糖尿病是导致美国工作年龄人群失明的主要原因。糖尿病导致视力下降 眼部疾病，包括糖尿病视网膜病变和水肿。糖尿病性眼病可以出现在任何视网膜病变。 它的位置和损害的内部和外部视网膜。除了血糖控制外，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，特别是如果位置特异性， 重要的是，它们可以帮助医生和患者积极主动地延缓视网膜病变和视力丧失。电流 临床测试，如多焦视网膜电图（mfERG）、眼相干断层扫描（OCT）和彩色 已经广泛地表明，视力评估在早期糖尿病中改变。然而， 来描述糖尿病视网膜的局部色觉缺陷， 这些细胞与色觉丧失有关。为了解决这些差距，拟议的研究将测试 患者使用定制的彩色微视野计精确量化整个视觉的颜色辨别力， 领域在目标1中，来自糖尿病和前驱糖尿病患者的颜色阈值将被示出为不同于 视力正常的对照受试者，其受损程度和检测变异与HbA 1c相关 程度.除了蓝-黄途径的预期减少外，据推测， 通路也将显示出缺陷，解决了关于S-锥丢失是否单独 是糖尿病色觉缺陷的基础在目标2中，额外的共同注册的结构和功能 mfERG、OCT和眼底照相术的测量结果将揭示空间定位损失与 与受损区域，奠定了基础，为未来的纵向研究，旨在早期发现 糖尿病和糖尿病前期的受影响区域。预测哪些地区受影响最严重的能力可能会 构成了该疾病诊断和管理的重大进步，并可能创造新的终点。 为今后的研究和试验提供了依据。糖尿病在美国和世界范围内已达到流行病的程度， 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.