VISUAL FUNCTION IN YOUNG IDDM PATIENTS OVER 8 YEARS OF AGE - A 4-YEARLONGITUDINAL-STUDY

OBJECTIVE - To carry out a longitudinal study of visual functions in y oung patients over the age of 8 years with IDDM and to assess the impa ct of metabolic control on the presence of diabetic retinopathy. RESEA RCH DESIGN AND METHODS - There were 37 young IDDM patients from the Pa ediatric and Adolescent Clinic at the University Hospital of Wales stu died annually for 4 years, with a control group of 24 healthy subjects observed over a 2-year period. Assessment of visual functions include d visual acuity, color vision, and contrast sensitivity. Ophthalmoscop y and retinal photography were used to determine the presence or absen ce of diabetic retinopathy. In addition, pubertal status and metabolic control (glycosylated hemoglobin) were determined at each visit. RESU LTS - Patients with IDDM demonstrate abnormal color vision and contras t sensitivity compared with the control group (P < 0.05), but visual a cuity was unaffected. Visual Functions were not significantly differen t between those IDDM patients with and without retinopathy. After 4 ye ars, diabetic retinopathy was present in 43% of the group and was rela ted to diabetes duration and metabolic control (P < 0.05). CONCLUSIONS - Visual function testing could not distinguish between those IDDM pa tients with and without retinopathy, but the color vision and contrast sensitivity in those with IDDM were significantly impaired compared w ith the control group. The presence of retinopathy was related to the duration of diabetes and metabolic control. It is important to ensure that good glycemic control and regular attendance for retinopathy scre ening is encouraged in the adolescent patients.