ACCOMMODATIVE AMPLITUDES IN THE EARLY TREATMENT DIABETIC-RETINOPATHY STUDY - EDTRS REPORT NUMBER-21

Purpose: Accommodative amplitude in persons with diabetes was investig ated using data collected as part of the Early Treatment Diabetic Reti nopathy Study. Methods: Accommodative amplitude was measured at the ba seline visit in 1,058 patients who had good visual acuity and who were less than 46 years old. Risk factors for low accommodative amplitude at baseline were evaluated using multivariable linear regression. Chan ge in accommodative amplitude after photocoagulation was evaluated usi ng paired t tests and repeated measures analysis of variance for the 5 78 patients who underwent followup measurements at the 4-month visit. Results: Accommodative amplitudes in Early Treatment Diabetic Retinopa thy Study patients were lower than normal accommodative amplitudes. Ol der age (P < 0.001) and increased duration of diabetes (P < 0.01) were risk factors associated with low amplitudes of accommodation in the E arly Treatment Diabetic Retinopathy Study. Full scatter photocoagulati on was associated with an apparently transient additional reduction in accommodative amplitude; a one third diopter loss in accommodative am plitude was demonstrated only at the 4-month visit (P < 0.001). Conclu sion: This study demonstrates that diabetes and duration of diabetes, along with age, are important risk factors for reduced accommodative a mplitude. These factors along with an apparently transient decrease in accommodative amplitude following scatter photocoagulation should be considered when assessing the accommodative needs of patients with dia betes and when discussing side effects of full scatter photocoagulatio n.