(P22-015-25) Changes in Eyes Structure, Functional Vision and Carotenoid Status in Individuals With Pre-diabetes and Diabetes Compared to Ocular Healthy

Objectives: This study was designed to evaluate changes in visual function, retinal vasculature and carotenoid status in individuals with prediabetes and diabetes compared to healthy ocular individuals. Carotenoids serve as antioxidants and neuroprotective agents in the retina; hence, a declined visual function and changes to retinal health in eyes exposed to high glycemic load will be visible, and their corresponding ocular carotenoid status will decline.

Methods: We recruited 79 ocular healthy controls normoglycemic participants along with individuals with prediabetes and diabetes (mean age of 50.6±0.9 years). Vital signs (Arterial blood pressure, blood glucose, intraocular pressure, BMI), visual function components (contrast sensitivity, color vision), and macular pigment parameters (Macular Pigment Density, Skin Resonance Raman Spectrometry) were measured. Retinal Angio OCT Scans were performed to obtain foveal avascular zone area (FAZ), Vascular Density Index (VDI) in Superficial and Deep retinal layer. Independent t-test was performed to investigate the differences in the groups.

Results: The mean HbA1c% were 5.2±0.3 in healthy(n=52), 5.9±0.2 in prediabetes(n=22), and 7.4±2.1 in diabetes(n=15) participants. Individuals with diabetes and pre-diabetes showed lower MPOD (p < 0.05), large area and perimeter of the FAZ, and decreased VDI of the superficial & deep capillary plexus in the foveal region (P < 0.001) compared to ocular healthy. The prediabetes group showed a remarkably reduced thickness of foveal inner layers and Ganglion Cell Layers (P < 0.001, P=0.03). Contrast sensitivity thresholds for high spatial frequency (i.e. on 12 and 16 CPD) and color contrast vision red, blue and green were remarkably reduced in prediabetes and diabetes groups compared to healthy participants.

Conclusions: The carotenoid status of the eye as measured by MPOD was lower in eyes of individuals with diabetes and pre-diabetes. Additionally, structural changes in retina enlargement of FAZ and decline of microvasculature are observed. The diminished color vision and contrast sensitivity correspond with the early microvascular. Pre-diabetes may not be as innocuous to the eyes, and appropriate follow-up and management are needed to prevent irreversible damage.

Funding Sources: WesternU intramural grant and EyePromise unrestricted funding