0
July 1986, Vol 104, No. 7 >
ARTICLE | July 1986

Diabetic Retinopathy Viewed as a Neurosensory Disorder FREE

George H. Bresnick, MD
Arch Ophthalmol. 1986;104(7):989-990. doi:10.1001/archopht.1986.01050190047037
Text Size: A A A
Published online
Article
References
Comments

Diabetic retinopathy is usually considered to be a disease of the retinal blood vessels, capable of causing visual deficits from macular edema, vitreous hemorrhage, and vitreoretinal tractional complications. However, it may also be useful to view diabetic retinopathy more broadly as a neurosensory disorder with functional deficits reflecting the systemic and local metabolic defects of diabetes mellitus, as well as the more obvious retinal vascular changes. To call diabetic retinopathy a disease only of the retinal blood vessels is analogous to considering diabetic neuropathy as a disease only of the neural vessels; while the vascular component is obviously important, it may not be the sole or even the primary cause of dysfunction.

See also p 997.

To demonstrate neurosensory deficits in diabetes as in other retinal disorders, testing more sophisticated than routine visual acuity measurement is required. An apt example is the demonstration by Higgins et al in this issue

REFERENCES

1 +
Higgins KE, Meyers SM, Jaffe MJ, et al:  Temporary loss of foveal contrast sensitivity associated with panretinal photocoagulation . Arch Ophthalmol 1986;;104:997-1003.
2 +
Roy MS, Gunkel RD, Podgor MJ:  Color vision defects in early diabetic retinopathy . Arch Ophthalmol 1986;;104:225-228.
3 +
Zisman F, Adams AJ:  Spectral sensitivity of cone mechanisms in juvenile diabetics . Doc Ophthalmol Proc 1982;;33:127-131.
4 +
Huie K, Adams AJ, Schefrin BE:  A simple clinical test of blue cone sensitivity . Invest Ophthalmol Vis Sci 1985;;26( (suppl) ):215.
5 +
Sokol S, Moskowitz A, Skarf B, et al:  Contrast sensitivity in diabetics with and without background retinopathy . Arch Ophthalmol 1985;;103:51-54.
6 +
Shafour M, Foulds WS, Allan D, et al:  Contrast sensitivity in diabetic subjects with and without retinopathy . Br J Ophthalmol 1982;;66:492-495.
7 +
Hyvarinen L, Laurinen P, Rovamo J:  Contrast sensitivity in evaluation of visual impairment due to diabetes . Acta Ophthalmol 1983;;61:94-101.
8 +
Hirsch J, Puklin JE:  Reduced contrast sensitivity may precede clinically observable retinopathy in type I diabetes , in Henkind P (ed): Acta XXIV International Congress of Ophthalmology, San Francisco, 1982 . New York, JB Lippincott, 1983;, pp 719-724.
9 +
Yamazaki H, Adachi-Usami E, Chiba J:  Contrast thresholds of diabetic patients determined by VECP and psychophysical methods . Acta Ophthalmol 1982;;60:386-392.
10 +
Regan D, Neima D:  Low contrast letter charts in early diabetic retinopathy, ocular hypertension, glaucoma, and Parkinson's disease . Br J Ophthalmol 1984;;68:885-889.
11 +
Della Sala S, Bertoni G, Somazzi L, et al:  Impaired contrast sensitivity in diabetic patients with and without retinopathy: A new technique for rapid assessment . Br J Ophthalmol 1985;;69:136-142.
12 +
Puvanendran K, Devathasan G, Wong PK:  Visual evoked responses in diabetes . J Neurol Neurosurg Psychiatry 1983;; 46:643-647.
13 +
Yonemura D, Kawasaki K:  New approaches to ophthalmic electrodiagnosis by retinal oscillatory potentials, drug-induced responses from retinal pigment epithelium, and cone potential . Doc Ophthalmol 1974;;48:163-222.
14 +
Lauritzen T, Frost-Larsen K, Larsen H-W, et al:  Effect of one year of near-normal blood glucose . Lancet 1983;;1:200-204.
15 +
Simonsen SE:  Prognostic value of ERG (oscillatory potential) in selecting juvenile diabetics at risk of developing proliferative retinopathy . Metab Pediatr Ophthalmol 1981;;5:55-61.
16 +
Bresnick GH, Korth K, Groo A, et al:  Electroretinographic oscillatory potentials predict progression of diabetic retinopathy . Arch Ophthalmol 1984;;102:1307-1311.
17 +
Frost-Larsen K, Larsen HW:  Nyctometry: A new screening method for selection of patients with simple diabetic retinopathy who are at risk of developing proliferative retinopathy . Acta Ophthalmol 1983;;61:353-361.
18 +
Frost-Larsen K, Larsen HW, Simonsen SE:  Oscillatory potential and nyctometry in insulin-dependent diabetics . Acta Ophthalmol 1980;;58:879-888.

First Page Preview

First page PDF preview

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Higgins KE, Meyers SM, Jaffe MJ, et al:  Temporary loss of foveal contrast sensitivity associated with panretinal photocoagulation . Arch Ophthalmol 1986;;104:997-1003.
2 +
Roy MS, Gunkel RD, Podgor MJ:  Color vision defects in early diabetic retinopathy . Arch Ophthalmol 1986;;104:225-228.
3 +
Zisman F, Adams AJ:  Spectral sensitivity of cone mechanisms in juvenile diabetics . Doc Ophthalmol Proc 1982;;33:127-131.
4 +
Huie K, Adams AJ, Schefrin BE:  A simple clinical test of blue cone sensitivity . Invest Ophthalmol Vis Sci 1985;;26( (suppl) ):215.
5 +
Sokol S, Moskowitz A, Skarf B, et al:  Contrast sensitivity in diabetics with and without background retinopathy . Arch Ophthalmol 1985;;103:51-54.
6 +
Shafour M, Foulds WS, Allan D, et al:  Contrast sensitivity in diabetic subjects with and without retinopathy . Br J Ophthalmol 1982;;66:492-495.
7 +
Hyvarinen L, Laurinen P, Rovamo J:  Contrast sensitivity in evaluation of visual impairment due to diabetes . Acta Ophthalmol 1983;;61:94-101.
8 +
Hirsch J, Puklin JE:  Reduced contrast sensitivity may precede clinically observable retinopathy in type I diabetes , in Henkind P (ed): Acta XXIV International Congress of Ophthalmology, San Francisco, 1982 . New York, JB Lippincott, 1983;, pp 719-724.
9 +
Yamazaki H, Adachi-Usami E, Chiba J:  Contrast thresholds of diabetic patients determined by VECP and psychophysical methods . Acta Ophthalmol 1982;;60:386-392.
10 +
Regan D, Neima D:  Low contrast letter charts in early diabetic retinopathy, ocular hypertension, glaucoma, and Parkinson's disease . Br J Ophthalmol 1984;;68:885-889.
11 +
Della Sala S, Bertoni G, Somazzi L, et al:  Impaired contrast sensitivity in diabetic patients with and without retinopathy: A new technique for rapid assessment . Br J Ophthalmol 1985;;69:136-142.
12 +
Puvanendran K, Devathasan G, Wong PK:  Visual evoked responses in diabetes . J Neurol Neurosurg Psychiatry 1983;; 46:643-647.
13 +
Yonemura D, Kawasaki K:  New approaches to ophthalmic electrodiagnosis by retinal oscillatory potentials, drug-induced responses from retinal pigment epithelium, and cone potential . Doc Ophthalmol 1974;;48:163-222.
14 +
Lauritzen T, Frost-Larsen K, Larsen H-W, et al:  Effect of one year of near-normal blood glucose . Lancet 1983;;1:200-204.
15 +
Simonsen SE:  Prognostic value of ERG (oscillatory potential) in selecting juvenile diabetics at risk of developing proliferative retinopathy . Metab Pediatr Ophthalmol 1981;;5:55-61.
16 +
Bresnick GH, Korth K, Groo A, et al:  Electroretinographic oscillatory potentials predict progression of diabetic retinopathy . Arch Ophthalmol 1984;;102:1307-1311.
17 +
Frost-Larsen K, Larsen HW:  Nyctometry: A new screening method for selection of patients with simple diabetic retinopathy who are at risk of developing proliferative retinopathy . Acta Ophthalmol 1983;;61:353-361.
18 +
Frost-Larsen K, Larsen HW, Simonsen SE:  Oscillatory potential and nyctometry in insulin-dependent diabetics . Acta Ophthalmol 1980;;58:879-888.

Correspondence

Submit a Letter
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

© 2012 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems