Fixation characteristics among subjects with diabetes: SN-DREAMS II, Report No. 5



      To evaluate fixation and scotoma characteristics among subjects with diabetes in a population-based study.


      Cohort study.


      A subset of 357 subjects was recruited from follow-up cohort of Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study I.


      All subjects underwent detailed ophthalmic evaluation including microperimetry and spectral domain optical coherence tomography. Fixation parameters such as stability of fixation, fixation location, and presence of scotoma were evaluated. A p value less than 0.05 was considered statistically significant.


      The mean age of the study sample was 56.86 ± 8.63 years. Relatively unstable fixation was observed in 73 and poor central fixation in 25 subjects. Among subjects with poor central fixation, 72% (18 subjects) had relatively unstable fixation. Poor central and relatively unstable fixation were significantly associated with best corrected visual acuity (BCVA; p = 0.002 and p = 0.017, respectively). Prevalence rate of scotoma was 24.4%, which was highly prevalent in females (p = 0.035) and among subjects with reduced BCVA (p < 0.001), reduced contrast sensitivity (p < 0.001), cataract (p < 0.001), impaired retinal sensitivity (p < 0.001), and presence of sight-threatening diabetic retinopathy (STDR; p < 0.001). Presence of scotoma was significantly associated with abnormal foveal contour (p = 0.046) and altered inner retinal layers (p < 0.001).


      We report that fixation characteristics are independent of ocular characteristics except for BCVA. Female sex, reduced visual acuity and contrast sensitivity, cataract, and STDR were significantly associated with presence of scotoma.



      Évaluer les caractéristiques de la fixation et du scotome chez des sujets diabétiques dans une étude basée sur une population.


      Étude de cohorte.


      Un sous-groupe de 357 sujets recrutés dans la cohorte de suivi de l'étude SN-DREAMS I.


      Tous les sujets ont été soumis à une évaluation ophtalmique détaillée avec micropérimétrie et tomographie de cohérence optique de domaine spectral. On a évalué des aspects tels que la stabilité de la fixation, la localisation de la fixation et la présence de scotome. Une valeur P de <0,05 était considérée comme statistiquement significative.


      L'âge moyen des participants était de 56,86 ± 8,63 ans. On a observé une fixation relativement instable chez 73 sujets et une piètre fixation centrale chez 25 sujets. Parmi les sujets présentant une piètre fixation centrale, 72 % (18 sujets) avaient une fixation relativement instable. La piètre fixation centrale et la fixation relativement instable étaient significativement associées à la meilleure acuité visuelle corrigée (MAVC) (p = 0,002, p = 0,017, respectivement). De l'ordre de 24,4 %, la prévalence de scotome était forte chez les femmes (p = 0,035) et dans les cas de MAVC réduite (p < 0,001), de perte de sensibilité au contraste (p < 0,001), de cataracte (p < 0,001), de perte de sensibilité rétinienne (p < 0,001) et de rétinopathie diabétique menaçant la vision (p < 0,001). La présence de scotome était significativement associée à un contour anormal de la fovéa (p = 0,046) et à l'altération des couches internes de la rétine (p < 0,001).


      Nous concluons que les caractéristiques de la fixation sont indépendantes des caractéristiques oculaires sauf pour la MAVC. Le sexe féminin, la perte d'acuité visuelle, la perte de sensibilité au contraste, la présence de cataracte et la rétinopathie diabétique menaçant la vision étaient significativement associés à la présence d'un scotome.
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