Abstract
It is commonly believed that diabetic optic neuropathy is very rare and visual loss in diabetes usually is attributed to other causes. We studied the extent of optic nerve involvement in 16 diabetics with no retinopathy or ocular disease and having an almost visual acuity, using visual evoked responses produced by pattern reversal stimulation. Comparing the responses with a group of 35 healthy subjects, the latency was increased by more than one standard deviation in 13 diabetics (81%) and by more than three standard deviations in 10 diabetics (62.5%), often associated with marked reduction in amplitude. There was good correlation between conduction in the optic nerve and peripheral sensory nerve. No correlation was noted to occur with duration of diabetes or diabetic control except perhaps with juvenile onset diabetes. Normal visual acuity was noted in many cases with severely slowed conduction showing early subclinical affection of optic nerves in diabetes. The extent of central nervous system involvement in diabetes has only recently been realised because of lack of physiological techniques and study of optic nerves in diabetes has not been attempted so far. The high incidence of abnormality of visual evoked potentials in diabetes could invalidate the usefulness of this test in diagnosing multiple sclerosis.
Full text
PDF
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Asselman P., Chadwick D. W., Marsden D. C. Visual evoked responses in the diagnosis and management of patients suspected of multiple sclerosis. Brain. 1975 Jun;98(2):261–282. doi: 10.1093/brain/98.2.261. [DOI] [PubMed] [Google Scholar]
- Chopra J. S., Hurwitz L. J., Montgomery D. A. The pathogenesis of sural nerve changes in diabetes mellitus. Brain. 1969;92(2):391–418. doi: 10.1093/brain/92.2.391. [DOI] [PubMed] [Google Scholar]
- DeJong R. N. CNS manifestations of diabetes mellitus. Postgrad Med. 1977 Jan;61(1):101–107. doi: 10.1080/00325481.1977.11714510. [DOI] [PubMed] [Google Scholar]
- Gupta P. R., Dorfman L. J. Spinal somatosensory conduction in diabetes. Neurology. 1981 Jul;31(7):841–845. doi: 10.1212/wnl.31.7.841. [DOI] [PubMed] [Google Scholar]
- Halliday A. M., McDonald W. I., Mushin J. Delayed pattern-evoked responses in optic neuritis in relation to visual acuity. Trans Ophthalmol Soc U K. 1973;93(0):315–324. [PubMed] [Google Scholar]
- Halliday A. M., McDonald W. I., Mushin J. Delayed visual evoked response in optic neuritis. Lancet. 1972 May 6;1(7758):982–985. doi: 10.1016/s0140-6736(72)91155-5. [DOI] [PubMed] [Google Scholar]
- Halliday A. M. Visually evoked responses in optic nerve disease. Trans Ophthalmol Soc U K. 1976 Sep;96(3):372–376. [PubMed] [Google Scholar]
- Lamontagne A., Buchthal F. Electrophysiological studies in diabetic neuropathy. J Neurol Neurosurg Psychiatry. 1970 Aug;33(4):442–452. doi: 10.1136/jnnp.33.4.442. [DOI] [PMC free article] [PubMed] [Google Scholar]
- McDonald W. I. Conduction in the optic nerve. Trans Ophthalmol Soc U K. 1976 Sep;96(3):352–354. [PubMed] [Google Scholar]