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André A. Dosso, MD; Ferah Yenice-Ustun, MD; Jorg Sommerhalder, PhD; Alain Golay, MD; Yves Morel, MD; Peter M. Leuenberger, MD

Arch Ophthalmol. 1998;116:1316-1320.

Objective  To evaluate contrast sensitivity in insulin-resistant obese patients and in aretinopathic diabetic patients.

Methods  Contrast sensitivity was measured at 3 letter sizes (44x44, 9x9, and 5x5 mm) in mesopic (5 candela [cd]/m²) and low photopic (85 cd/m²) vision in 20 dyslipidemic obese patients with insulin resistance, 20 age-matched patients with type 2 diabetes mellitus, and 20 aged-matched healthy control subjects.

Results  Significant loss of contrast sensitivity at all 3 letter sizes was observed in low photopic vision (at 44x44-mm letter size, control vs obese, P<.002, and control vs diabetic, P<.005; at 9x9-mm letter size, control vs obese, P<.02, and control vs diabetic, P<.001; and at 5x5-mm letter size, control vs obese, P<.05, and control vs diabetic, P<.005) and mesopic vision (at 44x44-mm letter size, control vs diabetic, P<.005; at 9x9-mm letter size, control vs obese, P<.005, and control vs diabetic, P<.01; and at 5x5-mm letter size, control vs obese, P<.005, and control vs diabetic, P<.001) in insulin-resistant obese and diabetic patients.

Conclusion  The results suggest that an early neurosensory dysfunction may occur without visible vascular involvement and without overt hyperglycemia.

From the University Eye Clinic (Drs Dosso, Yenice-Ustun, Sommerhalder, and Leuenberger) and Division of Treatment and Teaching for Chronic Diseases, University Hospital (Drs Golay and Morel), Geneva, Switzerland.

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