研究目的
To examine the distribution of cone photoreceptor density in the retina of adolescents with type 1 diabetes and determine if there are regional susceptibilities for photoreceptor deficit.
研究成果
Cone photoreceptor density in the parafoveal retina of adolescents with type 1 diabetes and no diabetic retinopathy is similar to that of control participants. No reduction in cone density was found, but participants with diabetes did not exhibit the radial asymmetry observed in controls, suggesting subtle neural changes may precede structural deficits. Future studies should investigate functional aspects and longer disease durations.
研究不足
Relatively small retinal regions analyzed for cone density, potential bias from variations across the imaged field. Difficulties in obtaining high-quality images in all retinal areas due to factors like eye movements or AO system focusing issues, leading to exclusion of some data. Missing axial length and HbA1c values for some participants.
1：Experimental Design and Method Selection:
Cross-sectional prospective study using adaptive optics scanning laser ophthalmoscopy (AOSLO) to image the cone photoreceptor mosaic in four retinal quadrants at an eccentricity of ~78 from the fovea. Image registration, averaging, and cone counting were performed with custom software. Statistical analysis used mixed model analysis of variance with repeated measures.
2：Sample Selection and Data Sources:
29 adolescents and young adults with type 1 diabetes and no diabetic retinopathy, and 44 control participants recruited from The Hospital for Sick Children. Inclusion criteria: duration of T1D ≥5 years, age 10-25 years, no signs of DR based on fundus photographs graded by a specialist.
3：List of Experimental Equipment and Materials:
Adaptive optics retinal imaging system (Physical Sciences, Inc.), I3 system—ABD ultrasound (Innovative Imaging, Inc.), topical corneal anesthetic (0.5% proparacaine), dilating agents (1% tropicamide and 2.5% phenylephrine), vision charts (Early Treatment of Diabetic Retinopathy Study), contrast sensitivity test (Pelli-Robson), color vision tests (Hardy-Rand-Rittler plates, Mollon-Ref?n Minimalist Test).
4：5% proparacaine), dilating agents (1% tropicamide and 5% phenylephrine), vision charts (Early Treatment of Diabetic Retinopathy Study), contrast sensitivity test (Pelli-Robson), color vision tests (Hardy-Rand-Rittler plates, Mollon-Ref?n Minimalist Test).
Experimental Procedures and Operational Workflow:
4. Experimental Procedures and Operational Workflow: Participants underwent visual acuity, contrast sensitivity, color vision tests, axial length measurement, and AO imaging. One eye was randomly selected, anesthetized, dilated, and imaged using SLO at 760 nm wavelength. Videos were postprocessed to remove dim frames, register frames, average images, and count cones in selected regions avoiding blood vessels.
5：Data Analysis Methods:
Mixed model analysis with random effects for participant ID, fixed effects for group, quadrant, distance from fovea, and interaction. Cone density calculated in cones/deg2 and cones/mm2 based on axial length measurements.
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