糖尿病における視機能インスリン依存型と非依存型

Visual function in diabetic subjects

　インスリン依存型糖尿病（IDDM）25名，インスリン非依存型糖尿病（NIDDM）49名，計74名（男44名，女30名）について，視力，色覚，空間周波数特性，中心フリッカー値を調べ，視機能を検討した．

　Farnsworth-Munsell 100 hue testを用いた色覚検査では，視力低下とともに，総偏差点が高くなったが，視力良好でも総偏差点の高い例が存在し，増殖型網膜症に特に多く，視力と色覚感度の間に差が認められた．また，青黄異常が多く認められた．Arden grating testを用いた空間周波数特性測定では，網膜症を認めない例でも高周波数域の異常を検出し得，糖尿病における網膜症発現以前の視機能異常の存在が示唆された．中心ブリッカー値は，視力が比較的良好な例で，著明に低下している例が少数認められた．また，これらの検査では，IDDMとNIDDMの視機能には，差異は認められなかった．

Seventy-four diabetic subjects were evaluated by means of Farnsworth-Munsell 100 hue test and Arden grating test. The visual acuity level was 0.1 or over in all the cases. The series included 25 insulin-dependent (IDDM) and 49 non-insulin dependent (NIDDM) dia-betics.

The total error score of 100 hue test was correlated, in general, with the deterioration in visual acuity. Dissociation between visual acuity and color vision was found in some NIDDM cases with proliferative retinopathy and with visual acuity of 0.8 or over, as the error scores were greater than in age-matched controls with a tendency to blue-yellow deficiency. Arden grating test revealed reduction in contrast sensitivities at higher spacial frequencies in eyes with-out retinopathy. In eyes with manifest retinopathy, reduction in contrast sensitivities was also present at lower frequencies. This test thus seemed to be of value as an early indicator of impaired retinal function, particularly in eyes without retinopathy.

Throughout the present study, there was no differ-ence in the tested visual functions between IDDM and NIDDM cases.

Rinsho Ganka (Jpn J Din Ophthalmol) 41(1) : 83-86, 1987