Pupil abnormalities in Type 2 Diabetes Mellitus: As an indicator of Diabetic Autonomic Neuropathy

Authors

  • Suchitra Kumari Junior Resident RIO, RIMS Ranchi, Jharkhand, India
  • Sunil Kumar Associate Professor RIO, RIMS Ranchi, Jharkhand, India
  • Taruni Kumari Junior Resident RIO, RIMS Ranchi, Jharkhand, India
  • Payal Mukherji Junior Resident RIO, RIMS Ranchi, Jharkhand, India

Keywords:

Autonomic neuropathy, Diabetes mellitus, Horizontal pupil diameter, Pupil cycle time.

Abstract

Background: Diabetic autonomic neuropathy is a recognized complication of type2 diabetes mellitus. It affects cardiovascular, gastrointestinal, genitourinary, sudomotor as well as ocular systems. Small pupil size and impaired pupillary response to darkness or light constitutes ocular autonomic dysfunction. Purpose: To study the relation between pupil abnormalities and the underlying Diabetic Autonomic Neuropathy (DAN) in type 2 diabetes mellitus patientsMaterial and methods: In this prospective, observational, cross-sectional study a total of 62 type 2 diabetic patients (33 females and 29 males) and 60 healthy age and sex matched controls (32 females and 28 females) were selected. The diabetic patients were further divided into two groups based on presence or absence of DAN. Horizontal Pupil Diameter (HPD) was measured in dark and in light (before and 60 minutes after instillation of 1% Tropicamide drops) using a pupil ruler and Pupil Cycle Time (PCT) was measured using slit lamp. Results: HPD in dark (5.367±1.16mm) as well as in light before (4.209± 0.39mm) and after(7.524±0.46mm) dilatation with 1% Tropicamide was significantly smaller(p<0.01) in diabetic group than control(6.153±1.24mm,4.503±0.24mm and 8.017±0.38mm respectively). PCT was significantly prolonged(p<0.01) in the diabetic group(965.77±152.73ms) than control (898.3±342.4ms). The reduction in HPD and prolongation of PCT was more evident in the diabetics with DAN(p<0.01)with mean values of dark adapted HPD, light adapted HPD before and after dilatation, and PCT being 4.647±43mm,3.931±72mm, 7.111±38mm and 1025.05±164.12 respectively. Conclusion: The significant smaller HPD and prolonged PCT in patients without DAN compared with that of healthy subjects and further shortening of HPD and prolongation of PCT in patients with DAN could be a sign for early involvement of the pupil function before manifestation of systemic autonomic diabetic neuropathy.

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Published

2021-12-09

How to Cite

Suchitra Kumari, Sunil Kumar, Taruni Kumari, & Payal Mukherji. (2021). Pupil abnormalities in Type 2 Diabetes Mellitus: As an indicator of Diabetic Autonomic Neuropathy. International Journal of Health and Clinical Research, 4(21), 76–80. Retrieved from https://ijhcr.com/index.php/ijhcr/article/view/3336