Exploring the Relationship Between Health Biomarkers and Performance on a Novel Color Perimetry Device in Prediabetes and Type 2 Diabetes.

Background/Objectives: Type 2 diabetes (T2DM) is a leading cause of vision loss. Functional measurements (color vision and contrast sensitivity) are sensitive to early changes in eyes even before retinopathy is present. This study evaluates a novel color perimetry device as an indicator of diabetic eye disease. Methods: 40 subjects (age-matched) were divided into 3 groups by HbA1c or previous diagnosis (control ≤5.6%, prediabetes 5.7-6.4%, diabetes ≥6.5%). Additional health metrics gathered included: BMI, body fat %, total cholesterol, HDL/LDL levels, blood glucose, and blood pressure. Novel color perimetry which measures chromatic thresholds at 4 locations 3 degrees from the fovea for 5 colors (achromatic, red, green, blue, and yellow) was completed. Mars contrast and L'Anthony D15 color testing were also completed. Lens photos excluded those with cataracts. Results: There were differences between the groups for HbA1c (p<0.001), BMI (p=0.046), body fat % (p=0.020), and color perimetry for the yellow condition only (p=0.013). The achromatic condition was highly associated with Mars contrast sensitivity (p<0.001). HbA1c was associated with both parvocellular (average of red and green) (p=0.014) and koniocellular (average of blue and yellow) color perimetry performance (p=0.022). Conclusions: HbA1c is associated with color perimetry across both retinal pathways. The yellow condition in particular holds promise as a biomarker for presence of functional changes in diabetes prior to the onset of retinopathy. Other health metrics did not influence chromatic thresholds. More research needs to be done to evaluate color perimetry in these patient groups to understand these relationships.