Amplitude of accommodation in type 1 diabetes

People with diabetes have accelerated age-related biometric ocular changes compared with people without diabetes. We determined the effect of type 1 diabetes on amplitude of accommodation.

There were 43 participants (33 ± 8 years) with type 1 diabetes and 32 (34 ± 8 years) age-balanced controls. There was no significant difference in mean equivalent refractive error and visual acuity between the groups. Amplitude of accommodation was measured using two techniques: objective by determining the accommodative response to a stimulus in a COAS-HD wavefront aberrometer and subjective with a Badal hand optometer. Influences of age and diabetes duration on amplitude of accommodation were analyzed using multiple regression analysis.

People with diabetes had lower objective (2.7 ± 1.6 diopters [D]) and subjective (4.0 ± 1.7 D) amplitudes than controls (objective 4.1 ± 2.1 D, subjective 5.6 ± 2.1 D). Across both groups, objective amplitude was less than subjective amplitude by 1.4 ± 1.2 D. For objective amplitude and the whole group, the duration of diabetes contributed 57% variation to the loss of amplitude relative to that provided by age. For the objective amplitude and only the diabetes group, this was 78%. For subjective amplitude, the corresponding proportions were 68% and 103%.

Lowered amplitude of accommodation exists in individuals with type 1 diabetes when compared with age-matched controls. The loss correlated strongly with duration of diabetes. The results suggest that individuals with diabetes will experience presbyopia earlier in life than people without diabetes, mainly due to changes in the lens.