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Contrast Sensitivity Impairment in Diabetic Retinopathy: Clinical and Structural Correlates
Laura Andreea Ghenciu1,2, Diana Andrei3, Alexandra Magdalena Ioana4,5
1Department of Functional Sciences, Discipline of Pathophysiology, "Victor Babeș" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Diagnostics (Basel, Switzerland)
|August 13, 2026
Summary
Contrast sensitivity (CS) is a key indicator of early diabetic retinopathy (DR) functional impairment, even with normal visual acuity. Impaired CS correlates with retinal neurodegeneration and microvascular changes, aiding early DR detection.
Area of Science:
- Ophthalmology
- Diabetology
- Neuroscience
Background:
- Diabetic retinopathy (DR) is a leading cause of vision loss, recognized as a complex neurovascular disease.
- Current assessments often miss early functional deficits, focusing on structural changes and visual acuity.
Purpose of the Study:
- To review the role of contrast sensitivity (CS) in diabetic retinopathy.
- To explore the pathophysiological basis, clinical significance, and structural correlations of CS in DR.
Main Methods:
- Systematic literature search of PubMed, Scopus, and Google Scholar (2000-2026).
- Analysis of studies investigating CS in diabetes mellitus and DR.
Main Results:
- Reduced CS is observed in diabetic patients, including those without clinically evident DR or with normal visual acuity.
- CS impairment correlates with retinal neurodegeneration, ganglion cell dysfunction, microvascular changes, and macular edema severity.
- OCT and OCT-A reveal structure-function links between reduced CS and retinal thinning, capillary loss, and reduced perfusion.
Conclusions:
- Contrast sensitivity is a promising functional biomarker for early detection and monitoring of diabetic retinal dysfunction.
- CS testing can complement visual acuity and structural imaging in DR evaluation.
- Digital technologies and multimodal strategies may enable future clinical integration of CS testing.
Keywords:
OCT angiographycontrast sensitivitydiabetes mellitusdiabetic macular edemadiabetic retinopathyoptical coherence tomographyretinal biomarkersretinal neurodegenerationvisual acuityvisual functionMore Related Videos
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