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 (age-matched) subjects were divided into three groups by HbA1c or previous diagnosis (control ≤ 5.6%, prediabetes 5.7–6.4%, and 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 four locations, three degrees from the fovea, for five 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 the 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 conducted to evaluate color perimetry in these patient groups to understand these relationships.