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A Light in the Darkness: New Hope for Prevention of Diabetic Retinopathy Perhaps one of the most devastating and most dreaded side effects of diabetes is blindness. Changes in the blood vessels in the retina brought on by the complications of diabetic conditions result in visual impairment which could, in a worse case scenario, lead to total loss of eyesight. While the exact nature of this connection is unknown, new research suggests that the cause may be hypoxia (a lack of oxygen) in the retinal blood flow occurring during hours of extended darkness. Several researchers now believe that one way of preventing and perhaps reversing the effects of the lack of oxygen may be as simple as sleeping with a light on. In an article published in The Lancet, June 29, 2002, Drs. Drasdo, Chiti, and North, of Cardiff University in Wales, and Prof. Owens, of the University of Wales College of Medicine, reported the results of recent clinical trials testing this theory. The Drasdo study began by noting a high degree of oxygen consumption in the normal eye during hours of darkness. Additionally, previous studies have shown that blood flow is less than adequate for "dark adaptation" in diabetic patients who do not have retinopathy. Noting that reduced color vision and contrast problems in diabetic patients have been at least partly corrected by the use of oxygen inhalation therapy, Drasdo's team felt that oxygen deprivation may be a contributing factor to other diabetic vision problems, including diabetic retinopathy. If darkness dramatically increases the demand for oxygen in the eye, Drasdo and his associates felt that providing some light during the hours of sleep might reduce this demand, resulting in increased oxygen levels and the slowing or prevention of retinal hypoxia which could trigger retinopathy in the diabetic. The trial group consisted of seven individuals with controlled Type 2 diabetes, with no current visual problems, and seven control subjects. Clinical examination of the diabetic group noted decreased tissue activity near the surface of the retina, indicating a loss of oxygen. When oxygen inhalation therapy was applied, the diabetes group had readings almost identical to the normal group. It should be noted that there was no significant change in readings in the normal group before or after oxygen. Light, even through closed eyelids, is known to suppress "dark adaptation" and thus reduce the increased demand for oxygen. While more clinical research and trials will be needed to determine the effect of a nightlight on diabetic retinopathy, Drasdo's work is truly a light in the darkness for diabetics and their loved ones. Reference Drasdo, N., Chiti, Z., Owens, D. R. & North, R. V. (2002, June 29). Effect of darkness on inner retinal hypoxia in diabetes. The Lancet, Vol. 359, No. 9325.

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