1315 Clinical application of lens autofluorescence

Background and purpose: A likely explanation for the increase in lens fluorescence with aging and the acceleration of this process in patients with diabetes, is that lens proteins are altered by non-enzymatic glycosylation and the further steps of the Maillard reaction. Thus, the lens fluorescence intensity appears to represent a cumulative index of glycemia over the entire lifetime of the subject. Together with th: gradual onset of hyperglycemia in non-insulin dependent diabetes (NIDDM), which usually precedes the clinical detection of the disease by several years, this implies that patients with newly detected NIDDM should have increased lens fluorescence. We have investigated this theory on 14 patients with newly detected NIDDM and 11 age-matched healthy subjects with normal glucose tolerance. Results: Lens fluoresceme in 11 of tit: I4 diabetic patients where higher than the age-related mean plus 2 standard deviations of the healthy subjects. Within both groups lens fluorescence was significantly correlated with HbA,,, fasting plasma glucose and the two-hour glucose tolerance test levels. Conclusion: The results confirm that lens fluorometry may valuable as a population screening for the presence of NIDDM, although a prospective population study is needed to determine how effectively this can be done.