The effect of diabetic retinopathy on standing posture during optic flow stimulation

Background: Diabetic retinopathy is a principal cause of visual damage and blindness, in which laser treatment offers proven therapy. The progressive degeneration of the retina, secondary to diabetes, is believed to cause postural instability although this is not well documented. The aim of this research was to assess how optic flow stimuli contribute to the control of stance in people with impaired retinal functions. Research question: Does the different retinal functionality correspond to different specific patterns of movements and muscles recruitment? Methods: Postural mechanisms and motor strategies were measured by testing subjects in quiet stance on a force platform with surface electromyography under different optic flow stimulations. Root mean square values of the center of pressure time-varying signals and normalized EMG values were used to evaluate the postural sway. Results: People with diabetic retinopathy, and to a greater extent laser group, were more unstable than healthy subjects. The greater amplitude of the body sway observed in the retinopathy group, and especially in the laser group, could be an expression of the difficulty for this population in processing this kind of visual information. Significance: The increase in muscle activity indicates that there are musculoskeletal and postural changes in the lower limb musculature with increasing severity of diabetic retinopathy. An impaired retinal function might negatively affect postural control in a way that is dependent on the severity of retinal damage.