$$\rightleftharpoonup{xx}$$
$$\longleftharp{xx}$$,
$$\longrightharp{xx}$$,
Over 463 million people live with diabetes, making it one of the largest global disease epidemics1. One of the serious complications that arises from diabetes is diabetic retinopathy (DR), a leading cause of blindness for working-age American adults2. In the next 30 years, the percentage of the population at risk for DR is projected to double, so it is crucial to find new ways of diagnosing DR in its earlier stages to prevent and mitigate DR development3. DR has conventionally been thought to be a vascular disease4,5,6. However, now with evidence of neuronal dysfunction and apoptosis in the retina that precedes vascular pathology, DR is defined to have neuronal and vascular components4,5,6,7,8,9. One way to diagnose DR would be to examine neural abnormalities in the retina, a tissue that may be more vulnerable to oxidative stress and metabolic strain from diabetes than other neural tissue10.
Declines in cognitive and motor function also occur with diabetes and are often correlated with retinal changes. Older individuals with Type II diabetes portray worse baseline cognitive performance and show more exacerbated cognitive decline than control participants11. Additionally, the retina has been established as an extension of the central nervous system and pathologies can manifest in the retina12. Clinically, the relationship between retina and brain has been studied in the context of Alzheimer’s and other diseases but is not commonly explored with diabetes12,13,14,15,16. Changes in the brain and retina during the progression of diabetes can be explored using animal models, including the STZ rat (a model of Type I diabetes in which the toxin, streptozotocin or STZ, is used to damage pancreatic beta cells) and the Goto-Kakizaki rat (a polygenic model of Type II diabetes in which animals develop hyperglycemia spontaneously at around 3 weeks of age). In this protocol, a description for the Y-maze and the optomotor response to assess cognitive and visual changes in diabetic rodents, respectively, is provided. The optomotor response (OMR) assesses spatial frequency (similar to visual acuity) and contrast sensitivity by monitoring characteristic reflexive head tracking movements to gauge visual thresholds for each eye17. Spatial frequency refers to the thickness or fineness of the bars, and contrast sensitivity refers to how much contrast there is between the bars and the background (Figure 1E). Meanwhile, the Y-maze tests short-term spatial memory and exploratory function, observed through spontaneous alternations and entries through the arms of the maze.
Both tests can be performed in awake, non-anesthetized animals and have the advantage of capitalizing on innate responses of the animals, meaning that they do not require training. Both are relatively sensitive, in that they can be used to detect deficits early in the progression of diabetes in rodents, and reliable, in that they produce results that correlate with other visual, retinal, or behavioral tests. Additionally, using the OMR and the Y-maze in conjunction with tests such as electroretinogram and optical coherence tomography scans can provide information on when retinal, structural, and cognitive changes develop relative to each other in disease models. These investigations could be useful in identifying neural degenerations that occur due to diabetes. Ultimately, this could lead to new diagnostic methods that effectively identify DR in early stages of progression.
The OMR and the Y-maze systems used to develop this protocol are described in the Table of Materials. Previous research on the OMR, by Prusky et al.18, and the Y-maze, by Maurice et al.19, was used as the starting point to develop this protocol.