This can be explained by the effects of insulin resistance on autoregulatory dysfunction.[35, 36] The dysfunctional vascular autoregulation of the eye produces impaired ocular blood flow, and this phenomenon may cause RNFLD-associated diseases such as glaucoma, retinal cotton-wool spots, and ischemic optic neuropathy. The gene discussed is INS; the disease is anterior ischemic optic neuropathy.