Our study suggests that blue-on-yellow perimetry is more useful and more sensitive than achromatic perimetry in the detection of preclinical visual field defects in diabetic children with microalbuminuria but without clinically detectable retinopathy.

Contrast sensitivity was studied in diabetic adolescents and young adults with and without retinopathy in order to evaluate their central vision, to analyze the relationship of metabolic control to the presence and severity of retinopathy, and to re-evaluate the response to this test after a significant improvement in metabolic control. Twenty adolescent and young adult diabetics without retinopathy and 40 diabetics with retinopathy of varying degree were enrolled in the study; 20 healthy age and sex-matched subjects served as controls. Contrast sensitivity was assessed with a CSV-1000 contrast testing instrument, testing for four spatial frequencies, 3, 6, 12 and 18 cycles per degree (cpd). Diabetics with no retinopathy showed a weak but significant difference at 18 cpd compared with controls (P = 0.04), while diabetics with background retinopathy showed a significant reduction of contrast sensitivity at 12 and 18 cpd when compared with controls (P < 0.001). In patients with preproliferative/proliferative retinopathy a highly significant reduction of contrast sensitivity at all frequencies was found compared with controls. Furthermore, these patients had a significantly lower mean contrast sensitivity than patients without retinopathy. The patients were re-evaluated after a significant amelioration of metabolic control. An improvement in contrast sensitivity was found in diabetics without retinopathy and with background retinopathy, while there was no change observed in diabetics with severe retinopathy. These results show that diabetic adolescents and young adults with and without signs of retinopathy observed by fluorescein angiography have a reduced contrast sensitivity, which is more severe in patients with preproliferative/proliferative retinopathy. A significant amelioration of metabolic control is associated with an improvement of contrast sensitivity in all patients with the exception of those patients who had signs of preproliferative/proliferative retinopathy observed by fluorescein angiography. In summary, this longitudinal study provides the first evidence that reduced contrast sensitivity is reversible in diabetics with or without background retinopathy only.

Our study demonstrates that treatment with VPA or CBZ can affect significantly both central and paracentral color vision after a short treatment period.

In this study concerning the prevalence of myopia in patients with open angle glaucoma, its distribution was analyzed within the sample tested in relation to the refraction defect size, compared with a control group of non-glaucomatous myopic subjects. The overall myopic rate was 17.2% of the glaucomatous patients; high myopia was more frequent in the subjects with open angle glaucoma (p less than 0.001) than in the myopic patients, thus appearing as a possible risk factor for the development of glaucoma.

Summary:Purpose: To evaluate retinal nerve retinal nerve fiber layer (RNFL) and macular thickness by using optical coherence tomography (OCT) in epileptic adolescents before and during monotherapy with valproic acid (VPA) and carbamazepine (CBZ).Methods: We examined prospectively 45 epilepsy patients with partial and generalized epilepsy. The patients were evaluated before the beginning of therapy and after 1 year of VPA or CBZ monotherapy. Forty-five untreated healthy controls were evaluated at baseline and after 1 year. Results:At the beginning of the study, the two groups of patients showed RNFL and macular thickness measurements similar to control values. At the end of the follow-up, the data of the three groups were similar to baseline, showing no significant differences in the evaluated parameters.Conclusions: The present study demonstrates that no modification of RNFL and macular thickness parameters is found after 1 year of treatment with VPA and CBZ monotherapy. Key Words: Valproate-Carbamazepine-EpilepsyRetinal nerve fiber layer thickness-Macular thickness.In recent years, alterations of visual function have been studied extensively in epilepsy patients treated with different antiepileptic drugs (AEDs); in particular, carbamazepine (CBZ) and valproic acid (VPA) can produce significant impairment of color perception (1-3). However, no data exist about possible morphologic retinal alterations related to this impairment. In a previous study (3), we demonstrated that epilepsy patients treated with VPA and CBZ can show color vision defects, in particular for blue vision, and that these abnormalities are present not only in the foveal area but also in peripheral macular areas. Optic nerve end and macula measurements may provide complementary structural information in assessing the pathogenetic mechanisms of the color-vision impairment induced by VPA and CBZ.In the present study, we studied the same patients who showed color-vision impairment to determine whether such impairment is related to anatomic changes, particularly in retinal and nerve fiber layer thickness. MATERIALS AND METHODSWe studied 45 adolescents (16 boys and 29 girls; mean age, 15.71 ± 2.01 years; range, 11.0-18.1) with partial and generalized cryptogenic epilepsy. A description of patients is reported in our previous article (3). We measured macular thickness and retinal nerve fiber layer (RNFL) before the beginning of AED therapy and after one year of therapy.Forty-five untreated healthy sex-and age-matched adolescents served as controls.Each subject underwent a comprehensive ophthalmologic examination performed by one of the authors (L.L.), including review of medical history, best-corrected visual acuity, slit-lamp biomicroscopy, intraocular pressure (IOP) measurement with Goldmann applanation tonometry, dilated funduscopy examination with a 90-diopter lens and seven-field fundus photography of the retina.Eyes with coexisting retinal disease, uveitis, or optic neuropathy were excluded from this investigation.The ophthalmologic evaluation...