To evaluate the usefulness of the retinal nerve fiber layer (RNFL) appearance in estimation of optic nerve damage in MS, we examined 20 patients with definite MS and 20 normal control patients. Photographs of the RNFL in 80 eyes were classified as normal or abnormal by two examiners working independently. The results were very similar, even though the clinical data of which they were informed and their experience with RNFL-evaluation differed. We found RNFL defects in 80% of MS patients and in 73% of MS eyes. In the control group the values were 5% and 2.5%. Subclinical optic neuropathy in eyes without any history of optic neuritis was demonstrated by RNFL defects in 68%. We conclude, that in detecting clinical and subclinical optic neuropathy, RNFL-evaluation is to be recommended as the method of choice.
In a population-based patient material of 138 insulin-dependent diabetics aged 25-34 years, and with a diabetes onset before 30 years of age, the relation between retinopathy and albumin excretion rate was studied. The prevalence rate of any retinopathy was 59% (81) and of proliferative retinopathy 17% (23). After 10 years' duration of diabetes, the prevalence of any retinopathy increased steeply and reached a maximum of about 90% after more than 20 years. Very few patients had proliferative retinopathy during the first 20 years, followed by a gradual increase in prevalence up to 40-50% after 25 years. Twenty-one percent (29) of the study population was found to have an increased urinary albumin excretion rate. These patients were found to have a statistically significant increase in frequency of retinopathy (p < 0.01) -and in particular of proliferative retinopathy -with increasing levels of urinary albumin excretion. Our results suggest a need for more frequent screening for diabetic retinopathy in diabetic patients with than without increased albumin excretion rate.
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