Visual Field Defects in Patients with Insulin-dependent and Noninsulin-dependent Diabetes

Trick, Gary L.; Trick, Linda R.; Kilo, Charles

doi:10.1016/s0161-6420(90)32557-5

Cited by 59 publications

(43 citation statements)

References 16 publications

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“…However, these tests evaluated mainly foveal function. It has also been reported that patients with diabetic retinopathy have a sensitivity loss in the midperipheral visual field by white-on-white (W/W) perimetry and that this loss in the mid-peripheral field was correlated with the retinal area of nonperfusion [6][7][8]. Thus, it seemed important to measure S cone system sensitivity in the peripheral visual field, especially in the area of lower perfusion, to determine whether this more vulnerable region can provide earlier evidence for the diabetic changes.…”

Section: Introductionmentioning

confidence: 99%

Blue-on-Yellow Perimetry to Evaluate S Cone Sensitivity in Diabetics

Nomura

Terasaki²,

Hirose³

et al. 2000

Ophthalmic Res

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Blue-on-yellow (B/Y) perimetry was performed on 31 patients with non-insulin-dependent diabetes mellitus to study the loss of sensitivity to short wavelengths. Of these patients, 21 were without retinopathy (NDR) and 10 had early background retinopathy (SDR). Eleven normal subjects served as controls. The results were compared to white-on-white (W/W) perimetry. Foveal sensitivity determined by B/Y and W/W perimetry showed no significant difference between NDR, SDR and normals. However, the mean sensitivity in the central 30-degree area and that in the upper half of the central 20- to 30-degree concentric circular field were significantly decreased in B/Y perimetry in SDR patients (p < 0.05, p < 0.01, respectively). No significant sensitivity loss was detected in the W/W test. We conclude that there is a blue cone system sensitivity loss in the central 30-degree area, particularly in the upper half of the visual field and the paracentral area in diabetic patients with early background retinopathy.

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Section: Introductionmentioning

confidence: 99%

Blue-on-Yellow Perimetry to Evaluate S Cone Sensitivity in Diabetics

Nomura

Terasaki²,

Hirose³

et al. 2000

Ophthalmic Res

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show abstract

“…Conventional white-on-white perimetry (WWP) has been reported to enable identification of retinal changes caused by diabetes in their early stages [5][6], and selective loss of short wavelength sensitivity has been reported in diabetic patients with no or minimal retinopathy [7][8]. Blue-on-yellow, or short wavelength automated perimetry (SWAP), has been suggested to be more sensitive to early retinal changes than WWP.…”

Section: Introductionmentioning

confidence: 99%

Visual fields correlate better than visual acuity to severity of diabetic retinopathy

2005

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Aims/hypothesis: We compared the outcomes of perimetric and visual acuity tests in patients with diabetic retinopathy. Methods: We examined 59 diabetic patients with different degrees of retinopathy using stereo fundus photography in accordance with the Early Treatment of Diabetic Retinopathy Study (ETDRS) and fluorescein angiography. Conventional white-on-white perimetry (WWP) and short wavelength automated perimetry (SWAP) were performed and analysed with reference to normal values. Visual acuity was measured with ETDRS charts. Results: Regression analysis revealed that visual acuity was significantly associated with increasing severity of retinopathy according to the ETDRS scale when visual acuity was estimated by counting logarithm of minimum angle of resolution (LogMar) scores, but not when visual acuity was measured by the conventional reading of the smallest line that could be seen. Visual acuity decreased by 0.02 LogMar per ETDRS step (p=0.03). The degree of visual field loss was significantly associated with increasing severity of retinopathy according to the ETDRS scale, perimetric sensitivity decreasing by 0.44 dB per ETDRS step (p=0.0001) using WWP, and by 0.40 dB per ETDRS step (p=0.04) with SWAP. The size of the area of the foveal avascular zone and adjacent perifoveal intercapillary areas (PIAs) also affected the central visual field as obtained both by WWP (−2.6 dB/ mm 2 , p=0.03), and by SWAP (−7.9 dB/mm 2 , p=0.002), but did not affect visual acuity. The regression model fit for peripheral retinopathy according to the ETDRS scale was better using WWP than SWAP or visual acuity, while SWAP testing was superior to both WWP and visual acuity when measuring effects caused by enlarged foveal avascular zones and PIAs. Conclusions/interpretation: Perimetry can provide more useful information than visual acuity on functional loss in diabetic retinopathy, particularly when the perifoveal capillary network is damaged.

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“…The most widely used test of retinal dysfunction is standard automated perimetry (SAP), which has rendered results indicating a reduction of retinal sensitivity in diabetic subjects without retinopathy (12,13) as well as in those with mild/moderate (14) or moderate/severe retinopathy (15,16). Moreover, reduction of retinal sensitivity revealed by SAP was found to correlate with stepwise increases in the severity of retinopathy (17,18).…”

mentioning

confidence: 99%

Progression of Early Retinal Dysfunction in Diabetes Over Time: Results of a Long-term Prospective Clinical Study

2014

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We explored signs of retinal dysfunction over time in diabetic subjects before or early in the course of retinopathy. Patients with no, mild, or moderate retinopathy were consecutively recruited and underwent standard automated perimetry, visual acuity measurement, and fundus photography. These examinations and measurements of HbA 1c and blood pressure were repeated for up to 5 years from baseline. Visual field improvement/deterioration in diabetic subjects was evaluated using significance limits for change. Progression or regression of retinopathy was defined as a two-step change on the Early Treatment Diabetic Retinopathy Study final severity scale. Seventy-four subjects completed at least 3 years of follow-up, and 22% showed visual field worsening, defined as repeated significant deterioration at ‡10% of the test points, whereas only 1% showed field improvement. Worsening occurred in subjects both with and without vascular lesions. The degree of retinopathy was stable throughout the observation period in 68 of 74 eyes, improved in 4, and worsened in 2. Visual field deterioration was not correlated with a change in retinopathy. By using perimetry with an analysis tailored for monitoring diabetic subjects, we were able to demonstrate progression of retinal dysfunction over time, which may represent early signs of retinal neurodegeneration.

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Visual Field Defects in Patients with Insulin-dependent and Noninsulin-dependent Diabetes

Cited by 59 publications

References 16 publications

Blue-on-Yellow Perimetry to Evaluate S Cone Sensitivity in Diabetics

Blue-on-Yellow Perimetry to Evaluate S Cone Sensitivity in Diabetics

Visual fields correlate better than visual acuity to severity of diabetic retinopathy

Progression of Early Retinal Dysfunction in Diabetes Over Time: Results of a Long-term Prospective Clinical Study

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