Blue-on-yellow perimetry versus achromatic perimetry in type 1 diabetes patients without retinopathy

Afrashi, Filiz; Erakgün, Tansu; Köse, Süheyla; Ardiç, Kübra; Menteş, Jale

doi:10.1016/s0168-8227(03)00082-2

Cited by 35 publications

(35 citation statements)

References 15 publications

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“…Perimetry outcomes represent both retinal and post-retinal visual pathway function. Several studies have demonstrated visual sensitivity reduction in the central 30°of visual field in diabetes prior to the development of clinically evident retinopathy [15][16][17][18]. This supports the prospect of a subset of visual function changes that are primarily related to neurodegeneration rather than to vascular dysfunction, although these neurodegenerative changes could, themselves, be a result of microangiopathy [19].…”

Section: Introductionmentioning

confidence: 72%

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Visual sensitivity loss in the central 30° of visual field is associated with diabetic peripheral neuropathy

et al. 2012

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Section: Introductionmentioning

confidence: 72%

“…This raises the prospect that previously reported visual field loss (using these measures) associated with pre-retinopathy diabetes [15][16][17][18] may have been attributable to neuropathy status. This factor was not accounted for in any of these earlier studies.…”

Section: Discussionmentioning

confidence: 94%

Visual sensitivity loss in the central 30° of visual field is associated with diabetic peripheral neuropathy

et al. 2012

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“…We and others have documented widespread abnormalities with SWAP in eyes of diabetic individuals without retinopathy that have normal achromatic visual fields (Afrashi, et al, 2003;, though some have not seen these changes until some retinopathy is present (Nomura, et al, 1999;Remky, et al, 2003). In diabetes without retinopathy, approximately 20% of SWAP locations tested were abnormal compared to about 40% in the presence of mild-to-moderate retinopathy ).…”

Section: Changes In Visionmentioning

confidence: 82%

A multifocal electroretinogram model predicting the development of diabetic retinopathy

Bearse

Adams

Han

et al. 2006

Progress in Retinal and Eye Research

212

173

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The prevalence of diabetes has been accelerating at an alarming rate in the last decade; some describe it as an epidemic. Diabetic eye complications are the leading cause of blindness in adults aged 25-74 in the United States. Early diagnosis and development of effective preventatives and treatments of diabetic retinopathy are essential to save sight. We describe efforts to establish functional indicators of retinal health and predictors of diabetic retinopathy. These indicators and predictors will be needed as markers of the efficacy of new therapies. Clinical trials aimed at either prevention or early treatments will rely heavily on the discovery of sensitive methods to identify patients and retinal locations at risk, as well as to evaluate treatment effects.We report on recent success in revealing local functional changes of the retina with the multifocal electroretinogram (mfERG). This objective measure allows the simultaneous recording of responses from over 100 small retinal patches across the central 45 degree field. We describe the sensitivity of mfERG implicit time measurement for revealing functional alterations of the retina in diabetes, the local correspondence between functional (mfERG) and structural (vascular) abnormalities in eyes with early nonproliferative retinopathy, and longitudinal studies to formulate models to predict the retinal sites of future retinopathic signs. A multivariate model including mfERG implicit time delays and 'person' risk factors achieved 86% sensitivity and 84% specificity for prediction of new retinopathy development over one year at specific locations in eyes with some retinopathy at baseline. A preliminary test of the model yielded very positive results. This model appears to be the first to predict, quantitatively, the retinal locations of new nonproliferative diabetic retinopathy development over a one-year period. In a separate study, the predictive power of a model was assessed over oneand two-year follow-ups. This permitted successful prediction of new retinopathy development in eyes with and without retinopathy at baseline. Finally, we briefly describe our current research efforts to (a) locally predict future sight-threatening diabetic macular edema, (b) investigate local retinal function change in adolescent patients with diabetes, and (c) better understand the physiological bases of the mfERG delays.The ability to predict the retinal locations of future retinopathy based on mfERG implicit time provides clinicians a powerful tool to screen, follow up, and even consider early prophylactic treatment of the retinal tissue in diabetic patients. It also aids identification of 'at risk' populations for clinical trials of candidate therapies, which may greatly reduce their cost by decreasing the size of the needed sample and the duration of the trial.

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“…Blue-on-yellow, or short wavelength automated perimetry (SWAP), has been suggested to be more sensitive to early retinal changes than WWP. A number of studies have compared SWAP and WWP in patients with diabetes [9][10][11][12][13], but the results are not conclusive regarding the relative usefulness of these two tests. Few studies have assessed to what extent the perimetry can document functional loss due to diabetes-induced damage of the perifoveal capillary network [10].…”

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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Blue-on-yellow perimetry versus achromatic perimetry in type 1 diabetes patients without retinopathy

Cited by 35 publications

References 15 publications

Visual sensitivity loss in the central 30° of visual field is associated with diabetic peripheral neuropathy

Visual sensitivity loss in the central 30° of visual field is associated with diabetic peripheral neuropathy

A multifocal electroretinogram model predicting the development of diabetic retinopathy

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

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