DiaComp Funded Abstracts
Program Application Abstract
Detection of early retinal sensory neuropathies using perimetry techniques
(University of Michigan-Ann Arbor)
Summer Student Program
INTRODUCTION: Diabetic retinopathy (DR) is a leading cause of blindness amongst adults worldwide, affecting nearly one in three individuals with diabetes. Current guidelines for screening DR include yearly dilated fundus examination with ophthalmic review for microvascular changes in the retina. However, there has been an increasing body of evidence to suggest that DR includes a prominent neurodegenerative component in which the neurovascular unit is disrupted. Diagnostic techniques that can identify early signs of DR before occurrence of microvascular changes could prevent vision loss and lead to better clinical outcomes. AIM: To determine the role of quantitative perimetry techniques in detecting early retinal sensory neuropathies in patients with no clinically detectable retinopathy or with non- proliferative diabetic retinopathy (NPDR). HYPOTHESIS: In this study, we tested the hypothesis that quantitative perimetry techniques may serve as effective diagnostic tools for early diabetic neuroretinal disease. METHODS: Participants were recruited from the clinical services at the Kellogg Eye Center (Ann Arbor, MI). 5 normal adults, 18 adults with type 1 or type 2 diabetes mellitus without clinically evident retinopathy, and 13 adults with NPDR underwent visual function testing using SITA, SITA-SWAP and FDT 24-2 perimetry techniques. Clinical diagnosis of retinopathy was confirmed via expert ophthalmic grading of 7-field stereoscopic fundus photography using the Early Treatment of Diabetic Retinopathy Study (ETDRS) grading system. RESULTS: Participants with NPDR exhibited impaired outcomes in SITA, SITA-SWAP, and FDT perimetry in comparison to normal and diabetic participants. 67% of participants with NPDR had FDT results outside the normal range during their first visit and 77.8% of participants had abnormal results in the second visit. Similarly, 58.3% and 55.5% of SITA-SWAP examinations were abnormal in participants with NPDR. Early sensory neuropathies were also detected in participants without NPDR;; 47% and 31% of FDT examinations as well as 40% and 36% of SITA-SWAP examinations were abnormal in visit one and two respectively in diabetic patients without NPDR. CONCLUSION SITA, SITA-SWAP, and FDT perimetry techniques can be used as diagnostic tools for NPDR. In addition, they may have diagnostic use in the detection of early retinal sensory neuropathy amongst diabetic patients without NPDR.
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