Early visual field changes in patients with type 1 diabetes mellitus

Area of Science:

• Ophthalmology
• Diabetology
• Neuroscience

Background:

• Type 1 diabetes mellitus (T1DM) can affect the retina, even without retinopathy.
• Early detection of retinal changes is crucial for managing T1DM complications.

Purpose of the Study:

• To evaluate visual field sensitivity changes in T1DM patients.
• To correlate visual field sensitivity with retinal nerve fiber layer (RNFL) thickness in T1DM.

Main Methods:

• Cross-sectional study comparing 46 T1DM patients (no retinopathy) with 50 healthy controls.
• Assessed RNFL thickness, standard automated perimetry (SAP), and short-wavelength automated perimetry (SWAP).
• Key outcomes included RNFL thickness, mean deviation (MD), pattern standard deviation (PSD), and short fluctuation (SF).

Main Results:

• T1DM patients had significantly thinner RNFL (p < 0.001).
• SWAP showed significantly greater MD and PSD in T1DM patients (p < 0.001).
• SWAP's PSD (≥1.57 dB) demonstrated 91% sensitivity and 90% specificity for detecting RNFL loss.

Conclusions:

• Thinner RNFL in T1DM may correlate with abnormal retinal sensitivity to short-wavelength stimuli (SWAP).
• SAP did not reveal significant differences in visual field sensitivity compared to controls.
• SWAP appears valuable for identifying early RNFL damage in T1DM.