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Objective perimetry and diabetic retinopathy progression: a 10-year follow-up study
Betelhem T Yibekal1, Bhim B Rai1, Joshua P van Kleef1
1Eccles Institute for Neuroscience, The John Curtin School of Medical Research, The Australian National University, Canberra, ACT, Australia.
Frontiers in Endocrinology
|January 28, 2026
Summary
ObjectiveFIELD Analyser (OFA) tests show retinal function changes predict diabetic retinopathy (DR) progression in type 2 diabetes patients over 10 years. Reduced sensitivity and delayed responses are key indicators of worsening DR.
Area of Science:
- Ophthalmology
- Diabetology
- Medical Technology
Background:
- Type 2 diabetes (T2D) poses significant risks for vision-threatening diabetic retinopathy (DR).
- Early detection and monitoring of DR progression are crucial for effective management.
- Objective measures of retinal function can complement existing clinical assessments.
Purpose of the Study:
- To investigate 10-year changes in retinal function in persons with type 2 diabetes (PWT2D) using the objectiveFIELD Analyser (OFA).
- To identify baseline retinal function parameters measured by OFA that predict diabetic retinopathy (DR) progression.
- To correlate changes in retinal sensitivity and response delay with DR severity over a decade.
Main Methods:
- A cohort of PWT2D underwent comprehensive eye examinations and OFA testing at baseline and 10-year follow-up.
- Four OFA test protocols varying in eccentricity and duration were used to measure per-region retinal sensitivity and response delay.
- Diabetic retinopathy (DR) severity was graded using Early Treatment of Diabetic Retinopathy Study (ETDRS) scores.
- Generalized linear mixed-effects logistic regression models identified predictors of DR progression.
Main Results:
- Over 10 years, 16 PWT2D showed DR progression, with over half exhibiting at least one ETDRS severity level increase.
- OFA30 tests revealed progressive sensitivity loss, especially in peripheral/nasal regions, and radially symmetric response delays.
- Reduced regional sensitivity and prolonged delays were significant predictors of DR progression, alongside blood glucose, diabetes duration, and baseline DR severity.
- Specific OFA30 findings: 10 dB nasal sensitivity loss increased progression odds by 1.74x; 10 ms central delay increased odds by 1.12x.
Conclusions:
- The objectiveFIELD Analyser (OFA) offers a rapid and convenient method for monitoring and predicting DR progression in PWT2D.
- OFA's ability to detect functional retinal changes over time shows potential as a sensitive tool for tracking disease.
- Integrating OFA measurements into clinical practice may enhance the management of diabetic retinopathy.
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