[Retinal nerve fiber layer photography and papillometry in juvenile diabetes mellitus]

Chronic complications in diabetes mellitus are angiopathy and neuropathy. The appearance of microangiopathy on angiographical examination with fluorescein has been understood to be a very important prognostic sign in cases of juvenile diabetes mellitus. There are few reports of changes in the retinal nerve fiber layer or optic disc. In 20 patients with juvenile diabetes mellitus, 20 eyes were examined by retinal nerve fiber layer photography, biomorphometry of the optic disc, fluorescein angiography and automated perimetry. Age, time of disease onset and the actual Hba1c value in the blood were noted for each patient. Pathologic changes could not be found in any of the ophthalmological examinations listed above. Statistical evaluation provided a relatively high (r = 0.53) correlation between the neuroretinal rim area and the actual Hba1c values. However, further evaluation indicated that this was caused by the covariance of the relation between neuroretinal rim area and disc area. Date of disease onset showed no correlation with topographical disc parameters. Our findings did not indicate increasing endoneuronal fluid pressure depending on glucose levels as an early sign of diabetic eye disease.