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Blue-on-yellow and achromatic perimetry in diabetic children without retinopathy
L Lobefalo1, A Verrotti, L Mastropasqua
1Institute of Ophthalmology, University G. D'Annunzio, Chieti, Italy. l.lobefalo@ophthalmology.unich.it
Insights
Blue-on-yellow perimetry is more sensitive than achromatic perimetry for detecting early visual field defects in children with diabetes and microalbuminuria. This advanced visual field testing aids in identifying preclinical retinopathy in diabetic youth.
Area of Science:
- Ophthalmology
- Diabetology
- Medical Imaging
Background:
- Diabetic children with microalbuminuria may have preclinical visual field defects.
- Early detection of visual field defects is crucial for managing diabetic retinopathy.
- Conventional achromatic perimetry may not be sensitive enough to detect these early changes.
Purpose of the Study:
- To compare the sensitivity of blue-on-yellow perimetry versus achromatic perimetry.
- To determine if blue-on-yellow perimetry is superior in detecting visual field defects in diabetic children.
- To assess visual field sensitivity in relation to microalbuminuria status.
Main Methods:
- Studied 50 children and adolescents with type 1 diabetes (IDDM).
- Patients were categorized based on the presence of persistent microalbuminuria.
- Visual fields were assessed using both blue-on-yellow and achromatic perimetry.
Main Results:
- Blue-on-yellow perimetry showed lower sensitivity in microalbuminuric patients across all tested subareas.
- A significant difference in visual field defects was detected outside 18 degrees using achromatic perimetry (P = 0.027).
- Blue-on-yellow perimetry demonstrated higher statistical significance (P < 0.0001 in central 18 degrees) for detecting differences.
Conclusions:
- Blue-on-yellow perimetry is more sensitive than achromatic perimetry for detecting preclinical visual field defects.
- This method is particularly useful in diabetic children with microalbuminuria but no retinopathy.
- Early visual field testing can aid in the management of diabetic complications.
Objective:
We compared blue-on-yellow perimetry with achromatic perimetry to determine whether the first was more sensitive in detecting visual field defects.
Research Design And Methods:
We studied 50 children and adolescents (22 male, 28 female) with IDDM, ranging in age from 10.1 to 16.3 years (mean 13.3+/-2.1 years), with a disease duration of 5.2-10.0 years (mean 7.1+/-1.9 years). Patients were divided into subgroups according to the presence of persistent microalbuminuria. No one had signs of diabetic retinopathy when studied with fluorescein angiography.
Results:
By achromatic perimetry, the analysis of subareas of the central 30 degrees of the visual field (0-9 degrees; 10-18 degrees; out of 18 degrees) showed no differences between diabetic subgroups in the central 18 degrees of the visual field, while a significant difference between the same subgroups was found outside the 18 degrees of the 24-2 program of the Humphrey perimeter (P = 0.027). By blue-on-yellow perimetry, in all three of the perimetric subareas evaluated, the sensitivity was lower in microalbuminuric patients than in normoalbuminuric ones. The differential sensitivity between the perimetric tests performed with blue-on-yellow and with achromatic stimuli showed statistically significant data, with a higher level of significance in the central 18 degrees (P < 0.0001) than outside the 18 degrees (P = 0.033).
Conclusions:
Our study suggests that blue-on-yellow perimetry is more useful and more sensitive than achromatic perimetry in the detection of preclinical visual field defects in diabetic children with microalbuminuria but without clinically detectable retinopathy.