Tip 2 diyabette erken dönem klinik retinopati bulgularının renkli ve renkli olmayan bilgisayarlı görme alanı ile karşılaştırmalı değerlendirilmesi
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2004
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Türkiye Klinikleri Oftalmoloji Dergisi
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Abstract
Öz: Amaç: Tip 2 diyabette belirgin klinik retinopati bulguları ortaya çıkmadan önce, santral görme alanında oluşabilecek değişiklikleri renkli ve renkli olmayan görme alanı testleri ile karşılaştırmalı incelemeyi amaçladık.Gereç ve Yöntemler: İnönü Üniversitesi Tıp Fakültesi Endokrinoloji ve Göz Klinikleri’ nde Tip 2 diyabet tanısı ile takip edilen 47 hasta çalışma kapsamına alındı. Retinopatisi olmayan 26 hasta ve başlangıç retinopatili 21 hastanın her iki gözünde, Humphrey Field Analyzer (HFA-750) ile renkli (sarı zeminde mavi) ve renkli olmayan santral 30-2 eşik testi uygulandı. Benzer yaş ve cinsiyet dağılımına sahip 12 sağlıklı olgunun 24 gözü kontrol grubu olarak incelendi. Demografik özellikler, kan HbA1c düzeyi ve objektif görme alanı parametreleri olarak ortalama sapma (MD) ve patern standart sapma (PSD) değerleri gruplar arasında istatistiksel yöntemlerle karşılaştırıldı. Bulgular: Yaş ve cinsiyet dağılımı yönünden gruplar arasında farklılık yoktu. Ortalama hastalık süresi başlangıç retinopati grubunda retinopatisi olmayan gruba göre, anlamlı olarak uzundu (p=0.0001). Diyabetik hasta gruplarında, kontrol grubuna göre, renkli ve renkli olmayan görme alanlarında MD’ deki azalma ve PSD deki artma istatistiksel olarak anlamlıydı (p<0.05). Başlangıç retinopati grubu, retinopatisi olmayan gruba göre renkli görme alanı testlerinde MD daki azalma ve PSD değerlerinde artma belirgin olup (P<0.05), renkli olmayan görme alanı testlerinde anlamlı değildi (P> 0.05). Diyabetik hastalarda diyabetin süresi ve kan HbA1c düzeyleri ile MD ve PSD değerleri arasındaki korelasyon istatistiksel olarak anlamlı değildi (p>0.05). Diyabetik hastalardaki lokal görme alanı kayıpları renkli ve renkli olmayan görme alanı testlerinde çoğunlukla 20-30 derece arasında ve üst yarıda yerleşim gösteriyordu.Sonuç: Tip 2 diyabetli hastalarda belirgin klinik retinopati bulguları ortaya çıkmadan önce, retina duyarlılığında azalma ve görme alanı kayıpları olabilmektedir. Bilgisayarlı renkli perimetre, preklinik görme alanı kayıplarını belirlemede renkli olmayan perimetreden daha duyarlı bir yöntemdir.
Abstract: Objective: We aimed to comparatively evaluate the possible cent-ral visual field changes prior to the development of clinically detectable retinopathy in type 2 diabetes with colour perimetric tests and achromatic perimetric tests. Material and Methods: Forty-seven patients with type 2 diabetes, survivor of Ophthalmology and Endocrinology Clinics, İnönü University Faculty of Medicine, were included in the study. The central 30-2 threshold tests (blue-on-yellow (B/Y) and white-on-white (W/W)) by Humphrey Field Analyzer (HFA-750) were applied to both eyes in 26 patients with no retinopathy and 21 with mild retinopathy. Twenty- four eyes of 12 healthy subjects of similar age and gender distribution served as control group. Demographic characteristics, blood HbA1c levels, mean deviation (MD) and pattern standard deviation (PSD) values as objective perimetric indices were compared among the groups by statistical methods.Results: There was no difference between the groups in age and gender distribution. The mean duration of diabetic disease was significantly (P=0.001) longer in mild background retinopathy group compared to the no retinopathy group. There were a significant decrease in MD values and increase in PSD values of the chromatic and achromatic visual field tests in diabetic groups compared to the control group (P<0.05). Decrease in MD values and increase in PSD values of the chromatic visual field tests were found remarkable (p<0.05), but were not detected significant (p=0.095) in the achromatic tests in mild background group compared to no retinopathy group. The duration of the disease. and blood HbA1c levels were not found significantly correlated with MD and PSD values in diabetic patients. The achromatic and chromatic visual field defects in the diabetic patients were often localized at the superior quadrants and between 20° - 30°.Conclusion: Prior to clinically detectable retinopathy, retinal sensitivity loss and visual field defects may develop in type 2 diabetic patients. Colour automated perimetry (B/Y) is a more sensitive method in early detection of the preclinical visual field defects than achromatic automated perimetry (W/W) in diabetic retinopathy.
Abstract: Objective: We aimed to comparatively evaluate the possible cent-ral visual field changes prior to the development of clinically detectable retinopathy in type 2 diabetes with colour perimetric tests and achromatic perimetric tests. Material and Methods: Forty-seven patients with type 2 diabetes, survivor of Ophthalmology and Endocrinology Clinics, İnönü University Faculty of Medicine, were included in the study. The central 30-2 threshold tests (blue-on-yellow (B/Y) and white-on-white (W/W)) by Humphrey Field Analyzer (HFA-750) were applied to both eyes in 26 patients with no retinopathy and 21 with mild retinopathy. Twenty- four eyes of 12 healthy subjects of similar age and gender distribution served as control group. Demographic characteristics, blood HbA1c levels, mean deviation (MD) and pattern standard deviation (PSD) values as objective perimetric indices were compared among the groups by statistical methods.Results: There was no difference between the groups in age and gender distribution. The mean duration of diabetic disease was significantly (P=0.001) longer in mild background retinopathy group compared to the no retinopathy group. There were a significant decrease in MD values and increase in PSD values of the chromatic and achromatic visual field tests in diabetic groups compared to the control group (P<0.05). Decrease in MD values and increase in PSD values of the chromatic visual field tests were found remarkable (p<0.05), but were not detected significant (p=0.095) in the achromatic tests in mild background group compared to no retinopathy group. The duration of the disease. and blood HbA1c levels were not found significantly correlated with MD and PSD values in diabetic patients. The achromatic and chromatic visual field defects in the diabetic patients were often localized at the superior quadrants and between 20° - 30°.Conclusion: Prior to clinically detectable retinopathy, retinal sensitivity loss and visual field defects may develop in type 2 diabetic patients. Colour automated perimetry (B/Y) is a more sensitive method in early detection of the preclinical visual field defects than achromatic automated perimetry (W/W) in diabetic retinopathy.
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Türkiye Klinikleri Oftalmoloji Dergisi
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Volume
13
Issue
3
Citation
AYDIN E,TOTAN Y,DAĞLIOĞLU M. C,CUMURCU T (2004). Tip 2 diyabette erken dönem klinik retinopati bulgularının renkli ve renkli olmayan bilgisayarlı görme alanı ile karşılaştırmalı değerlendirilmesi. Türkiye Klinikleri Oftalmoloji Dergisi, 13(3), 129 - 133.
