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Early Functional Changes in Diabetes Assessed by Short-wavelength Automated Perimetry
Remky A., Weber A., Hendricks S., Plange N., Arend O.,
RWTH Aachen, Universitätsaugenklinik (Aachen)
Background: The short-wavelength sensitive (SWS) cone mediated sensitivity is a sensible indicator of functional changes of the macula in diabetic maculopathy (Diabetologia 1998; 41: 918). This study was performed to investigate whether functional losses of the macula are detectable prior the development of clinically significant macula edema (CSME).
Methods: In 72 patients with diabetes mellitus (dm) with clear optical media and no CSME conventional white-on-white perimetry (WWP), as well as short-wavelength automated perimetry (SWAP) was performed. Fifty-two healthy subjects in the age of 16-52 years served as controls (norms). There were no differences in the age of both groups. (dm: 37.4 ± 10.9 years, norm: 36.2 ± 13.7 years; p = 0.60).
Results: Variance analysis (ANOVA) revealed a significant difference in mean sensitivity between both groups. (SWAP: dm: 24.9 dB ± 4.3, norm: 27.5 dB ± 2.9; WWP: dm: 31.1 dB ± 1.8, norm 31.8 dB ± 1.5; p < 0.0001). SWAP thresholds were significantly more affected by diabetes than those of WWP (ANOVA - interaction: p = 0.0048).
Conclusions: SWS-sensitivity is affected in early diabetic retinopathy prior the development of CSME and may act as screening tool for eyes at risk of further visual loss.