Ozates Serdar, Simsek Mert, Elgin Ufuk, Keskin Melikşah, Aycan Zehra
Department of Ophthalmology, Kars Harakani State Hospital, Kars, Turkey.
Department of Ophthalmology, University of Health Sciences, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey.
Eur J Ophthalmol. 2020 Nov;30(6):1467-1472. doi: 10.1177/1120672119872896. Epub 2019 Aug 30.
To assess the visual field sensitivity changes and investigate the association between visual field sensitivity and retinal nerve fiber layer thickness in patients with type 1 diabetes mellitus.
In this cross-sectional and observational study, 46 patients (22 males, 24 females) with type 1 diabetes mellitus and no diabetic retinopathy formed the diabetes mellitus group and 50 age-matched healthy subjects (32 males, 18 females) formed the control group. Retinal nerve fiber layer thickness, full-threshold standard automated perimetry, and short-wavelength automated perimetry were performed. Main outcomes were retinal nerve fiber layer thickness, mean deviation, pattern standard deviation, and short fluctuation.
Average retinal nerve fiber layer thickness was significantly thinner in the diabetes mellitus group (p < 0.001). The mean values of mean deviation and pattern standard deviation of the full-threshold standard automated perimetry did not differ between the groups (p = 0.179, p = 0.139, respectively). Mean short fluctuation was significantly greater in the diabetes mellitus group (p < 0.001). Both mean deviation and pattern standard deviation of the short-wavelength automated perimetry were significantly greater in the diabetes mellitus group (p < 0.001, p < 0.001, respectively). Pattern standard deviation of short-wavelength automated perimetry equal or higher than 1.57 dB had 91% sensitivity and 90% specificity (area under the curve = 0.969, p < 0.001) and short fluctuations of full-threshold standard automated perimetry equal or higher than 0.80 dB had 80% sensitivity and 76% specificity over detecting early retinal nerve fiber layer loss in patients with type 1 diabetes mellitus (area under the curve = 0.855, p < 0.001).
This study showed that thinner retinal nerve fiber layer in patients with type 1 diabetes mellitus may be associated with abnormal retinal sensitivity to short-wavelength stimulations in short-wavelength automated perimetry; however, retinal sensitivity to white stimulus was similar to that in healthy subjects in full-threshold standard automated perimetry.
评估1型糖尿病患者的视野敏感度变化，并研究视野敏感度与视网膜神经纤维层厚度之间的关联。
在这项横断面观察性研究中，46例无糖尿病视网膜病变的1型糖尿病患者（22例男性，24例女性）组成糖尿病组，50例年龄匹配的健康受试者（32例男性，18例女性）组成对照组。进行了视网膜神经纤维层厚度测量、全阈值标准自动视野计检查和短波长自动视野计检查。主要观察指标为视网膜神经纤维层厚度、平均偏差、模式标准偏差和短程波动。
糖尿病组的平均视网膜神经纤维层厚度明显更薄（p < 0.001）。全阈值标准自动视野计检查的平均偏差和模式标准偏差的平均值在两组之间无差异（分别为p = 0.179，p = 0.139）。糖尿病组的平均短程波动明显更大（p < 0.001）。短波长自动视野计检查的平均偏差和模式标准偏差在糖尿病组均明显更大（分别为p < （此处原文有误，推测为p < 0.001），p < 0.001）。短波长自动视野计检查的模式标准偏差等于或高于1.57 dB时，在检测1型糖尿病患者早期视网膜神经纤维层损伤方面具有91%的敏感度和90%的特异度（曲线下面积 = 0.969，p < 0.001），全阈值标准自动视野计检查的短程波动等于或高于0.80 dB时，具有80%的敏感度和76%的特异度（曲线下面积 = 0.855，p < 0.001）。
本研究表明，1型糖尿病患者较薄的视网膜神经纤维层可能与短波长自动视野计检查中视网膜对短波长刺激的异常敏感度有关；然而，在全阈值标准自动视野计检查中，视网膜对白色刺激的敏感度与健康受试者相似。
