Owusu-Afriyie Bismark, Wu Christopher S, Burhans Liam, Coates Daniel R, Harrison Wendy W
University of Houston College of Optometry, Houston, Texas.
Optom Vis Sci. 2025 Sep 1;102(9):578-585. doi: 10.1097/OPX.0000000000002285. Epub 2025 Aug 5.
Sensitive diagnostic techniques are crucial for the early detection of diabetes. Here, we tested a novel color perimeter and found it repeatable in control subjects. It also has the potential to detect functional changes in diabetic eye disease.
Type 2 diabetes (T2DM) causes retinal dysfunction before the appearance of retinopathy. Our group developed a color perimeter that measures chromatic sensitivity at discrete retinal locations. This study evaluates the repeatability of this perimeter in detecting chromatic sensitivity changes in normal and glucose-dysfunctional states.
Eighteen subjects, 49.4 (7.8) years, nine controls (HbA1c ≤5.6%), nine with glucose dysfunction (HbA1c ≥5.7%, no/mild retinopathy), participated. Congenital color defects, diseases affecting color vision, vision >20/32, and those with tinted glasses were excluded. Visual acuity, L'Anthony D-15, and color perimetry were performed at two visits within 9 months. Lens and fundus photographs were taken. Chromatic thresholds were measured at four diagonal locations 3° from fixation in the right eye using 0.5° diameter red, green, blue, and yellow stimuli through a randomly interleaved staircase method. Thresholds were converted to log cone contrast and averaged. The test-retest repeatabilities were analyzed using Bland-Altman plots. Trends were analyzed using linear regression, and Wilcoxon matched-pairs signed rank test and t tests for comparisons.
Clinical tests did not differ between visits (all p ≥ 0.05). Bland-Altman control group plots showed bias lines and measurement differences near zero for all colors (all p > 0.53). Trend lines were horizontal and near zero for all colors (all p > 0.22). In the glucose dysfunction group, the mean of measurement differences was not significantly different from zero for all colors (all p > 0.13). However, green, blue, and yellow stimuli had significant or trending negative-sloped trend lines (p = 0.03, 0.04, and 0.06, respectively). Detailed review of individual clinical data revealed that subjects with relatively longer duration of T2DM, higher HbA1c, and/or mild retinopathy often performed worse on their second visit.
The novel color perimeter demonstrated both good repeatability and potential for detecting subtle visual changes due to glucose dysfunction. Further testing is necessary to compare performance with other structural and functional tests.
灵敏的诊断技术对于糖尿病的早期检测至关重要。在此，我们测试了一种新型彩色视野计，发现其在对照受试者中具有可重复性。它还有潜力检测糖尿病眼病中的功能变化。
2型糖尿病（T2DM）在视网膜病变出现之前就会导致视网膜功能障碍。我们团队开发了一种彩色视野计，可测量视网膜离散位置的色觉敏感度。本研究评估了该视野计在检测正常和糖代谢功能异常状态下色觉敏感度变化方面的可重复性。
18名受试者，年龄49.4（7.8）岁，9名对照者（糖化血红蛋白≤5.6%），9名糖代谢功能异常者（糖化血红蛋白≥5.7%，无/轻度视网膜病变）参与研究。排除先天性色觉缺陷、影响色觉的疾病、视力>20/32者以及戴有色眼镜者。在9个月内进行两次视力、L'Anthony D-15和彩色视野检查。拍摄晶状体和眼底照片。使用0.5°直径的红色、绿色、蓝色和黄色刺激物，通过随机交错阶梯法，在右眼距注视点3°的四个对角位置测量色觉阈值。将阈值转换为对数视锥细胞对比度并求平均值。使用Bland-Altman图分析重测可重复性。使用线性回归分析趋势，并使用Wilcoxon配对符号秩检验和t检验进行比较。
两次检查之间的临床测试无差异（所有p≥0.05）。Bland-Altman对照组图显示所有颜色的偏差线和测量差异均接近零（所有p>0.53）。所有颜色的趋势线均为水平且接近零（所有p>0.22）。在糖代谢功能异常组中，所有颜色的测量差异平均值与零无显著差异（所有p>0.13）。然而，绿色、蓝色和黄色刺激物有显著或呈负斜率的趋势线（分别为p = 0.03、0.04和0.06）。对个体临床数据的详细审查显示，T2DM病程相对较长、糖化血红蛋白较高和/或有轻度视网膜病变的受试者在第二次检查时通常表现较差。
新型彩色视野计显示出良好的可重复性以及检测因糖代谢功能异常引起的细微视觉变化的潜力。需要进一步测试以将其性能与其他结构和功能测试进行比较。
