| 1. |
- Agardh, Elisabet, et al.
(författare)
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Stable refraction and visual acuity in diabetic patients with variable glucose levels under routine care
- 2011
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Ingår i: Acta Ophthalmologica. - : Wiley-Blackwell. - 1755-375X .- 1755-3768. ; 89:2, s. 107-110
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To investigate how refraction and visual acuity may vary in patients with diabetes under routine care.METHODS: Fifty-three eyes of 53 patients with various degrees of diabetic retinopathy were examined prospectively on four different occasions within a month. Refraction, best-corrected visual acuity (expressed as logMAR score) and blood glucose were measured on each occasion. Intraindividual variability was calculated as the range between the highest and lowest measurements. Associations between blood glucose levels and each of the other variables were tested by linear regression analysis for each patient.RESULTS: Refraction was completely stable in 43 patients and changed only slightly in 10, in whom the mean intraindividual variability of the spherical equivalent was 0.4 dioptres. Visual acuity test results were also highly reproducible. Mean intraindividual variability in visual acuity was 0.08 logMAR. Mean haemoglobin A1c (HbA1c) was 7.3 ± 1.5% but individual blood glucose levels ranged from 2.8 to > 22.2 mmol/l. Intraindividual variability ranged from 0.5 to 18.1 mmol/l, with a median of 6.0 mmol/l for the entire group. There were no associations between refraction or visual acuity and blood glucose levels or inter- or intraindividual glucose variations.CONCLUSION: Refraction and visual acuity test results were highly reproducible and stable in patients with reasonably well controlled diabetes but variable blood glucose levels under routine care.
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| 2. |
- Bengtsson, Boel, et al.
(författare)
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Test-retest variability for standard automated perimetry and short-wavelength automated perimetry in diabetic patients
- 2008
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Ingår i: Acta Ophthalmologica. - : Wiley-Blackwell. - 1755-375X .- 1755-3768 .- 1395-3907. ; 86:2, s. 170-6
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To assess limits for significant improvement or deterioration of visual fields in diabetic patients based on short-term test-retest variability in subjects with different degrees of retinopathy.METHODS: Fifty patients with diabetic retinopathy ranging from level 10 to 75 [according to the Early Treatment Diabetic Retinopathy Study (ETDRS) severity scale] were tested repeatedly with both standard automated perimetry (SAP) and short-wavelength automated perimetry (SWAP) with short intervals. The association between visual field loss and degree of retinopathy outside fovea was analysed. Test-retest variability of global and local visual field indices and prediction limits for significant change were calculated.RESULTS: The amount of visual field loss was significantly associated to the degree of retinopathy, with a correlation coefficient of -0.51 for SAP (P = 0.0003) and -0.45 for SWAP (P = 0.002). Global test-retest variability was smaller with SAP than with SWAP (P < 0.0001). For both SAP and SWAP, local test-retest variability was considerably smaller at test points with normal sensitivity than at test points with reduced sensitivity (P < 0.0001). Paracentral test points within 10 degrees of eccentricity had less variability than peripheral points (P < 0.0001), implying that smaller change is required to reach statistically significant improvement or deterioration at initially normal and paracentral points than at depressed points and peripherally located test points.CONCLUSION: Our results propose that SAP, as well as SWAP, can be useful for monitoring visual function outside fovea in diabetic patients with various degrees of retinopathy. We report a preference for SAP because of less variability generally. Limits for significant improvement or deterioration have been assessed but need future validation in a longitudinal study.
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| 3. |
- Hellgren, Karl-Johan, 1971-, et al.
(författare)
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Functional and structural change in diabetic eyes. Interim results from an ongoing longitudinal prospective study
- 2013
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Ingår i: Acta Ophthalmologica. - : Wiley-Blackwell. - 1755-375X .- 1755-3768. ; 91:7, s. 672-677
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To presents results after 18months of follow-up of a longitudinal study aiming at exploring the correlation between diabetic retinal vascular lesions and functional change.Methods: Patients were consecutively recruited from attendees to the screening program for diabetic retinopathy. Subjects are followed every sixth month for the first 3years and thereafter annually up to 5years. Progression of diabetic retinopathy is evaluated using the Early Treatment Diabetic Retinopathy Study (ETDRS) scale and improvement/deterioration in visual fields by predefined significance limits for change.Results: Of 81 subjects, with no/mild/moderate diabetic retinopathy included, 76 have passed the 18-month visit. At that time, retinal progression by two steps according to the ETDRS scale had occurred in two subjects. Visual acuity was -0.14 logMAR and had decreased with two letters (0.04 logMAR) (p<0.001) from baseline. The global visual field index mean deviation was almost unchanged with a negligible improvement of 0.03dB (p=0.79). In 21 subjects, repeated significant deterioration was seen in 10% of all points tested in the field, while almost no improved points were noted. The two subjects with retinal progression were not among those 21 with indication of perimetric progression.Conclusions: This is, to our knowledge, the first longitudinal study evaluating change of visual fields in a representative diabetic cohort with no or mild/moderate retinopathy. In this interim report, we demonstrate deteriorated perimetric sensitivity in subjects already at 18months of follow-up. The results will have implications for evaluating change in visual function in future clinical trials.
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| 4. |
- Hellgren, Karl-Johan, 1971-, et al.
(författare)
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Progression of Early Retinal Dysfunction in Diabetes Over Time : Results of a Long-term Prospective Clinical Study
- 2014
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Ingår i: Diabetes. - : American Diabetes Association. - 0012-1797 .- 1939-327X. ; 63:9, s. 3104-3111
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Tidskriftsartikel (refereegranskat)abstract
- We explored signs of retinal dysfunction over time in diabetic subjects before or early in the course of retinopathy. Patients with no, mild, or moderate retinopathy were consecutively recruited and underwent standard automated perimetry, visual acuity measurement, and fundus photography. These examinations and measurements of HbA(1c) and blood pressure were repeated for up to 5 years from baseline. Visual field improvement/deterioration in diabetic subjects was evaluated using significance limits for change. Progression or regression of retinopathy was defined as a two-step change on the Early Treatment Diabetic Retinopathy Study final severity scale. Seventy-four subjects completed at least 3 years of follow-up, and 22% showed visual field worsening, defined as repeated significant deterioration at 10% of the test points, whereas only 1% showed field improvement. Worsening occurred in subjects both with and without vascular lesions. The degree of retinopathy was stable throughout the observation period in 68 of 74 eyes, improved in 4, and worsened in 2. Visual field deterioration was not correlated with a change in retinopathy. By using perimetry with an analysis tailored for monitoring diabetic subjects, we were able to demonstrate progression of retinal dysfunction over time, which may represent early signs of retinal neurodegeneration.
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