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Visual sensitivity loss in the central 30° of visual field is associated with diabetic peripheral neuropathy

Sampson, G. P., Shahidi, A. M., Vagenas, D., Pritchard, N., Edwards, K., Russell, A. W., Malik, R. A. and Efron, N. 2012, Visual sensitivity loss in the central 30° of visual field is associated with diabetic peripheral neuropathy, Diabetologia, vol. 55, no. 4, pp. 1179-1185, doi: 10.1007/s00125-012-2457-9.

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Title Visual sensitivity loss in the central 30° of visual field is associated with diabetic peripheral neuropathy
Author(s) Sampson, G. P.
Shahidi, A. M.
Vagenas, D.
Pritchard, N.
Edwards, K.
Russell, A. W.ORCID iD for Russell, A. W. orcid.org/0000-0002-7323-9501
Malik, R. A.
Efron, N.
Journal name Diabetologia
Volume number 55
Issue number 4
Start page 1179
End page 1185
Total pages 7
Publisher Springer
Place of publication Heidelberg, Germany
Publication date 2012-04
ISSN 0012-186X
1432-0428
Keyword(s) diabetes mellitus
perimetry
peripheral neuropathy
type 2 diabetes
visual field
visual sensitivity
Summary Aims/hypothesis
Impaired central vision has been shown to predict diabetic peripheral neuropathy (DPN). Several studies have demonstrated diffuse retinal neurodegenerative changes in diabetic patients prior to retinopathy development, raising the prospect that non-central vision may also be compromised by primary neural damage. We hypothesise that type 2 diabetic patients with DPN exhibit visual sensitivity loss in a distinctive pattern across the visual field, compared with a control group of type 2 diabetic patients without DPN.

Methods
Increment light sensitivity was measured by standard perimetry in the central 30° of visual field for two age-matched groups of type 2 diabetic patients, with and without neuropathy (n = 40/30). Neuropathy status was assigned using the neuropathy disability score. Mean visual sensitivity values were calculated globally, for each quadrant and for three eccentricities (0–10°, 11–20° and 21–30°). Data were analysed using a generalised additive mixed model (GAMM).

Results
Global and quadrant between-group visual sensitivity mean differences were marginally but consistently lower (by about 1 dB) in the neuropathy cohort compared with controls. Between-group mean differences increased from 0.36 to 1.81 dB with increasing eccentricity. GAMM analysis, after adjustment for age, showed these differences to be significant beyond 15° eccentricity and monotonically increasing. Retinopathy levels and disease duration were not significant factors within the model (p = 0.90).

Conclusions/interpretation
Visual sensitivity reduces disproportionately with increasing eccentricity in type 2 diabetic patients with peripheral neuropathy. This sensitivity reduction within the central 30° of visual field may be indicative of more consequential loss in the far periphery.
Language eng
DOI 10.1007/s00125-012-2457-9
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2012, Springer
Persistent URL http://hdl.handle.net/10536/DRO/DU:30066305

Document type: Journal Article
Collection: School of Health and Social Development
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