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Ana Carolina N. Yamada, Aline L. Coutinho, Cristina Miyamoto, Augusto Paranhos; The Use Of New Diagnosis Instruments in Diabetic Patients. Invest. Ophthalmol. Vis. Sci. 2011;52(14):988.
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Find out new diagnosis instruments that could evaluate diabetic patients before installation of the retinopathy.
This is a prospective, transversal, non-controlled study in 34 patients selected in Retina sector of the Department of Ophthalmology at Federal University of São Paulo (UNIFESP).Patients with diabetes type II and between 5 and 20 years of the disease entered the study. They were submitted to a complete ophthalmological evaluation. Patients that confirmed to enter in the study, signed the consent term. Inclusion criteria: Macular edema confirmed by angiogram fluorescein, HRA and OCT; best corrected visual acuity, better than 20/50; absence of any other ocular pathology; no ocular surgeries or previous treatment for retinopathy and any media opacities .It was made the following psychophysical tests:FDT Matrix: The Humphrey Matrix. (10-2 and macular)SAP 10-2: Visual field - Humphrey Field Analyzer 640. (10-2)SWAP 10-2: Visual field - Humphrey Field Analyzer 640. (10-2 and macular)PHP: The preferential hyperacuity perimeter (PreView PHP Carl Zeus Mediate).
It was analyzed 68 eyes of 34 diabetic type II patients. It was encountered significant association between anatomic and psychophysical parameters for the majority of the tests. There was significant association between MD FDT macular and OCT findings. Presence of macular edema characterized in retinography and fluorescein angiography showed significant association with FDT 10-2 and FDT macular. The SAP which utilized the 10-2 program did not have a good correlation with OCT measures, but, we found a significant association between SAP and the presence of edema seen in the retinography and not so strong with angiography. The SWAP perimeter showed significant association with OCT findings and retinography but not so strong with angiography. PHP alterations were analyzed as present or absent in a logistic model that the dependent variable was binary. It was not found any significant association between PHP and anatomic variables.
FDT and SWAP are the most reliable visual fields tests for patients without clinical diabetic maculopathy or initial alterations. Their findings also correlate with anatomical alterations seen mostly by OCT, but also in fluorescein angiogram. SAP and PHP didn’t show good association with these initial alterations and should be used to moderate and worse diabetic retinopathy.
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