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Central visual field in diabetes.

1969; BMJ; Volume: 53; Issue: 1 Linguagem: Inglês

10.1136/bjo.53.1.16

1468-2079

Jan Roth,

Retinal Diseases and Treatments

Little detailed work has been reported on the central visual field in diabetes.Scott (I957) stated that "the causation of scotomata by endogenic toxins is extremely rare"; Dubois- Poulsen (1952) reported a study of diabetic patients using rod scotometry (Livingston, 1943) in which central field scotomata were found in eyes with no visible retinopathy.The original reference to diabetic patients has not been traced (Livingston, personal communication).King, Dobree, Kok, Foulds, and Dangerfield (I963), during trial of a corn oil diet, found central field scotomata, using the Bjerrum screen, in diabetic patients with exudative retinopathy, which persisted after the exudates had cleared.Lakowski and Aspinal (I966) mentioned three types of defects in diabetic visual fields, found by static methods using the Goldmann perimeter.These defects were a general loss of sensitivity, peripheral field losses, and central field losses; it is not clear whether retinopathy was present or not.The present paper reports the investigation of central visual fields of diabetic patients with and without retinopathy, using a new central field scotometer (Roth, I968). MethodsPatients were selected as follows: Non-diabetic controls (i) no history or past suspicion of diabetes;(2) no history or ocular signs of any disease likely to cause visual field defects;(3) visual acuity in the eye(s) to be tested better than 6/9 (6/I 2 pt.) corrected.Diabetics (i) known diabetics attending the Diabetic Clinic at the Radcliffe Infirmary, Oxford, or referred for investigation from the Hammersmith Hospital, London;(2) as for the Control Group, except that diabetic patients with visible retinopathy were included;(3) patients with visual acuity better than 6/9 (6/12 pt.) corrected if there was no retinopathy, and better than 6/12 (6/I8 pt.) corrected if retinopathy was present.All patients with obvious opacities of the media were excluded.Visual acuity was tested with a 6 metre Snellen chart, distance correction being worn when required.Diabetic eyes were examined with dilated pupils (Cyclopentolate i per cent.), using poly- chromatic light, at least 3 days before the visual field tests.The presence or absence of visible retinopathy was then noted and fundus photographs were taken (Kowa RC and Kodachrome 2 film).The ocular media were examined with an ophthalmoscope.The apparatus used for visual field testing was designed for this project (Roth, I968) to investigate the central 200 field at a test distance of i metre.Patients were given from I o to 20 minutes to adapt to the dim lighting conditions of the test (about I foot candle reflected from the screen).Distance correction, if necessary, was worn for the test;