STUDY OF THE EARLY DETECTION OF DIABETIC RETINOPATHY IN INSULIN DEPENDENT DIABETICS

Abstract

Summary and conclusion This study aimed to evaluate the usefulness of assessment of color vision, electroretinogram (ERG) and perimetry as early prediction of diabetic retinal changes among cases with insulin dependent diabetes mellitus (IDDM) and to detect the association of microalbuminuria with early diabetic retinal changes.

The present work included 90 children and adolescent patients with IDDM (group I). They were recruited among those attending the Ophthalmologic and Diabetologic Pediatric Clinic, Ain Shams University Hospital. A cohort number of thirty non-diabetic children and adolescents were chosen form the ophthalmic clinics to help as a control group (Group II). All the patients and controls (120) underwent thefollowing: 1- History taking including: • Onset of diabetes, age of the onset, duration of the disease, history of important viral infections like rubella, mumps & unknown viral infections with fever. • Drug intake, type, dose, frequency and method of administration of insulin. • Degree of control assessed by history of recurrent coma whether hypoglycemic or diabetic ketoacidosis or history of admission to hospital. • Any complications as renal failure, visual or neurological. 2- Complete general examination laying stress on weight & height also local examination especially neurological. 3- Qualitative determination of microalbuminuria to exclude diabetic children with incipient nephropathy by urinary protein dipstick testing using strips supplied by Boehringer Mannheim Corporation (U.K) and quantitative confirmation was done for positive cases using kits supplied from Behring. 4- Mean random blood sugar. 5- Mean glycosylated hemoglobin. 6- Complete urine analysis, if positive, for pus urinary tract infection was cells treated first. 7- Complete ophthalmological examination, evaluating right eye first : • Assessment of absolute visual acuity • Measurements of ocular tension • Fundus examination • Color vision • Fluorescein angiography • Visual field assessment. • Electroretinogram