Effect of neuropathy on pupillary response measured with infrared static pupillography in type 2 diabetes mellitus patients

Year 2019, , 280 - 284, 28.04.2019

Gözde Şahin , Esat Karademir Onur Temizsoylu , Mehmet Vural Cenap Güler

https://doi.org/10.28982/josam.542567

Abstract

Aim: Diabetic autonomic neuropathy is manifested by pupillary dysfunction in the eye; so pupillary assessment can be vital for early detection. We aim to determine the relationship between diabetic polyneuropathy and pupil response for evaluating the presence of neuropathy via static pupillometer that is a non-invasive and quantitative method. This method could be used as an indicator for early diagnosis of neuropathy in diabetic patients. 

Methods: This case-control study was planned on 420 patients. All participants have been diagnosed with Type 2 Diabetes Mellitus and were referred to Neurology Department. The first group includes 60 patients who have type 2 diabetes mellitus with distal symmetric polyneuropathy (DPN). Second group includes 212 diabetic patients who don't have polyneuropathy. Besides, age-sex matched 208 non-diabetic controls were included in the study. Mesopic, scotopic and photopic pupil measurements were recorded via infrared static pupillography.

Results: The photopic pupil diameter was 3.72 (0.86) mm, 3.64 (0.78) mm, 3.74 (0.78) mm and mesopic pupil diameter were 4.06 (0.76) mm, 4.22 (0.80), 4.39 (0.83) mm and scotopic pupil diameter was 4.58 (0.76) mm, 4.56 (0.84) mm, 4.77 (0.85) mm respectively in DPN group, non-neuropathic diabetic group, and control group. There was no statistically significant difference in groups (p>0.05) except for mesopic and scotopic pupil diameters between control and non-neuropathic diabetic group (p=0.03 and p=0.01, respectively).

Conclusion: Pupillographic methods are not as reliable as diabetic autonomic neuropathy in the early diagnosis of DPN.

Keywords

Diabetes mellitus, Pupillography, Polyneuropathy, Diabetic complications

Tip 2 diyabetes mellitus hastalarında infrared statik pupillografi yardımıyla nöropatinin pupil cevabı üzerine etkisi

Abstract

Amaç: Diyabetik otonomik nöropati pupil disfonksiyonu ile karşımıza çıkabildiği için erken tanıda pupil değerlendirmesi önemli olabilir. Bu çalışmada statik pupilometre aracılığıyla diyabetik polinöropatinin pupil cevabına etkisini araştırmayı amaçladık.

Yöntemler: Vaka kontrol çalışmamız 420 katılımcı üzerinde gerçekleştirildi. Tüm hastalar nöroloji departmanına konsülte edilen tip 2 diyabetes mellitus hastalarıydı. Birinci grupta Tip 2 Diyabetes Mellitus u bulunan 60 distal simetrik polinöropatili hasta bulunmaktaydı. İkinci gruba 202 polinöropatisi olmayan diyabetik hasta dahil edildi. Ayrıca diyabetik olmayan 208 hasta da kontrol grubu olarak çalışmaya dahil edildi. İnfrared statik pupillografi cihazı ile mezopik, skotopik ve fotopik şartlarda ölçümler alındı.

Bulgular: Diyabetik Polinöropatili , nöropatisi olmayan diyabetik ve kontrol gruplarındaki cevaplar sırasıyla; fotopik şartlarda 3,72 (0,86) mm, 3,64 (0,78) mm, 3,74 (0,78) mm, mezopik şartlarda 4,06 (0,76) mm, 4,22 (0,80), 4,39 (0,83) ve skotopik şartlarda 4,58 (0,76) mm, 4,56 (0,84) mm, 4,77 (0,85) mm idi. Kontrol grubu ile nöropatisi olmayan diyabetik hastalardaki mezopik ve skotopik pupil çapları dışında (sırasıyla p=0,03 ve p=0,01) gruplar arasında istatiktiksel olarak anlamlı (p>0,05) bir farklılık bulunamadı.

Sonuç: Pupillografik metodlar diyabetik polinöropati nin erken tanısında diyabetik otonomik nöropati kadar güvenilir sonuçlar vermemektedir.

Keywords

Diabetes mellitus, Pupillografi, Polinöropati, Diabet komplikasyonları

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