Human ; Male ; Female ; INTRAOCULAR PRESSURE ; GLAUCOMA ; OCULAR HYPERTENSION ;

OBJECTIVE: To investigate the significance of short wavelength automated perimetry (SWAP) in detecting retinal functional impairment in early diabetic patients without retinopathy and with mild non-proliferative diabetic retinopathy (NPDR).

METHODS: This is a prospective, cross-sectional study of 37 eyes of early diabetics which were divided into 2 groups: no DR with 18 subjects and mild NPDR with 19. All subjects underwent HBA1C, SWAP, peripapillary RNFL thickness measurement and fundus photo. Visual field indices: MD and PSD as well as average RNFL thickness were compared among the 2 groups. Correlation of MD with RNFL thickness and HBA1C were also analyzed.

RESULTS: There was no statistically significant difference in the MD (-4.46 ± 3.03 vs -2.94 ± 2.21; p=0.09), PSD (3.08 ± 1.28 vs 2.69 ± 0.47; p=0.23) and average peripapillary RNFL thickness (98.47 ± 6.89 vs 98.72 ± 11.01; p=0.93) among early diabetics with mild NPDR and no signs of DR. There is no correlation between MD and RNFL thickness in the no DR group (R2=0.017) and the mild DR group (R2=0.000). There was a weak correlation between MD and HBA1C in the no DR group (R2=0.137), while no correlation was seen in the mild NPDR group (R2=0.000).

CONCLUSION: SWAP does not appear to be a sensitive measure of worsening retinopathy in older individuals with early diabetes. The usefulness of SWAP and peripapillary RNFL thickness in the early stages of retinopathy are inconclusive.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Diabetic Retinopathy ; Visual Field Tests ; Visual Fields ; Retina ; Fundus Oculi ; Retinal Diseases

OBJECTIVE: To describe the demographic and clinical characteristics of patients with glaucoma managed at private and government institutions in the Philippines between 2009 and 2014.

METHODS: A research team from two private and two government institutions in the Philippines reviewed the case records of 1246 patients seen who met the following criteria: intraocular pressure of >21 mmHg, optic nerve and nerve fiber layer abnormalities, and visual field defects. For bilateral cases, we selected the eye with worse glaucoma parameters.

RESULTS: There were 600 and 646 patients in the private and government groups (mean age at presentation, 60.51 and 55.88 years), respectively, with the majority being Filipino (91%). Patients with visual acuity (VA) of 20/20 to 20/40 were more frequently observed in private centers (58.7% vs. 41.3%), while a VA worse than counting fingers was more frequently observed in government centers (66.1% vs. 33.9%). Within-group analysis showed that primary angle-closure glaucoma was the most frequent glaucoma subtype in both private (27.3%) and government institutions (37.8%). In between-group analysis showed the following to be more common in private than government centers: primary open-angle glaucoma (61.3% vs. 38.7%), normal-tension glaucoma (63.9% vs. 36.1%), ocular hypertension (92.3% vs. 7.7%), and glaucoma suspects (80.4% vs. 19.6%) while government institutions registered a larger number of primary angle-closure glaucoma (59.8% vs. 40.2%) and secondary glaucoma (70.3% vs. 29.7%) cases. Medical treatment using a single drug and multiple drugs was employed for 245 (23%) and 825 (77%) patients, respectively. Within-group analysis showed that laser iridotomy and trabeculectomy were the most commonly performed laser and surgical procedures in both institution types.

CONCLUSION: There is a contrasting profile of glaucoma between clinical institutions in the Philippines with openangle glaucoma being more predominant in private centers while closed-angle glaucoma and secondary glaucoma being more frequent in government centers. Our findings may provide important preliminary information that can aid future health studies or training programs.

Human ; Glaucoma ; Patients