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 assess the level of awareness and practice patterns of pediatricians in various government and private hospitals in the Philippines regarding retinopathy of prematurity (ROP). Methods: This is a prospective, multicenter, cross-sectional study of the practice profile and awareness of pediatricians of the Philippine Pediatric Society (PPS) ROP screening recommendations. Six hundred selfadministered questionnaires were distributed to pediatricians from 40 randomly selected government and private hospitals in the Philippines between July and September 2013. Frequency distribution for each data was noted. Association of referral rates, distribution of barriers, and availability of protocol among the subgroups were analyzed using chi square. Results: A total of 409 eligible surveys were analyzed with a response rate of 68.1%. 92% of the respondents referred their at-risk preterm babies to ophthalmologists for ROP screening. Of those who referred, 57% considered a cut-off value of less than 32 weeks age of gestation, and 45% considered a cut-off value of less than 1500g birth weight. 47% referred at 4-6 weeks post-natal age, and 48% had a protocol for ROP screening. Only 19% were aware of the PPS ROP screening recommendations. The major barrier encountered was the inability of the families to follow up after discharge (41%). Higher referral rates were noted from private institutions (p=0.013) and tertiary hospitals (p=0.019), including those with a protocol on ROP screening (p=0.002). Conclusion Majority of the respondents referred their at-risk preterm babies for ROP screening. A significant proportion was unaware of the PPS ROP screening guidelines. More than half do not have an established protocol. There were variations in practice patterns of the pediatricians in referring babies at-risk for ROP. Based on these, there is still a need to increase awareness among pediatricians. A uniform, national, published guideline on ROP screening, establishment of referral systems, and training of qualified ophthalmologists are recommended.
Retinopathy of Prematurity ; Mass Screening ; Surveys and Questionnaires