BLUE-ON-YELLOW AND ACHROMATIC PERIMETRY IN DIABETIC CHILDREN WITHOUT RETINOPATHY

OBJECTIVE - We compared blue-on-yellow perimetry with achromatic perim etry to determine whether the first was more sensitive in detecting vi sual field defects. RESEARCH DESIGN AND METHODS - We studied 50 childr en and adolescents (22 male, 28 female) with IDDM, ranging in age from 10.1 to 16.3 years (mean 13.3 +/- 2.1 years), with a disease duration of 5.2-10.0 years (mean 7.1 +/- 1.9 years). Patients were divided int o subgroups according to the presence of persistent microalbuminuria. No one had signs of diabetic retinopathy when studied with fluorescein angiography. RESULTS - By achromatic perimetry, the analysis of subar eas of the central 30 degrees of the visual field (0-9 degrees; 10-18 degrees; out of 18 degrees) showed no differences between diabetic sub groups in the central 18 degrees of the visual field, while a signific ant difference between the same subgroups was found outside the 18 deg rees of the 24-2 program of the Humphrey perimeter (P = 0.027). By blu e-on-yellow perimetry, in all three of the perimetric subareas evaluat ed, the sensitivity was lower in microalbuminuric patients than in nor moalbuminuric ones. The differential sensitivity between the perimetri c tests performed with blue-on-yellow and with achromatic stimuli show ed statistically significant data, with a higher level of significance in the central 18 degrees (P < 0.0001) than outside the 18 degrees (P = 0.033). CONCLUSIONS - Our study suggests that blue-on-yellow perime try is more useful and more sensitive than achromatic perimetry in the detection of preclinical visual field defects in diabetic children wi th microalbuminuria but without clinically detectable retinopathy.