FLICKER PERIMETRY IN DIABETIC CHILDREN WITHOUT RETINOPATHY

Objective: To determine the flicker fusion frequency in children and a dolescents with insulin-dependent diabetes mellitus (IDDM) who did nor Rave fluorescein angiographic signs of retinopathy. Design: Cross-sec tional study. Setting: Antidiabetic Centre, departments of Ophthalmolo gy and Pediatrics, University of Chieti, Chieti, Italy, Patients: Fort y-five patients aged 9 to 18 years with IDDM without fluorescein angio graphic signs of retinopathy, Ferry-five healthy subjects matched for sex and age constituted the control group, The patients were classifie d into two subgroups according to their metabolic control: good (perce ntage hemoglobin A(lc) 9% or less) or poor (percentage hemoglobin A(lc ) greater than 9%). Outcome measures: Retinal flicker fusion frequency , evaluated with an automated flicker perimeter in the central 30 degr ees of the visual field. Results: The subjects with poor metabolic con trol had a significantly lower mean flicker fusion frequency than the control subjects (27.43 Hz [standard deviation (SD) 5, 16 Hz] vs. 38.7 2 Hz [SD 4.27 Hz]) and the patients with good metabolic control (33.94 Hz [SD 5.54 Hz]) (p < 0.001). There was a significant relation betwee n flicker fusion frequency and the percentage of hemoglobin A(lc) (r = -0.533, p < 0.001). Conclusions: Our results show that children with poorly controlled IDDM without fluorescein angiographic signs of retin opathy have an impairment of retinal flicker sensitivity in the centra l 30 degrees of the central visual field and that this impairment is r elated to the degree of metabolic control, Flicker perimetry is a simp le, noninvasive tool that may be useful to evaluate the eye function o f diabetic children.