Research Article
PDF Zotero Mendeley EndNote BibTex Cite

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

Year 2019, Volume 3, Issue 4, 280 - 284, 28.04.2019
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.

References

  • 1. Guariguata L, Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract. 2014;103.2:137-49.
  • 2. Katz B, Simmons I. Pupillary changes of diabetic eye. Ophthalmol Clin North Am. 1992;5:379-88.
  • 3. Nakayama M, Nakamura J, Hamada Y, Chaya S, Mizubayashi R. Aldose Reductase Inhibition Ameliorates Pupillary Light Reflex and F-Wave Latency in Patients With Mild Diabetic Neuropathy. Diabetes Care 2001;24:1093-8.
  • 4. Mc Nally PG, Lawrence IG, Panerai RB, Weston PJ, Thurston H. Sudden death in type-1 diabetes. Diab Obes Metabol. 1999;1:151-8.
  • 5. Ko ML, Chen YY, Ouyang Y, Huang TW, Tsuen BS, Jeng WD, et al. Design and analysis of wearable pupillometer for autonomic neuropathy of diabetic patients. Appl Opt. 2014 Oct 10;53(29):H27-34. doi: 10.1364/AO.53.000H27.
  • 6. Smith SE, Smith SA Pupillary signs in diabetic autonomic neuropathy Br Med J. 1978; 30;2(6142):924-7.
  • 7. Young MJ, Boulton AJM, MacLeod AF, Williams DRR, Sonksen PH. A multicentre study of the prevalence of diabetic peripheral neuropathy in the United Kingdom hospital clinic population. Diabetologia 1993;36(2):150-4.
  • 8. Tentolouris N, Pagoni S, Tzonou A, Katsilambros N. Peripheral neuropathy does not invariably coexist with autonomic neuropathy in diabetes mellitus. Eur J Intern Med. 2001;12:20–27.
  • 9. Pozzessere G, Rossi P, Gabriele A, Cipriani R, Morocutti A, Di Mario U, et al. Early detection of small-fiber neuropathy in diabetes: a laser-induced pain somatosensory-evoked potentials and pupillometric study. Diabetes Care. 2002 Dec;25(12):2355-8.
  • 10. Toyry JP, Partanen JV, Niskanen LK , Lansimies EA, Uusitupa MI Divergent development of autonomic and peripheral somatic neuropathies in NIDDM. Diabetologia 1997;40:953–8.
  • 11. Winkler AS, Ejskjaer N, Edmonds M, Watkins PJ. Dissociated sensory loss in diabetic autonomic neuropathy. Diabet Med. 2000 Jun;17(6):457-62.
  • 12. Dütsch M, Marthol H, Michelson G, Neundörfer B, Hilz MJ. Pupillography refines the diagnosis of diabetic autonomic neuropathy. J Neurol Sci. 2004:222(1-2):75-81.
  • 13. Dyck PJ, Giannini C. Pathologic alterations in the diabetic neuropathies of humans: a review. J Neuropathol Exp Neurol. 1996;55:1181–93
  • 14. Davson H. Physiology of the eye. 1980;New York: Churchill Livingstone.
  • 15. Heller PH, Perry F, Jewett DL, Levine JD. Autonomic components of the human pupillary light reflex. Invest Ophthalmol Visual Sci. 1990;31:156–62.
  • 16. Merritt SL, Keegan AP, Mercer PW. Artifact management in pupillometry. Nurs Res. 1994;43:56–9.
  • 17. Alexandridis E, Argyropoulos T, Krastel H. The latent period of the pupil light reflex in lesions of the optic nerve. Ophthalmologica. 1981;182:211–7.
  • 18. Smith SA, Smith SE. Reduced pupillary light reflexes in diabetic autonomic neuropathy. Diabetologia. 1983;24:330–2.
  • 19. Hayashi M, Ishikawa S. Pharmacology of pupillary responses in diabetics—a correlative study of the responses and grade of retinopathy. Jpn J Ophthalmol. 1979;23:65–72.
  • 20. Smith S, Dewhirst R. A simple diagnostic test for pupillary abnormality in diabetic autonomic neuropathy. Diabet Med. 1986;3:38–41.
  • 21. Smith SA, Smith SE. Pupil function: test and disorders. In: Bannister R, Mathias CJ, editors. Autonomic failure. A textbook of clinical disorders of the autonomic nervous system. Oxford: Oxford Univ. Press 1999;245–53.
  • 22. Piha SJ, Halonen JP. Infrared pupillometry in the assessment of autonomic function. Diabetes Res Clin Pract. 1994 Nov;26(1):61-6.

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

Year 2019, Volume 3, Issue 4, 280 - 284, 28.04.2019
https://doi.org/10.28982/josam.542567

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.

References

  • 1. Guariguata L, Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract. 2014;103.2:137-49.
  • 2. Katz B, Simmons I. Pupillary changes of diabetic eye. Ophthalmol Clin North Am. 1992;5:379-88.
  • 3. Nakayama M, Nakamura J, Hamada Y, Chaya S, Mizubayashi R. Aldose Reductase Inhibition Ameliorates Pupillary Light Reflex and F-Wave Latency in Patients With Mild Diabetic Neuropathy. Diabetes Care 2001;24:1093-8.
  • 4. Mc Nally PG, Lawrence IG, Panerai RB, Weston PJ, Thurston H. Sudden death in type-1 diabetes. Diab Obes Metabol. 1999;1:151-8.
  • 5. Ko ML, Chen YY, Ouyang Y, Huang TW, Tsuen BS, Jeng WD, et al. Design and analysis of wearable pupillometer for autonomic neuropathy of diabetic patients. Appl Opt. 2014 Oct 10;53(29):H27-34. doi: 10.1364/AO.53.000H27.
  • 6. Smith SE, Smith SA Pupillary signs in diabetic autonomic neuropathy Br Med J. 1978; 30;2(6142):924-7.
  • 7. Young MJ, Boulton AJM, MacLeod AF, Williams DRR, Sonksen PH. A multicentre study of the prevalence of diabetic peripheral neuropathy in the United Kingdom hospital clinic population. Diabetologia 1993;36(2):150-4.
  • 8. Tentolouris N, Pagoni S, Tzonou A, Katsilambros N. Peripheral neuropathy does not invariably coexist with autonomic neuropathy in diabetes mellitus. Eur J Intern Med. 2001;12:20–27.
  • 9. Pozzessere G, Rossi P, Gabriele A, Cipriani R, Morocutti A, Di Mario U, et al. Early detection of small-fiber neuropathy in diabetes: a laser-induced pain somatosensory-evoked potentials and pupillometric study. Diabetes Care. 2002 Dec;25(12):2355-8.
  • 10. Toyry JP, Partanen JV, Niskanen LK , Lansimies EA, Uusitupa MI Divergent development of autonomic and peripheral somatic neuropathies in NIDDM. Diabetologia 1997;40:953–8.
  • 11. Winkler AS, Ejskjaer N, Edmonds M, Watkins PJ. Dissociated sensory loss in diabetic autonomic neuropathy. Diabet Med. 2000 Jun;17(6):457-62.
  • 12. Dütsch M, Marthol H, Michelson G, Neundörfer B, Hilz MJ. Pupillography refines the diagnosis of diabetic autonomic neuropathy. J Neurol Sci. 2004:222(1-2):75-81.
  • 13. Dyck PJ, Giannini C. Pathologic alterations in the diabetic neuropathies of humans: a review. J Neuropathol Exp Neurol. 1996;55:1181–93
  • 14. Davson H. Physiology of the eye. 1980;New York: Churchill Livingstone.
  • 15. Heller PH, Perry F, Jewett DL, Levine JD. Autonomic components of the human pupillary light reflex. Invest Ophthalmol Visual Sci. 1990;31:156–62.
  • 16. Merritt SL, Keegan AP, Mercer PW. Artifact management in pupillometry. Nurs Res. 1994;43:56–9.
  • 17. Alexandridis E, Argyropoulos T, Krastel H. The latent period of the pupil light reflex in lesions of the optic nerve. Ophthalmologica. 1981;182:211–7.
  • 18. Smith SA, Smith SE. Reduced pupillary light reflexes in diabetic autonomic neuropathy. Diabetologia. 1983;24:330–2.
  • 19. Hayashi M, Ishikawa S. Pharmacology of pupillary responses in diabetics—a correlative study of the responses and grade of retinopathy. Jpn J Ophthalmol. 1979;23:65–72.
  • 20. Smith S, Dewhirst R. A simple diagnostic test for pupillary abnormality in diabetic autonomic neuropathy. Diabet Med. 1986;3:38–41.
  • 21. Smith SA, Smith SE. Pupil function: test and disorders. In: Bannister R, Mathias CJ, editors. Autonomic failure. A textbook of clinical disorders of the autonomic nervous system. Oxford: Oxford Univ. Press 1999;245–53.
  • 22. Piha SJ, Halonen JP. Infrared pupillometry in the assessment of autonomic function. Diabetes Res Clin Pract. 1994 Nov;26(1):61-6.

Details

Primary Language English
Subjects Ophthalmology
Journal Section Research article
Authors

Gözde ŞAHİN
UNIVERSITY OF HEALTH SCIENCES, ERZURUM REGION HEALTH RESEARCH CENTER, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, DEPARTMENT OF OPHTHALMOLOGY
0000-0002-6989-4378
Türkiye


Esat KARADEMİR This is me
BALIKESIR UNIVERSITY, FACULTY OF MEDICINE, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, DEPARTMENT OF OPHTHALMOLOGY
0000-0003-2111-697X
Türkiye


Onur TEMİZSOYLU
0000-0001-5950-9790
Türkiye


Mehmet VURAL This is me
Konya Ereğli State Hospital Ophthalmology Department
0000-0001-7550-9512


Cenap GÜLER This is me
BALIKESIR UNIVERSITY, FACULTY OF MEDICINE, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, DEPARTMENT OF OPHTHALMOLOGY
0000-0002-3640-271X
Türkiye

Publication Date April 28, 2019
Published in Issue Year 2019, Volume 3, Issue 4

Cite

Bibtex @research article { josam542567, journal = {Journal of Surgery and Medicine}, issn = {}, eissn = {2602-2079}, address = {jsurgmed@gmail.com}, publisher = {Fatih BAŞAK}, year = {2019}, volume = {3}, pages = {280 - 284}, doi = {10.28982/josam.542567}, title = {Effect of neuropathy on pupillary response measured with infrared static pupillography in type 2 diabetes mellitus patients}, key = {cite}, author = {Şahin, Gözde and Karademir, Esat and Temizsoylu, Onur and Vural, Mehmet and Güler, Cenap} }
APA Şahin, G. , Karademir, E. , Temizsoylu, O. , Vural, M. & Güler, C. (2019). Effect of neuropathy on pupillary response measured with infrared static pupillography in type 2 diabetes mellitus patients . Journal of Surgery and Medicine , 3 (4) , 280-284 . DOI: 10.28982/josam.542567
MLA Şahin, G. , Karademir, E. , Temizsoylu, O. , Vural, M. , Güler, C. "Effect of neuropathy on pupillary response measured with infrared static pupillography in type 2 diabetes mellitus patients" . Journal of Surgery and Medicine 3 (2019 ): 280-284 <http://jsurgmed.com/en/pub/issue/44120/542567>
Chicago Şahin, G. , Karademir, E. , Temizsoylu, O. , Vural, M. , Güler, C. "Effect of neuropathy on pupillary response measured with infrared static pupillography in type 2 diabetes mellitus patients". Journal of Surgery and Medicine 3 (2019 ): 280-284
RIS TY - JOUR T1 - Effect of neuropathy on pupillary response measured with infrared static pupillography in type 2 diabetes mellitus patients AU - Gözde Şahin , Esat Karademir , Onur Temizsoylu , Mehmet Vural , Cenap Güler Y1 - 2019 PY - 2019 N1 - doi: 10.28982/josam.542567 DO - 10.28982/josam.542567 T2 - Journal of Surgery and Medicine JF - Journal JO - JOR SP - 280 EP - 284 VL - 3 IS - 4 SN - -2602-2079 M3 - doi: 10.28982/josam.542567 UR - https://doi.org/10.28982/josam.542567 Y2 - 2019 ER -
EndNote %0 Journal of Surgery and Medicine Effect of neuropathy on pupillary response measured with infrared static pupillography in type 2 diabetes mellitus patients %A Gözde Şahin , Esat Karademir , Onur Temizsoylu , Mehmet Vural , Cenap Güler %T Effect of neuropathy on pupillary response measured with infrared static pupillography in type 2 diabetes mellitus patients %D 2019 %J Journal of Surgery and Medicine %P -2602-2079 %V 3 %N 4 %R doi: 10.28982/josam.542567 %U 10.28982/josam.542567
ISNAD Şahin, Gözde , Karademir, Esat , Temizsoylu, Onur , Vural, Mehmet , Güler, Cenap . "Effect of neuropathy on pupillary response measured with infrared static pupillography in type 2 diabetes mellitus patients". Journal of Surgery and Medicine 3 / 4 (April 2019): 280-284 . https://doi.org/10.28982/josam.542567
AMA Şahin G. , Karademir E. , Temizsoylu O. , Vural M. , Güler C. Effect of neuropathy on pupillary response measured with infrared static pupillography in type 2 diabetes mellitus patients. J Surg Med. 2019; 3(4): 280-284.
Vancouver Şahin G. , Karademir E. , Temizsoylu O. , Vural M. , Güler C. Effect of neuropathy on pupillary response measured with infrared static pupillography in type 2 diabetes mellitus patients. Journal of Surgery and Medicine. 2019; 3(4): 280-284.
IEEE G. Şahin , E. Karademir , O. Temizsoylu , M. Vural and C. Güler , "Effect of neuropathy on pupillary response measured with infrared static pupillography in type 2 diabetes mellitus patients", Journal of Surgery and Medicine, vol. 3, no. 4, pp. 280-284, Apr. 2019, doi:10.28982/josam.542567

The DNS issue is resolved. jsurgmed.com and current publication are fully accessible.

To use the submission system properly, please use one of the following browsers, Chrome or Firefox, with the latest updates.
If you experience problems, it may be necessary to clear the browser cache and history; and disable blocker extensions, i.e., uBlock, of the browsers
Mobile phones are not recommended, please use a personal computer.