Effect of neuropathy on pupillary response measured with infrared static pupillography in type 2 diabetes mellitus patients
Keywords:Diabetes mellitus, Pupillography, Polyneuropathy, Diabetic complications
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.
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