Turkiye Klinikleri Journal of Pediatrics

.: ORIGINAL RESEARCH
Diyabetik Çocuklarda Statik ve Dinamik Pupillar Parametrelerin Değerlendirilmesi
Evaluation of Static and Dynamic Pupillary Parameters in Children with Diabetes
Kemal TEKİNa, Hasan KIZILTOPRAKb, Servet YELc, Merve İNANÇa, Mustafa KOÇb, Zehra AYCANc
aGöz Hastalıkları Kliniği, Erciş Devlet Hastanesi, Van, TÜRKİYE
bGöz Hastalıkları Kliniği, Sağlık Bilimleri Üniversitesi Ankara Ulucanlar Göz Eğitim ve Araştırma Hastanesi,
cÇocuk Endokrinoloji Kliniği, Dr. Sami Ulus Kadın Doğum, Çocuk Sağlığı ve Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, TÜRKİYE
Turkiye Klinikleri J Pediatr. 2019;28(2):71-6
doi: 10.5336/pediatr.2019-66476
Article Language: TR
Full Text
ÖZET
 Amaç: Tip 1 diabetes mellituslu çocuklarda statik ve dinamik pupilla yanıtlarını araştırmak ve bu sonuçları sağlıklı çocuklardan elde edilen verilerle karşılaştırmaktır. Gereç ve Yöntemler: Bu ileriye dönük çalışmaya, retinopatisi olmayan iyi kontrollü Tip 1 diabetes mellituslu çocuklar (diabetes mellitus grubu) ve benzer yaş ve cinsiyetteki sağlıklı çocuklar (kontrol grubu) dâhil edildi. Statik ve dinamik pupilla yanıtları otomatik, kantitatif pupillometri cihazı (MonPack One, Vision Monitor System, Metrovision, Fransa) kullanılarak yapıldı. Statik pupillometri ölçümlerinden skotopik, mezopik, düşük fotopik ve yüksek fotopik pupil çapları kaydedildi. Dinamik pupillometri ölçümlerinden ise dinlenme çapı, pupil kontraksiyon amplitüdü, pupil kontraksiyon latansı, pupil kontraksiyon süresi, pupil kontraksiyon hızı, pupil dilatasyon latansı, pupil dilatasyon süresi ve pupil dilatasyon hızı değerleri kaydedildi. Bulgular: Çalışmada toplam 83 hastanın 83 gözü incelendi: 43 hasta diabetes mellitus grubunu, 40 hasta ise kontrol grubunu oluşturdu. Diabetes mellitus ve kontrol grubunda yaş ve cinsiyet açısından istatistiksel anlamlı fark izlenmedi. Diabetes mellitus grubunda skotopik, mezopik, düşük fotopik ve yüksek fotopik ortamlardaki pupil çapları kontrol grubuna göre düşükse de bu farklar istatistiksel anlamlı düzeye ulaşamadı. Dinamik pupillometri ölçümlerinden sadece pupil kontraksiyon amplitüdü değerleri diabetes mellitus grubunda kontrol grubuna göre istatistiksel anlamlı düzeyde düşük idi. Sonuç: Retinopatisi olmayan iyi kontrollü Tip 1 diabetes mellituslu çocuklarda, pupil kontraksiyon amplitüdü değerleri benzer yaştaki sağlıklı olgulara göre anlamlı düzeyde düşüktür. Bu değişiklik, subklinik diyabetik otonom nöropati ile ilişkili olabilir.

Anahtar Kelimeler: Tip 1 diabetes mellitus; pupil
ABSTRACT
 Objective: To investigate the static and dynamic pupillary responses of children with Type 1 diabetes mellitus and to compare these results with data obtained from healthy children. Material and Methods: This prospective study included well-controlled Type 1 diabetes mellitus children without retinopathy (diabetes mellitus group) and healthy children of similar age and gender (control group). Static and dynamic pupillary responses were performed using automatic, quantitative pupillometry device (MonPack One, Vision Monitor System, Metrovision, France). Scotopic, mesopic, low-photopic and high-photopic pupil diameters were recorded from static pupillometry measurements. Dynamic pupillometry measurements including resting diameter, amplitude of pupil contraction, latency of pupil contraction, duration of pupil contraction, velocity of pupil contraction, latency of pupil dilation, duration of pupil dilation, and velocity of pupil dilation were also recorded. Results: In this study, 83 eyes of 83 patients were examined: 43 cases were in diabetes mellitus group and 40 cases were in control group. There was no statistically significant difference between diabetes mellitus and control groups in terms of age and gender. The pupil diameters in scotopic, mesopic, low-photopic and high-photopic conditions were lower in diabetes mellitus group, than control group, but these differences did not reach statistical significance. Only amplitude of pupil contraction values among dynamic pupillometry measurements were found to be significantly lower in diabetes mellitus group compared to control group. Conclusion: In children with well-controlled Type 1 diabetes mellitus without retinopathy, amplitude of pupil contraction values are significantly lower than those of healthy children. This change may be associated with subclinical diabetic autonomic neuropathy.

Keywords: Type 1 diabetes mellitus; pupil
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