Detection of early functional changes in diabetic retina using slow double-stimulation mfERG paradigm

• Published in: British journal of ophthalmology Vol. 95; no. 11; pp. 1560 - 1563
• Main Authors: Chan, Henry Ho-lung, Chu, Patrick Ho-wai, Lung, Jenny Chun-yee, Ho, Wing-cheung, Ting, Patrick Wai-ki, Sum, Rita Wing-man, Ng, Yiu-fai
• Format: Journal Article
• Language: English
• Published: BMA House, Tavistock Square, London, WC1H 9JR BMJ Publishing Group Ltd 01.11.2011; BMJ Publishing Group; BMJ Publishing Group LTD
• Subjects: Adaptation; Adaptations; Adult; Biological and medical sciences; Blood; Case-Control Studies; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 2 - complications; Diabetes. Impaired glucose tolerance; Diabetic retinopathy; Diabetic Retinopathy - diagnosis; Diabetic Retinopathy - etiology; diagnostic tests/investigation; Differentiation; Early Diagnosis; electrophysiology; Electroretinograms; Electroretinography - methods; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Glucose; Humans; Insulin; Medical sciences; Middle Aged; Miscellaneous; Ophthalmology; Photic Stimulation - methods; physiology; Retina; Secretion; Sensitivity and Specificity; Signal Processing, Computer-Assisted; Studies; Hong Kong; Endocrinopathy; Paradigm; Diabetes mellitus; Early; Retina; Stimulation; Ophthalmology; Medical screening; Detection
• ISSN: 0007-1161; 1468-2079
• DOI: 10.1136/bjo.2010.192476

AimDiabetes mellitus (DM) is a systemic disease with insufficient secretion of insulin or poor response to insulin. This typically causes poor control of blood glucose level leading to a range of complications. Early detection of the retinal function alteration in DM is needed.MethodsA newly modified paradigm—slow double-stimulation multifocal electroretinogram (mfERG)—was introduced to measure early changes of retinal function in DM and to investigate changes in the adaptation mechanisms in the diabetic retina. The mfERG was measured by using a slow double-stimulation mfERG paradigm (M1M2OOO).ResultsThe m1 amplitude of M1 stimulation from diabetic subjects was significantly reduced in ring 1 in contrast to that of a control group. The m2 amplitude of M2 stimulation from diabetic subjects was also significantly reduced in ring 1 and 2 as compared with those of the control group. The m1/m2 ratio which minimises intersubject variation shows a reasonable differentiation between the control and diabetic groups. There was a significant increase in the amplitude ratio from diabetic subjects in ring 2 and 3 as compared with those of the control group.ConclusionsThe present findings suggest that the new mfERG paradigm is a fast and sensitive test for the detection of early functional changes in the diabetic retina.