Functional assessment of early retinal changes in diabetic patients without clinical retinopathy using multifocal electr
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RESEARCH ARTICLE
Open Access
Functional assessment of early retinal changes in diabetic patients without clinical retinopathy using multifocal electroretinogram Mai A. Mohammed1, Mohamed M. Lolah1, Mohamed Fahmy Doheim2 and Amir AbouSamra1*
Abstract Background: We aimed to assess early retinal changes in diabetic subjects without clinical retinopathy using multifocal electroretinogram (mfERG). Methods: Twenty eyes of 20 diabetic subjects type 2 without retinopathy and 20 eyes of 20 healthy controls of the same age and sex were eligible for our study and underwent mfERG. MfERG responses were recorded; N1–P1 amplitude and P1 implicit time of the 5 rings recorded were measured and analyzed. Results: The reduction in N1–P1 amplitude and the delay in P1-implicit time in type 2 diabetic subjects were statistically significant in most of the assessed rings compared to controls (p < 0.001). Moreover, N1–P1 amplitude was negatively correlated with diabetes duration. However, there was a positive correlation between P1-implicit time and diabetes duration in type 2 diabetic subjects in four out of five rings (p < 0.001). Conclusions: Our study showed reduced mfERG N1–P1 amplitude and delayed P1-implicit time indiabetic patients without retinopathy compared to normal controls. Implicit time andamplitude were significantly affected by diabetes duration. These results propose a valuable role of mfERG in evaluating the expected neuroretinal dysfunction before the clinical development of diabetic retinopathy. Early detection of functional abnormalities indicates that the patients need more tight medical control of diabetes. More well-designed studies are needed to assert upon these results. Keywords: Multifocal electroretinogram, Diabetic retinopathy, Diabetes duration, Amplitude, Implicit time
Background Diabetes mellitus (DM) is a growing global disease that affects about 366 million patients worldwide with an increasing trend in developing countries [1, 2]. Diabetic retinopathy (DR) is a highly prevalent complication for DM patients. It affects almost one-third of DM patients and may be a leading cause of visual impairment among * Correspondence: [email protected] 1 Ophthalmology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt Full list of author information is available at the end of the article
vital groups of population [3, 4]. There is an asymptomatic stage from developing DM to the appearance of clinical signs of DR in which clinically unnoticed microvascular changes and neural retinal damage occur and progress. Therefore, if the disease can be detected at an early stage, this could provide a better way of managing patients at a known risk of progressing DR and we may preserve the vision of a lot of people with DM for a longer time [5]. The previous evidence from published studies proposed that clinical vascular changes follow the neural
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharin
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