The electroretinogram sensitivity in patients with diabetes

Chung, Nak Hong; Kim, Sang-Ha; Kwak, Mi Seon

doi:10.3341/kjo.1993.7.2.43

Cited by 16 publications

(11 citation statements)

References 2 publications

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“…Since then numerous studies have reported an array of ERG changes in diabetic subjects, including delayed OPs, [22][23][24][25][26] delayed 30-Hz flicker implicit time, 25,27 decreased a-and b-wave amplitudes, 28,29 and delayed a-and b-wave implicit times. 25,[30][31][32][33] Similar changes have been reported in diabetic animal models, including delayed OPs, [34][35][36] decreased a-and b-wave amplitudes, 34,[37][38][39][40][41] and delays in a-and/or b-wave implicit times. 35,41,42 However, reported ERG changes in both humans and animals have been inconsistent across studies, likely due to different techniques, time-points measured, and diabetic animal models.…”

Section: Introductionmentioning

confidence: 49%

“…Previous studies have reported rod-driven bipolar cell dysfunction, as measured by b-wave delays in response to dim flash luminance in patients with no or minimal retinopathy. 25,33,81 However, few studies have examined inner retinal function reflected in OP wavelets under a range of dim luminances. The ISCEV ERG standard 48 recommends recording darkadapted OPs in response to bright flashes of 3.0 log cd s/m 2 .…”

Section: Scotopic Ops Detect Preclinical Drmentioning

confidence: 99%

“…21,[24][25][26]28,33,[77][78][79] Notably, studies have found diminished dark-adapted threshold [80][81][82][83] and abnormal dark-adapted OPs 20,50 in human subjects with diabetic retinopathy, indicative of rod pathway dysfunction. In this study as well, ERG changes were detectable in the DR group, as indicated by decreased a-wave amplitudes after a bright stimulus and delayed b-wave implicit times in response to a standard dim stimulus or Test Flashes (Supplementary Fig.…”

Section: Erg Changes In Diabetic Subjectsmentioning

confidence: 99%

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Rodent Hyperglycemia-Induced Inner Retinal Deficits are Mirrored in Human Diabetes

Pardue

Barnes

Kim

et al. 2014

Trans. Vis. Sci. Tech.

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Citation: Pardue MT, Barnes CS, Kim MK, et al. Rodent hyperglycemiainduced inner retinal defects are mirrored in human diabetes. Tran Vis Sci Tech. 2014;3(3):6, http:// tvstjournal.org/doi/full/10. 1167/tvst. 3.3.6, doi:10.1167/tvst.3.3.6 Purpose: To evaluate the utility of low luminance stimuli to functionally probe inner retinal rod pathways in the context of diabetes mellitus in both rat and human subjects.Methods: Inner retinal dysfunction was assessed using oscillatory potential (OP) delays in diabetic rats. Scotopic electroretinograms (ERGs) in response to a series of increasing flash luminances were recorded from streptozotocin (STZ)-treated and control Sprague-Dawley rats after 7, 14, 20, and 29 weeks of hyperglycemia. We then evaluated OP delays in human diabetic subjects with (DR) and without (DM) diabetic retinopathy using the International Society for Clinical Electrophysiology in Vision (ISCEV) standard scotopic protocol and two additional dim test flashes.Results: Beginning 7 weeks after STZ, OP implicit times in diabetic rats were progressively delayed in response to dim, but not bright stimuli. In many diabetic subjects the standard ISCEV dim flash failed to illicit measureable OPs. However, OPs became measurable using a brighter, nonstandard dim flash (Test Flash 1, À1.43 log cd s/m 2 ), and exhibited prolonged implicit times in the DM group compared with control subjects (CTRL).Conclusions: Delays in scotopic OP implicit times are an early response to hyperglycemia in diabetic rats. A similar, inner retinal, rod-driven response was detected in diabetic human subjects without diabetic retinopathy, only when a nonstandard ISCEV flash intensity was employed during ERG testing.Translational Relevance: The addition of a dim stimulus to standard ISCEV flashes with assessment of OP latency during ERG testing may provide a detection method for early retinal dysfunction in diabetic patients.

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Section: Introductionmentioning

confidence: 49%

Section: Scotopic Ops Detect Preclinical Drmentioning

confidence: 99%

Section: Erg Changes In Diabetic Subjectsmentioning

confidence: 99%

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Rodent Hyperglycemia-Induced Inner Retinal Deficits are Mirrored in Human Diabetes

Pardue

Barnes

Kim

et al. 2014

Trans. Vis. Sci. Tech.

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“…In fact, it has already been shown that other ERG parameters, such b/a amplitude ratio [37] and b-wave implicit time [38], can be more sensitive than the darkadapted sensitivity, estimated with the parameter k, to retinal functional changes due to retinal ischemia or diabetic retinopathy.…”

Section: Discussionmentioning

confidence: 98%

Electroretinographic findings associated with panretinal photocoagulation (PRP) versus PRP plus intravitreal ranibizumab treatment for high-risk proliferative diabetic retinopathy

et al. 2012

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To evaluate changes in electroretinographic (ERG) findings after panretinal photocoagulation (PRP) compared to PRP plus intravitreal injection of ranibizumab (IVR) in eyes with high-risk proliferative diabetic retinopathy (PDR). Patients with high-risk PDR and no prior laser treatment were assigned randomly to receive PRP (PRP group; n = 9) or PRP plus IVR (PRPplus group; n = 11). PRP was administered in two sessions (weeks 0 and 2), and IVR was administered at the end of the first laser session (week 0) in the PRPplus group. Standardized ophthalmic evaluations including (ETDRS) best-corrected visual acuity (BCVA), and fluorescein angiography to measure area of fluorescein leakage (FLA), were performed at baseline and at weeks 16 (±2), 32 (±2) and 48 (±2). ERG was measured according to ISCEV standards at baseline and at week 48 (±2). At 48 weeks, 2,400-3,000 laser spots had been placed in eyes in the PRP group, while only 1,400-1,800 spots had been placed in the PRPplus group. Compared to baseline, there was a statistically significant (P < 0.05) FLA reduction observed at all study visits in both groups, with the reduction observed in the PRPplus group significantly larger than that in the PRP group at week 48. ROD b-wave amplitude was significantly reduced to 46 ± 5% (P < 0.05) of baseline in the PRP group and 64 ± 6% (P < 0.05) in the PRPplus group. This reduction was significantly larger in the PRP group than in the PRPplus group (P = 0.024; t Test). Similar results were observed for the dark-adapted Combined Response (CR) b-wave amplitude, with a reduction at 48 weeks compared to baseline of 45 ± 4% in the PRP group and 62 ± 5% in the PRPplus group; the reduction in CR b-wave amplitude was significantly larger in the PRP group than in the PRPplus group (P = 0.0094). CR a-wave, oscillatory potentials, cone single flash, and 30 Hz flicker responses showed statistically significant within-group reductions, but no differences in between-group analyses. These results suggest that treating high-risk PDR with PRP plus IVR is effective for PDR control, and permits the use of less extensive PRP which, in turn, induces less retinal functional loss, in particular for rod-driven post-receptoral responses, than treatment with PRP alone.

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“…Thus, the retinal alterations of these chemically induced diabetic animals are likely to be confined to the inner retina. However, in advanced stages of DR, abnormalities in the a-and b-waves appear [9].…”

Section: Introductionmentioning

confidence: 96%

Electroretinographic study of spontaneously diabetic Torii rats

et al. 2008

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Spontaneously diabetic Torii (SDT) rats are an inbred strain of rats with a non-obese type 2 diabetes mellitus that were isolated from an outbred colony of Sprague-Dawley (SD) rats. Electroretinograms (ERGs) were recorded from SDT and SD (controls) rats at 10- and 44-weeks-of-age to determine their retinal function. The amplitudes and implicit times of the ERGs of the right and left eyes were not significantly different indicating that the intra-individual variation was small. Both amplitudes and implicit times of the ERGs in the SDT rats were not significantly different from those of SD rats at 10-weeks-of-age. At 44-weeks-of-age, however, the a- and b-waves and the oscillatory potentials were significantly reduced with prolonged implicit times in the SDT rats compared to SD rats. These depressed ERGs may reflect vascular and neuronal damage throughout the retina as are seen in the advanced stages of human diabetic retinopathy. Thus, the SDT rat can be used to study the retinal physiology of diabetic retinopathy.

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The electroretinogram sensitivity in patients with diabetes

Cited by 16 publications

References 2 publications

Rodent Hyperglycemia-Induced Inner Retinal Deficits are Mirrored in Human Diabetes

Rodent Hyperglycemia-Induced Inner Retinal Deficits are Mirrored in Human Diabetes

Electroretinographic findings associated with panretinal photocoagulation (PRP) versus PRP plus intravitreal ranibizumab treatment for high-risk proliferative diabetic retinopathy

Electroretinographic study of spontaneously diabetic Torii rats

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