Electroretinographic oscillatory potentials in insulin‐dependent diabetes patients: A long‐term follow‐up

Abstract

ABSTRACT.Purpose: The aim of this research was to study the relevance of long-term follow-up of electroretinographic oscillatory potentials (OPs) in predicting the onset of minimal non-proliferative diabetic retinopathy in insulin-dependent diabetes patients. Methods: A total of 80 insulin-dependent diabetics, with normal fundi and normal OPs at first examination, were followed prospectively for 10 years. Oscillatory potentials were measured and fundus examinations performed once or twice per year. Results: During follow-up, 35% of patients developed diabetic retinopathy after a mean disease duration of 12 ∫ 2 years. A decrease in OP amplitudes was seen in 46% of this group, but reductions were also seen in the 25% of patients whose fundi remained normal. Statistical analysis of best-fit survival curves shows a significant difference (p ∞0.001) in the point of Kaplan-Meiers' curve maximal linearity (TmaxS).Conclusions: It appears that eyes with reduced OP amplitude have a greater probability of developing diabetic retinopathy. Subnormal OP amplitudes are not proof of real concomitant visible vascular damage, but may reflect a predisposition to functional neurosensorial disorder.

Protection of exendin-4 analogue in early experimental diabetic retinopathy

“…It has been reported that electrophysiologic changes in diabetes occur before the appearance of visible lesions [11,22,38]. Thus, an electrophysiological assessment of retinal function could be valuable in diabetic patients.…”

“…Sakai et al [34] reported that OPs were delayed soon after the onset of elevated blood sugar in an animal model of diabetes and before the onset of vitreous fluorophotometric changes. Numerous studies have pointed out that the OPs were the most sensitive electrophysiologic indicator of DR [17,22,38]. Layton [24] demonstrated that the amplitudes of the total OPs and the b-wave amplitude were reduced in early diabetes.…”

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

“…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.…”

Baseline haemoglobin A1c influences retinal function after long-term insulin pump therapy

“…Lower baseline oscillatory potential amplitudes and poorer nyctometry results have been identified as risk factors for long-term retinopathy progression [19], which also occurs earlier in patients with reduction of oscillatory potential amplitudes to subnormal values [20]. Thus, the reduction of ERG amplitudes and slowing of dark adaptation in the present study might reflect progression of subclinical aspects of diabetic retinopathy.…”

“…Thus, the reduction of ERG amplitudes and slowing of dark adaptation in the present study might reflect progression of subclinical aspects of diabetic retinopathy. However, reductions in oscillatory potential amplitudes were also observed in a 10-year study in 25 % of patients without detectable worsening of retinopathy [20]. Also, using standard automated perimetry, a recent study found progressive visual field deterioration in patients with diabetes but findings did not correlate with changes in retinopathy [21].…”