Oscillatory Potentials and Permeability of the Blood-retinal Barrier in Noninsulin-dependent Diabetic Patients without Retinopathy

Yoshida, Akitoshi; Kojima, M; Ogasawara, Hironobu; Ishiko, Satoshi

doi:10.1016/s0161-6420(91)32144-4

Cited by 50 publications

(25 citation statements)

References 9 publications

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“…Previous studies indicated that neuro-retinal degeneration is one of the earliest detectable retinal abnormalities in patients with DM, and possibly even preceding vasculopathy. [38][39][40] Earlier studies were limited to older age groups and changes were reported in patients with no or minimal DR. 22,29,33 However, in our study patients were all in the pediatric age group with no DR, and our results emphasized the presence of primary pathology in inner retinal layers, particularly the GCC and confirmed its occurrence very early in the disease course even before any clinically detected fundus changes.…”

Section: Discussionmentioning

confidence: 99%

Retinal Nerve Fiber Layer and Ganglion Cell Complex Thicknesses Are Reduced in Children With Type 1 Diabetes With No Evidence of Vascular Retinopathy

El-Fayoumi

Eldine

Esmael

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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Citation: El-Fayoumi D, Badr Eldine NM, Esmael AF, Ghalwash D, Soliman HM. Retinal nerve fiber layer and ganglion cell complex thicknesses are reduced in children with type 1 diabetes with no evidence of vascular retinopathy. Invest Ophthalmol Vis Sci. 2016;57:5355-5360. DOI: 10.1167/iovs.16-19988 PURPOSE. To determine whether type 1 diabetes (T1DM) in children with a mean age of 12.21 6 3.04 years affects the retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) when compared to age-and sex-matched healthy children.METHODS. Forty-six children with T1DM with no diabetic retinopathy (DR) and 50 normal ageand sex-matched controls underwent full clinical ophthalmic and spectral-domain optical coherence tomography (SD-OCT) examination. Using RTVue Fourier-Domain OCT (version 6.11.0.12) average, superior, and inferior RNFL and GCC thicknesses (in lm) were measured. Mean values of patients and the control group were compared. RESULTS.In children with T1DM with no DR, the mean average RNFL thickness was 110.9 lm 6 10.46, and the mean GCC thickness was 95.59 lm 6 5.13; both were significantly thinner than the control group (115.62 lm and 99.30 lm, respectively). The retinal nerve fiber layer and GCC thickness showed no correlation to either age of onset, duration of the disease, or glycosylated hemoglobin (HbA1c). A positive correlation was found between the daily insulin dose and the average RNFL thickness (r ¼ 0.378, P ¼ 0.01). The average GCC in children with dyslipidemia was thinner than those with normal lipid profile (91.29 6 6.46 lm, 97.11 6 3.59 lm, respectively) with a P value of 0.011. CONCLUSIONS.Thinning of the RNFL and GCC in children with T1DM with no DR compared to healthy controls suggests that neurodegenerative changes occur in the absence of vascular changes. It also shows that neurodegeneration is not related to either disease duration, onset, or control.

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Section: Discussionmentioning

confidence: 99%

Retinal Nerve Fiber Layer and Ganglion Cell Complex Thicknesses Are Reduced in Children With Type 1 Diabetes With No Evidence of Vascular Retinopathy

El-Fayoumi

Eldine

Esmael

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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“…Because of this, these methods are much less influenced by noise contamination than measurements of peak implicit time and peak to peak amplitude that depend only on one or two points on the response waveform. Another consideration is the fact that diabetes is a relatively conservative disease example because previous conventional ERG studies reported preferential losses of high frequency response components in diabetes [21][22][23][24][25] and the standard mfERG technique does not elicit those frequencies effectively, even in normal eyes.…”

Section: Discussionmentioning

confidence: 99%

Towards optimal filtering of "standard" multifocal electroretinogram (mfERG) recordings: findings in normal and diabetic subjects

Han

Bearse²,

Schneck³

et al. 2004

British Journal of Ophthalmology

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“…Specifically, full-field flash ERG studies have shown the high frequency oscillatory potentials (OPs), which are thought to be largely generated by the activity of amacrine cells, are preferentially affected by diabetes and diabetic retinopathy (Bresnick, et al, 1984;Bresnick and Palta, 1987;Tzekov and Arden, 1999;Yonemura, et al, 1962;Yoshida, et al, 1991). The sf-mfERG stimulus evokes local responses with high frequency components similar to full-field flash OPs (Bearse, et al, 2000;Fortune, et al, 2003;Hood, et al, 1997;Rangaswamy, et al, 2003;Wu and Sutter, 1995).…”

Section: Are Local "Inner" Retinal Response Contributions Abnormal?mentioning

confidence: 99%

A multifocal electroretinogram model predicting the development of diabetic retinopathy

Bearse

Adams

Han

et al. 2006

Progress in Retinal and Eye Research

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173

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The prevalence of diabetes has been accelerating at an alarming rate in the last decade; some describe it as an epidemic. Diabetic eye complications are the leading cause of blindness in adults aged 25-74 in the United States. Early diagnosis and development of effective preventatives and treatments of diabetic retinopathy are essential to save sight. We describe efforts to establish functional indicators of retinal health and predictors of diabetic retinopathy. These indicators and predictors will be needed as markers of the efficacy of new therapies. Clinical trials aimed at either prevention or early treatments will rely heavily on the discovery of sensitive methods to identify patients and retinal locations at risk, as well as to evaluate treatment effects.We report on recent success in revealing local functional changes of the retina with the multifocal electroretinogram (mfERG). This objective measure allows the simultaneous recording of responses from over 100 small retinal patches across the central 45 degree field. We describe the sensitivity of mfERG implicit time measurement for revealing functional alterations of the retina in diabetes, the local correspondence between functional (mfERG) and structural (vascular) abnormalities in eyes with early nonproliferative retinopathy, and longitudinal studies to formulate models to predict the retinal sites of future retinopathic signs. A multivariate model including mfERG implicit time delays and 'person' risk factors achieved 86% sensitivity and 84% specificity for prediction of new retinopathy development over one year at specific locations in eyes with some retinopathy at baseline. A preliminary test of the model yielded very positive results. This model appears to be the first to predict, quantitatively, the retinal locations of new nonproliferative diabetic retinopathy development over a one-year period. In a separate study, the predictive power of a model was assessed over oneand two-year follow-ups. This permitted successful prediction of new retinopathy development in eyes with and without retinopathy at baseline. Finally, we briefly describe our current research efforts to (a) locally predict future sight-threatening diabetic macular edema, (b) investigate local retinal function change in adolescent patients with diabetes, and (c) better understand the physiological bases of the mfERG delays.The ability to predict the retinal locations of future retinopathy based on mfERG implicit time provides clinicians a powerful tool to screen, follow up, and even consider early prophylactic treatment of the retinal tissue in diabetic patients. It also aids identification of 'at risk' populations for clinical trials of candidate therapies, which may greatly reduce their cost by decreasing the size of the needed sample and the duration of the trial.

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Oscillatory Potentials and Permeability of the Blood-retinal Barrier in Noninsulin-dependent Diabetic Patients without Retinopathy

Cited by 50 publications

References 9 publications

Retinal Nerve Fiber Layer and Ganglion Cell Complex Thicknesses Are Reduced in Children With Type 1 Diabetes With No Evidence of Vascular Retinopathy

Retinal Nerve Fiber Layer and Ganglion Cell Complex Thicknesses Are Reduced in Children With Type 1 Diabetes With No Evidence of Vascular Retinopathy

Towards optimal filtering of "standard" multifocal electroretinogram (mfERG) recordings: findings in normal and diabetic subjects

A multifocal electroretinogram model predicting the development of diabetic retinopathy

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