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M. Tyrberg, U. Lindblad, A. Melander, M. Lövestam-Adrian, V. Ponjavic, S. Andréasson; Electrophysiological and Clinical Evaluation for Early Detection of Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3256.
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Early detection of retinopathy in patients with prediabetic stage, IFG (B-glc 5.6-6-0 mmol/l) or diabetic patients with no sign of retinopathy according to fundus examinations is a major challenge for accurate treatment of this group of patients.Two groups of patients have been further investigated:a/ 154 subjects with Impaired Fasting Glucose (IFG) were classified according to Wisconsin Epidemiologic Study of Diabetic retinopathy (WESDRS).b/ 31 diabetic patients with 23±9 years duration of diabetes and visual acuity 20/20, with no, mild or moderate retinopathy were further examined with multifocal electroretinogram (mfERG).
In an ongoing study 20 patients with newly diagnosed type2 DM (normal B-glucose measured within 2 years) without vascular retinopathy and with visual acuity 20/20 are examined with full-field ERG, mfERG and multifocal vision evoked potential (mfVEP).
Of the 154 subjects with IFG, 16 had retinopathy, giving a prevalence of 10% in this group. Those with retinopathy had significant higher systolic (154 vs. 141 mmHg, p=0.013) and diastolic (86 vs 81 mmHg, p=0.008) blood pressure and Body mass index (BMI) (32.4 vs. 29.2 kg/m2, p=0.013) compared with those without retinopathy, independent of differences in age, sex and known hypertension.In the group of diabetic patients 15 of 31 patients’ mfERG demonstrated an absence of the third wave in the second order kernel (representing inner retina) but present in all controls.In the ongoing study at this point 15 patients have been examined with full-field ERG, mfERG and mfVEP.
Retinopathy is present in subjects with prediabetes andassociated with higher blood pressure and body mass. The mfERG studies in diabetics indicate alterations in neuronal function in inner retina before (vascular) retinopathy develops.Further results will be presented regarding the electrophysiological results in the newly onset diabetes study group.
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