Introduction:
Risk factors of diabetic retinopathy (DR) include elevated blood glucose and abnormal serum lipids but there are no guidelines from the National Cholesterol Education Program and the American Diabetic Association with respect to the role of serum lipids and DR. Electroretinography (ERG) is an objective, noninvasive and quantitative method measuring retinal function. 30 Hz Flicker ERG has been used to evaluate ischemia in microvascular diseases. 30 Hz Flicker ERG may be a more sensitive indicator of the relationship between DR and lipids. Asian Americans (AA) are thought to be at high risk of type II diabetes due to their predilection for central obesity. Thus, it may be important to examine if glucose and lipids have ethnic-specific effects on DR.
Purpose:
To use 30 Hz Flicker ERG to examine the relationship of lipids and glucose levels in Asian American and Caucasian diabetic patients with good vision.
Methods:
32 patients, 64 eyes, 16 Asian American and 16 Caucasian age-matched pairs, ERG (ISCEV protocol, LKC UTAS System), Inclusion criteria: 20/20-20/60 vision, lipid profiles, FBS, HbA1c, dilated funduscopic exam. A retrospective chart review was performed. Fisher’s exact test and Student’s t-test were used.
Results:
Conclusions:
This study shows that 30 Hz flicker ERG amplitude and implicit time are significantly altered by serum lipids in diabetics. Abnormal LDL changes the ERG in all diabetics. Of note, lower HDL and elevated Cholesterol differentially affects Asian Americans more than Caucasians. Our study suggests that 30 Hz flicker may have a role in delineating retinal function in diabetics with abnormal serum lipids. More work is needed to further evaluate the use of ERG in diabetics with abnormal serum lipids.
Keywords: diabetes • electrophysiology: clinical • diabetic retinopathy