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G. Wu, G. Tso, F. Yu, Q. Nguyen, M. Severns; Dyslipidemia: Is It a Factor in Retinal Ischemia in Diabetes?. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2733.
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To use the 30 Hz flicker electroretinogram (ERG) to compare retinal function in diabetic patients (DP) and non-diabetic patients (NDP) with elevated lipid levels.
Lipid profiles, fasting blood sugars, were collected. The diabetic patients' HbA1c were collected, as well. All patients had a Snellen visual acuity eligibility range of 20/20-20/40. The diabetic patients (DP) were age matched with non-diabetic patients (NDP). NDP Photopic 30 Hz flicker were recorded according to the ISCEV standard protocol using Epic 4000 system (LKC Technologies). Eyes were dilated and a DTL electrode was used for recording. Implicit time (IT) and amplitude (AMP) of the ERG were measured by placing cursors on the waveform.
20 patients were included in the study. 10 DP and 10 NDP. The age range of the DP=39-86yrs, avg 67.9yrs +13.9 ; NDP=39-81yrs, avg 67.6yrs +11.8. Lipid levels were: Cholesterol (CH) avg: DP=169.1mg/dl +50.65, NDP=178.1mg/dl +37.7 (p=ns); Triglycerides (TG) avg: DP=109.3mg/dl +41.9, NDP= 85.2mg/dl +38.68(p≤0.05); Low density lipoprotein (LDL) avg: DP= 91.8 mg/dl +37.5, NDP=96.3 mg/dl +27.9 (p=ns); High density lipoprotein (HDL) avg: DP=52.7 mg/dl +14.4, NDP=63.8 mg/dl +23.4 (p≤ 0.03). For age matched group, there were 9 DP (18 eyes) and 9 NDP (18 eyes) : DP AMP range=46.9 - 118.2 uV; avg=75.94 uV + 19.09, NDP AMP=range 52.1 - 166.5 uV; avg =100.10 uV + 35.70 (p≤0.016, t-test), DP IT range=26.2 - 36.6 msec; avg=29.80 msec + 3.72, NDP IT range=26.3 - 35.7 msec; avg =29.03 msec + 3.11 (p=ns, t-test). Using chi square analysis of the age matched DP and NDP: in patients with elevated TG ≥ 100 mg/dl and implicit times≥ 32 msec or below, the implicit times were increased in DP vs. NDP(p≤0.05, chi square). In patients with elevated cholesterol ≥150 and implicit times ≥ 32 msec or below, DP had a greater delay in implicit time than NDP(p≤ 0.05, chi square). For DP, using regression analysis, Implicit time vs. LDL was significant(p≤0.036).
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