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Victor Chen, Don Byongdo Kim, Scott E Brodie, Gloria Wu; RETeval in Patients with Glaucoma and/or Diabetes. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3950. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Using RETeval to assess retinal function in elderly patients with diagnoses of both glaucoma and diabetes.
ISCEV light adapted 3 ERG and 30 Hz flicker testing was done with RETeval (LKC Technologies Gaithersburg, MD, Firmware version 2) on dilated patients using skin electrodes. Skin was prepped with alcohol pads prior to testing. All RETeval reports from June 2014 to November 2015 from a clinic in San Jose, CA were retrospectively analyzed. Inclusion criteria: Diabetic patients had HbA1c >6.0, FBS > 100, diagnosis of diabetes. Open angle glaucoma pts (G): diagnosis of open angle glaucoma or taking glaucoma medications. Controls: no retinal diseases, diabetes, AMD, glaucoma, or uveitis. Eyes with visual acuity within 20/20-20/50. Exclusion criteria: Inability to cooperate for ERG testing, poor dilation.
From a total of 157 patients, 48 met the inclusion criteria. 182 ERGs were performed for those 48 pts.Control (C): (n=15) 7M/ 8F; avg age: 44.3±16.4 yrs, range: 20-70Glaucoma pts (G): (n = 21) 10 M/11 F; avg age: 72.3±12.5 yrs, range: 48-95Diabetes and glaucoma pts (DG): (n=12) 6M/ 6F; avg age: 71.4±10.7 yrs, range: 51-85For C ERG LA3 (n=29), IT = 29.5±1.3 msec, Amp = 40.7±11.8 uV. (Coefficient of variation (Cv) = 0.044, 0.29 respectively.) 30 Hz flicker (n=26), IT = 25.6±0.9 msec, Amp = 28.8±8.1 uV. (Cv = 0.035, 0.309 respectively.)For G ERG LA3 (n=37), IT = 31.7±2.8 msec, Amp = 28.5±10.5 uV. (Cv = 0.090, 0.37 respectively.) 30 Hz flicker (n= 48), IT = 27.9±2.4 msec, Amp = 19.0±9.0 uV. (Cv = 0.09, 0.47 respectively.)For DG ERG LA3 (n=18), IT = 31.3±2.8 msec, Amp = 31.0±15.2 uV. (Cv = 0.090, 0.49 respectively.) 30 Hz flicker (n=24), IT = 29.7±2.9 msec, Amp = 21.8±16.9. uV. (Cv = 0.099, 0.78 respectively.)Student t-tests were performed.C vs G, LA3 and 30Hz, IT and AMP, all p values<0.01. C vs DG, LA3, IT and AMP comparisons p=0.02, p=0.03, respectively. For IT only in C vs DG in 30 Hz, p<0.01. (See Table 1)
The light adapted ERG and 30Hz flicker in our study suggest that there are visual function changes for glaucoma patients versus controls. However, for patients with both diabetes and glaucoma, the data in our small study suggest implicit time changes only. The RETeval is a new device and and its amplitude data is still new to ophthalmology. In the future, the RETeval may provide retina and glaucoma specialists another method for evaluating retinal function.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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