Abstract
Purpose :
Using RETeval (firmware version 2.0) with ISCEV protocol to assess retinal function in patients with diabetes and age related macular degeneration.
Methods :
Inclusion criteria: Dilated fundus examination to 5mm or more. Controls: no retinal diseases, no diabetes, no AMD, no glaucoma, no uveitis. AMD patients drusen or small choroidal neovascular membranes. Va for all patients between 20/20 - 20/50. Informed consent was obtained. Exclusion criteria: Poor dilation. Testing was done with RETeval (LKC Technologies Gaithersburg, MD, firmware version 2.0), using alcohol skin prep and skin electrodes. Using photopic white flash as defined by ISCEV light adapted 3 ERG (standard flash “cone” ERG) (LA3), implicit times (IT) and amplitudes (Amp) and 30 Hz flicker data were obtained from a retinal practice in San Jose, CA between 6/2014 and 11/2015.
Results :
Of 157 patients, 54 patients met the inclusion criteria. Form 54 patients, 172 ERG tests were performed.
Control patients: (n = 15) 8 M, 7 F avg age: 44.3±16.4 yrs, range 20-70.
AMD patients: (n = 13) 6 M, 7 F avg age: 71.4±16.7 yrs, range 43-91.
DM patients: (n = 26) 13 M, 13 F avg age: 64.0±13.6 yrs, range 28-88.
For control 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 ERG (n=26), IT = 25.6±0.9 msec, Amp = 28.8±8.1 uV. (Cv = 0.035, 0.309 respectively.)
For AMD ERG LA3 (n=14), IT = 31.4±2.2 msec, Amp = 29.6±12.8 uV. (Cv = 0.070, 0.43 respectively.) 30 Hz flicker ERG (n= 22), IT = 27.6±1.8 msec, Amp = 20.9±8.8 uV. (Cv = 0.070, 0.42 respectively.)
For DM ERG LA3 (n=34), IT = 30.6±1.7 msec, Amp = 33.0±15.5 uV. (Cv = 0.056, 0.47 respectively.) 30 Hz flicker (n=47), IT = 28.5±3.3 msec, Amp = 20.8±11.9. uV. (Cv = 0.12, 0.57 respectively.)
For both C vs AMD and C v DM: IT and AMP, all p values <0.05. See Table 1.
Conclusions :
The RETeval is a new technology allowing for portability, ease of use and brings electrophysiology to the clinical practice. In this small study, the RETeval results suggest inner and outer retina ERG changes in both diabetic and age related macular degeneration patients. In the future, RETeval may provide additional visual function testing for retina patients.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.