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Motonobu Fukuo, Akira Hirose, Shigehiko Kitano, Kumiko Kato, Mineo Kondo; Screening for diabetic retinopathy using RETevalTM, new mydriasis-free full-field ERG recording system. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6340.
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© ARVO (1962-2015); The Authors (2016-present)
A small, hand-held mydriasis-free full-field electroretinogram (ERG) recording system called the RETevalTM was recently developed (LKC Technologies, Gaithersburg, MD). The purpose of this study was to determine whether the RETevalTM system can be used to screen for diabetic retinopathy (DR).
This prospective study was approved by the Medical Ethics Committee of Tokyo Women’s Medical University Hospital (No. 3125). Forty-eight eyes from 48 normal subjects and 109 eyes from 109 patients with diabetes mellitus (DM) were studied. Eyes that had received any type of treatments for DR were excluded. Full-field flicker ERGs were elicited by the RETevalTM system by 8 Td-s retinal illuminance without mydriasis. This system delivered a constant flash retinal luminance by adjusting the flash luminance to compensate for changes in the pupil size. The amplitudes and implicit times of the fundamental component were analyzed. After the ERG recordings, the pupils were dilated, and the DR were classified according to the International Clinical Diabetic Retinopathy Disease Severity Scale. The receiver operating characteristic (ROC) analyses were also performed for the detection of DR.
Of the 109 eyes of DM patients, 74 eyes were diagnosed with DR (+) and 35 eyes with DR (-). The mean (± SD) implicit time was 33.8±1.6 ms for normal eyes, 34.5 ± 1.7 ms for eyes with DR (-), and 37.0 ± 2.7 ms for eyes with DR (+). There were significant differences in the implicit times among these three groups (P<0.05). The implicit time was significantly more prolonged as the severity of DR advanced (mild NPDR; 35.3 ± 1.2ms, moderate; 37.0 ± 2.7 ms, severe; 37.2 ± 2.1 ms, PDR; 38.8 ± 3.9 ms, P<0.05). The area under the ROC curve was 0.80 for detecting DR (+), and was 0.86 for detecting severe NPDR or PDR.
These results suggest that the implicit time of flicker ERG recorded by the RETevalTM system can be used to screen for DR.
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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