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Yuen Ying Jacqueline Chan, Ann-Marie Mora, Jason H Hill, Celina Villanueva, Nasser Issa, Luke Mein, Joshua Michael Iltis, David Wilde, Rene Renteria, Divya Narayanan, Randolph D Glickman; Early Detection and Spatial Co-incidence of Localized Retinal Neuronal and Vascular Dysfunction in Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5323. doi: https://doi.org/.
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Clinical experience suggests that early detection of diabetic retinopathy is key to treatment and management to maintain visual function and prevent complications. Current clinical practice is to evaluate individual tests such as Optical Coherence Tomography (OCT) and Electrodiagnostic testing (MfERG). We hypothesize that earlier detection of retinopathy may be achieved by correlating these tests, which was explored in this study.
In this ongoing study, 28 Hispanics, 14 Whites, and 6 Blacks (26 males and 22 females aged 56.5±10.9 years, ranging from 27 to 70 years) completed ERG, fundus, OCT, and diabetic eye exams. Patients were classified as either healthy control or as having diabetes with or without retinopathy. We excluded patients who had refractive surgeries, > 6D of refractive error, and other eye diseases. Three optometrists independently rated fundus photos utilizing ETDRS, using a scale from 0 (no abnormalities) to 3 (severe abnormalities) for OCT images. Descriptive statistics were collected on demographic data. MfERG averages were generated across rings 1 thru 5 (from 61 Diagnosys hexagons) for N1 and P1 amplitudes and latencies across OD and OS. We ran Wilks Shapiro tests of normality and Pearson’s & Spearman’s bivariate correlations to assess the statistical correlation of mfERG with images of the eye (fundus) and retina (OCT).
Pearson’s test of fundus ratings with mfERG data revealed positive correlations pertaining to N1 amplitudes amongst rings 2 (r=0.30), 3 (r=0.29) & 5 (r=0.34) at P≤0.05 level across OS. Significant negative correlations were revealed among P1 amplitudes amongst rings 2 (r= -0.30), 3 (r= -0.30), 4 (r=-0.31) & 5 (r=-0.31) across OS. Analysis of OCT Ratings with mfERG data revealed correlations pertaining to OD ring 3 N1 amplitude (r=0.25), and ring 3 P1 latency (r=0.37) and OS ring 3 N1 latency (r=0.34). Spearman’s bivariate test yielded strong positive correlations of OCT and fundus ratings across OD (r=0.36, p=0.016) and OS (r=0.45, p=0.002).
Our results support a correlation between diagnostic data yielded from OCT, fundus photography, and mfERG data, suggesting that a concerted correlation of these tests may lead to earlier and more sensitive diagnosis of diabetic retinopathy. Other findings approached but did not achieve significance, likely due to small sample sizes.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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