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Poor Glycemic Control Predicts Increased Neuro-retinal Dysfunction in Adolescents with Type 1 DiabetesLakhani, Ekta 15 February 2010 (has links)
Studies demonstrate localized neuro-retinal dysfunction in patients with diabetes and no visible diabetic retinopathy (DR). Poor glycemic control is a strong risk factor for DR. We hypothesized that poor glycemic control predicts increased areas of localized neuro-retinal dysfunction in patients with diabetes.
Forty-eight adolescents with diabetes and 45 controls were tested using the standard (103 hexagons) multifocal electroretinogram (mfERG). Negative binomial regression analysis was conducted with number of abnormal hexagons (delayed responses) as the dependent variable and glycated hemoglobin (HbA1c), disease duration, age and sex as covariates.
Results indicate that a one-unit increase in HbA1c predicts an 80% (p = 0.002) increase in the number of abnormal hexagons when controlling for age. Increased areas of neuro-retinal dysfunction are predicted by worsening glycemic control in patients with no visible DR. Standard mfERG may be useful in monitoring patients with diabetes and identifying those who may be at risk of developing DR.
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Poor Glycemic Control Predicts Increased Neuro-retinal Dysfunction in Adolescents with Type 1 DiabetesLakhani, Ekta 15 February 2010 (has links)
Studies demonstrate localized neuro-retinal dysfunction in patients with diabetes and no visible diabetic retinopathy (DR). Poor glycemic control is a strong risk factor for DR. We hypothesized that poor glycemic control predicts increased areas of localized neuro-retinal dysfunction in patients with diabetes.
Forty-eight adolescents with diabetes and 45 controls were tested using the standard (103 hexagons) multifocal electroretinogram (mfERG). Negative binomial regression analysis was conducted with number of abnormal hexagons (delayed responses) as the dependent variable and glycated hemoglobin (HbA1c), disease duration, age and sex as covariates.
Results indicate that a one-unit increase in HbA1c predicts an 80% (p = 0.002) increase in the number of abnormal hexagons when controlling for age. Increased areas of neuro-retinal dysfunction are predicted by worsening glycemic control in patients with no visible DR. Standard mfERG may be useful in monitoring patients with diabetes and identifying those who may be at risk of developing DR.
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Localizing Structural and Functional Damage in the Neural Retina of Adolescents with Type 1 DiabetesTan, Wylie 27 November 2012 (has links)
Studies demonstrate neuro-retinal damage in patients with diabetes and no clinically visible diabetic retinopathy. It is unknown which retinal regions are most vulnerable to diabetes. We hypothesized that the standard and slow-flash (sf-) multifocal electroretinogram (mfERG) and adaptive optics (AO) imaging will localize retinal regions of vulnerability.
Fifty-five adolescents with diabetes and 54 controls underwent mfERG testing to isolate predominately retinal bipolar cell activity and sf-mfERG testing to isolate three oscillatory potentials (OPs) from intraretinal amacrine and interplexiform cells. Greatest mfERG delays were in the superior temporal quadrant and at 5°-10° eccentricity. Greatest sf-mfERG delays were found at different eccentricities for each OP.
Twenty adolescents with diabetes and 14 controls underwent AO imaging. No significant differences in cone photoreceptor density were found; however, patients showed a trend towards reduced density in the superior nasal region.
Inner retinal structures may be more susceptible to damage by diabetes than outer retinal structures.
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Localizing Structural and Functional Damage in the Neural Retina of Adolescents with Type 1 DiabetesTan, Wylie 27 November 2012 (has links)
Studies demonstrate neuro-retinal damage in patients with diabetes and no clinically visible diabetic retinopathy. It is unknown which retinal regions are most vulnerable to diabetes. We hypothesized that the standard and slow-flash (sf-) multifocal electroretinogram (mfERG) and adaptive optics (AO) imaging will localize retinal regions of vulnerability.
Fifty-five adolescents with diabetes and 54 controls underwent mfERG testing to isolate predominately retinal bipolar cell activity and sf-mfERG testing to isolate three oscillatory potentials (OPs) from intraretinal amacrine and interplexiform cells. Greatest mfERG delays were in the superior temporal quadrant and at 5°-10° eccentricity. Greatest sf-mfERG delays were found at different eccentricities for each OP.
Twenty adolescents with diabetes and 14 controls underwent AO imaging. No significant differences in cone photoreceptor density were found; however, patients showed a trend towards reduced density in the superior nasal region.
Inner retinal structures may be more susceptible to damage by diabetes than outer retinal structures.
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