Posters

Early detection of neurodegeneration in type 2 diabetic patients without diabetic retinopathy using electroretinogram and spectral-domain optical coherence tomography

Poster Details

First Author: M.Abdelshafy EGYPT

Co Author(s):                        

Abstract Details

Purpose:

To assess early functional and structural changes in the neural retina in type 2 diabetic patients with no clinical signs of diabetic retinopathy (DR).

Setting:

Prospective, cross sectional comparative study.

Methods:

30 eyes of 16 diabetic patients without clinical DR ,with a mean age of 48.75±3.09 years (group 1), 30 eyes of 16 diabetic patients with DR ,with a mean age of 51.75±2.86 years (group 2) and a control group of 32 eyes of 16 healthy age and sex matched subjects ,with mean age of 49.88±4.26 years were included. After full ophthalmologic examination optical coherence tomography scans, multifocal electroretinogram (mfERG) ,pattern electroretinogram (PERG) and photonegative response (PhNR) were tested for all participants. Statistical analysis was performed to compare ganglion cell complex (GCC) thicknesses, mfERG , PERG and phNR values between groups.

Results:

Significant differences of total GCC thickness were found between group 1 (107.13±7.04 µm), group 2 ( 97.27±10.97 µm) and control group(113.81±5.26 µm) (p<0.001) . Significant differences of Mf-ERG P1 wave, PERG/N95, phNR values were found between groups (p<0.001). The inferior GCC thickness had the ROC curve with AUC value (0.831, p<0.001) ,the sensitivity and specificity for a cutoff point of 100.5 μm were 93.3 % and 66.7%, respectively ,followed by the superior quadrant (AUC=0.753 ) . The PERG/N95 amplitude was with the widest AUC= 0.931with 100% sensitivity,86.7% specificity, followed by the phNR amplitude with AUC=:0.90 with 100% sensitivity,66.7% specificity.

Conclusions:

The preclinical DR presents with neural loss in the macular area evident by the reduction GCC thickness and impairments of mf-ERG,PERG ,phNR parameters. Neurodegenerative changes may precede the microvascular damage in these patients. GCC thickness ,PERG and phNR values may prove to be a useful biomarker for early detection of neurodegeneration in diabetic patients and may also serve as an indicator of disease progression.

Financial Disclosure:

None