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McAnany JJ, Park JC, Chau FY, Leiderman YI, Lim JI, Blair NP. AMPLITUDE LOSS OF THE HIGH-FREQUENCY FLICKER ELECTRORETINOGRAM IN EARLY DIABETIC RETINOPATHY. Retina 2020; 39:2032-2039. [PMID: 30024576 DOI: 10.1097/iae.0000000000002262] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate retinal dysfunction in diabetic patients who have mild or no nonproliferative diabetic retinopathy (DR) using the high-frequency flicker electroretinogram. METHODS Light-adapted flicker electroretinograms were recorded from 15 diabetic patients who have no clinically apparent retinopathy, 15 diabetic patients who have mild nonproliferative DR, and 15 nondiabetic, age-equivalent controls. Electroretinograms were elicited by full-field flicker at 2 temporal frequencies, 31.25 and 62.5 Hz, and were recorded using conventional techniques. Amplitude and timing of the flicker responses were compared among the groups and correlated with clinical characteristics including age, acuity, disease duration, and HbA1c. RESULTS The 31.25-Hz flicker amplitude was slightly, but nonsignificantly, smaller for subjects with no DR and mild nonproliferative DR , compared with the control group (both t < 1.38, P > 0.31); small, nonsignificant response delays for both patient groups were also observed (both t < 1.57, P > 0.12). By contrast, there were significant amplitude reductions for the 62.5-Hz flicker stimulus: mean amplitude was reduced by 32% for subjects with no DR and by 41% for subjects with mild nonproliferative DR (both t > 2.92 and P < 0.01). Response timing at 62.5 Hz did not differ significantly from control for either group (both t < 1.2 and P > 0.39). Electroretinogram amplitude and timing were not correlated significantly with clinical characteristics. CONCLUSION The 62.5-Hz flicker electroretinogram is useful for evaluating retinal dysfunction in diabetic patients who have mild or no DR because this response can be significantly reduced. Attenuation of the high-frequency flicker electroretinogram, which is primarily generated by bipolar cells, suggests a relatively early retinal site of neural dysfunction.
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Affiliation(s)
- J Jason McAnany
- Departments of Ophthalmology and Visual Sciences, and.,Bioengineering, University of Illinois at Chicago, Chicago, Illinois
| | - Jason C Park
- Departments of Ophthalmology and Visual Sciences, and
| | - Felix Y Chau
- Departments of Ophthalmology and Visual Sciences, and
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McAnany JJ, Park JC. Temporal Frequency Abnormalities in Early-Stage Diabetic Retinopathy Assessed by Electroretinography. Invest Ophthalmol Vis Sci 2019; 59:4871-4879. [PMID: 30347080 PMCID: PMC6181244 DOI: 10.1167/iovs.18-25199] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Purpose To define the nature and extent of temporal frequency abnormalities in diabetics who have mild or no nonproliferative diabetic retinopathy (NPDR) by using the flicker electroretinogram (ERG). Methods Light-adapted flicker ERGs were recorded from 20 diabetics who have no clinically apparent retinopathy, 20 diabetics who have mild NPDR, and 20 nondiabetic, age-equivalent controls. ERGs were elicited by full-field sinusoidal flicker across the temporal frequency range of 6 to 100 Hz and were recorded using conventional techniques. The amplitude and phase of the fundamental and harmonic response components were derived by Fourier analysis and compared among the groups. Results Analysis of variance indicated that compared with the controls, both patient groups had significant amplitude reductions of the fundamental ERG component for temporal frequencies greater than 56 Hz (all P ≤ 0.03). Modeling the amplitude measurements indicated that both patient groups had significant reductions in the high-frequency response cutoff. Response phase, however, did not differ significantly among the groups at any frequency. The amplitude and phase of the high-frequency harmonics (32–96 Hz) of the patients' responses to a low-frequency stimulus (16 Hz) were normal over the temporal frequency range that the fundamental response was abnormal. Conclusions Taken together, the diabetics' fundamental amplitude attenuation for rapid flicker combined with their normal high-frequency harmonic responses generated by slow flicker suggest that the likely site of the abnormal temporal filtering occurs prior to the nonlinearity that generates the harmonic components of the ERG, implicating a photoreceptor origin.
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Affiliation(s)
- J Jason McAnany
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, United States.,Department of Bioengineering, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Jason C Park
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, United States
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Mokbel T, Saleh S, Abdelkader M, El-Khouly SE, Abou Samra W, Mamdouh M. Functional and anatomical evaluation of the effect of nepafenac in prevention of macular edema after phacoemulsification in diabetic patients. Int J Ophthalmol 2019; 12:387-392. [PMID: 30918805 DOI: 10.18240/ijo.2019.03.06] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 11/09/2018] [Indexed: 12/20/2022] Open
Abstract
AIM To evaluate the effect of prophylactic administration of nepafenac in prevention of macular edema occurring in diabetic patients after phacoemulsification and to investigate the correlation between optical coherence tomography (OCT) foveal thickness and multifocal electroretinogram (MF-ERG) parameters. METHODS The study included two groups. Group 1 included 50 diabetic patients with senile cataract (50 eyes, 30 females, 20 males, aged 55±7y) received nepafenac 0.1% eye drop. Group 2 included another 50 diabetic patients with senile cataract (50 eyes, 22 female, 28 males, aged 53.8±8y) did not receive nepafenac. All patients were followed up for 3mo postoperatively. OCT and MF-ERG were done preoperative and at 1wk, 1, 2 and 3mo. RESULTS The mean foveal thickness was statistically significantly lower in Group 1. Five eyes in Group 2 developed clinical cystoid macular oedema (CMO) (10%), and no patients in Group 1 developed central macular thickening more than 50 µm. There were insignificant differences in MF-ERG amplitudes and latencies between the two groups except in the five eyes that developed CMO, there statistically significant reduction of MF-ERG amplitude with increase in foveal thickness. CONCLUSION Perioperative nepafenac reduces the incidence of CMO following uncomplicated phacoemulsification significantly. Nepafenac has no side effects.
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Affiliation(s)
- Tharwat Mokbel
- Mansoura Ophthlmic Center, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Sameh Saleh
- Mansoura Ophthlmic Center, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Mona Abdelkader
- Mansoura Ophthlmic Center, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Sherief E El-Khouly
- Mansoura Ophthlmic Center, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Waleed Abou Samra
- Mansoura Ophthlmic Center, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Mohamed Mamdouh
- Mansoura Ophthlmic Center, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
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You ZP, Zhang YL, Shi K, Shi L, Zhang YZ, Zhou Y, Wang CY. Suppression of diabetic retinopathy with GLUT1 siRNA. Sci Rep 2017; 7:7437. [PMID: 28785055 PMCID: PMC5547104 DOI: 10.1038/s41598-017-07942-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 07/05/2017] [Indexed: 01/12/2023] Open
Abstract
To investigate the effect of glucose transporter-1 (GLUT1) inhibition on diabetic retinopathy, we divided forty-eight mice into scrambled siRNA, diabetic scrambled siRNA, and GLUT1 siRNA (intravitreally injected) groups. Twenty-one weeks after diabetes induction, we calculated retinal glucose concentrations, used electroretinography (ERG) and histochemical methods to assess photoreceptor degeneration, and conducted immunoblotting, leukostasis and vascular leakage assays to estimate microangiopathy. The diabetic scrambled siRNA and GLUT1 siRNA exhibited higher glucose concentrations than scrambled siRNA, but GLUT1 siRNA group concentrations were only 50.05% of diabetic scrambled siRNA due to downregulated GLUT1 expression. The diabetic scrambled siRNA and GLUT1 siRNA had lower ERG amplitudes and ONL thicknesses than scrambled siRNA. However, compared with diabetic scrambled siRNA, GLUT1 siRNA group amplitudes and thicknesses were higher. Diabetic scrambled siRNA cones were more loosely arranged and had shorter outer segments than GLUT1 siRNA cones. ICAM-1 and TNF-α expression levels, adherent leukocyte numbers, fluorescence leakage areas and extravasated Evans blue in diabetic scrambled siRNA were higher than those in scrambled siRNA. However, these parameters in the GLUT1 siRNA were lower than diabetic scrambled siRNA. Together, these results demonstrate that GLUT1 siRNA restricted glucose transport by inhibiting GLUT1 expression, which decreased retinal glucose concentrations and ameliorated diabetic retinopathy.
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Affiliation(s)
- Zhi-Peng You
- Department of Ophthalmology, The Second Affiliated Hospital, Nanchang University, Nanchang, 330006, China
| | - Yu-Lan Zhang
- Department of Ophthalmology, The Second Affiliated Hospital, Nanchang University, Nanchang, 330006, China
| | - Ke Shi
- Department of Ophthalmology, The Second Affiliated Hospital, Nanchang University, Nanchang, 330006, China.
| | - Lu Shi
- Department of Ophthalmology, The Second Affiliated Hospital, Nanchang University, Nanchang, 330006, China
| | - Yue-Zhi Zhang
- Department of Ophthalmology, The Second Affiliated Hospital, Nanchang University, Nanchang, 330006, China
| | - Yue Zhou
- Department of Ophthalmology, The Second Affiliated Hospital, Nanchang University, Nanchang, 330006, China
| | - Chang-Yun Wang
- Department of Ophthalmology, The Second Affiliated Hospital, Nanchang University, Nanchang, 330006, China
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Structural and functional assessment after intravitreal injection of ranibizumab in diabetic macular edema. Doc Ophthalmol 2017; 135:165-173. [PMID: 28756595 DOI: 10.1007/s10633-017-9604-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 07/26/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE To evaluate structure and function improvement in central retina by optical coherence tomography (OCT) and multifocal electroretinography (mf-ERG) in diabetic macular edema (DME) patients after intravitreal injection of ranibizumab (IVR) treatment. METHODS Twenty-seven eyes in 27 patients with DME received three consecutive monthly injections of IVR (0.05 ml, 10 mg/ml) and as needed thereafter. The clinical parameters of best-corrected visual acuity (BCVA), central foveal thickness (CFT) and mf-ERG were monitored for 6 months before and after IVR. The findings at baseline, 1, 3 and 6 months were analyzed. Correlation and regression analyses were performed on BCVA, CFT, mf-ERG amplitude and implicit time of the N1 and P1 waves. RESULTS IVR significantly improved visual acuity from the beginning of the treatment (P < 0.05). There were significant decreases in the CFT compared with the baseline after IVR (P < 0.05). The mean amplitude of P1 and N1 in the central ring at all examinations increased significantly compared with the baseline (P < 0.05). The mean P1 and N1 implicit times in the central ring were shortened, but not significantly (P > 0.05). There were significant correlations of BCVA with CFT, P1 and N1 amplitudes in the central retina (P < 0.05). CONCLUSION In addition to the improvement in BCVA and the reduction in CFT, IVR improved macular retinal function, as assessed by mf-ERG, in diabetic eyes. The combination of OCT and mf-ERG for macular evaluation may better assess DME.
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Lung JCY, Swann PG, Chan HHL. The Multifocal On- and Off-Responses in the Human Diabetic Retina. PLoS One 2016; 11:e0155071. [PMID: 27187490 PMCID: PMC4871365 DOI: 10.1371/journal.pone.0155071] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 04/24/2016] [Indexed: 11/18/2022] Open
Abstract
The characteristics of the on- and off-responses in the human diabetic retina by a "long-duration" multifocal electroretinogram (mfERG) paradigm were investigated. Changes in the retinal antagonistic interaction were also evaluated in the early stage of diabetes mellitus (DM). Twenty type II diabetic patients with no or mild non-proliferative diabetic retinopathy (NPDR) and twenty-one age-matched healthy controls were recruited for "long-duration" mfERG measurements. A 61-hexagon mfERG stimulus was displayed under two chromatic conditions (white/black and blue/black) at matched luminance. The amplitudes and implicit times of the on-response components (N1, P1 and N2) and off-response (P2) components were analysed. The blue stimulation generally triggered greater mfERG amplitudes in P1, N2 and P2 (p<0.05) than those from white stimulation in both control and diabetic groups. The diabetic group showed significantly greater N2 amplitude than the controls under white stimulation in mid-retinal regions (Rings 2 and 4) (p<0.05). When the stimulus was changed from white to blue, the diabetic group showed a smaller percentage change in N2 amplitude than the controls in peripheral retinal region (Ring 5) (p<0.02). When a stimulus is changed from white (broad-band spectral stimulation) to blue (narrow-band spectral stimulation), a decrease in the involvement of lateral antagonism would be expected. The larger amplitude of the on-response component (N2) in the diabetic patients suggested an imbalance of lateral antagonism, and the lesser percentage change of N2 amplitude in the diabetic group may indicate an impairment of the cross-talk at the middle retinal level in early stages of DM.
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Affiliation(s)
- Jenny C. Y. Lung
- Laboratory of Experimental Optometry (Neuroscience), School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Peter G. Swann
- Laboratory of Experimental Optometry (Neuroscience), School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
- School of Optometry, The Queensland University of Technology, Queensland, Australia
| | - Henry H. L. Chan
- Laboratory of Experimental Optometry (Neuroscience), School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
- * E-mail:
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Tehrani NM, Riazi-Esfahani H, Jafarzadehpur E, Mirzajani A, Talebi H, Amini A, Mazloumi M, Roohipoor R, Riazi-Esfahani M. Multifocal Electroretinogram in Diabetic Macular Edema; Correlation with Visual Acuity and Optical Coherence Tomography. J Ophthalmic Vis Res 2015; 10:165-71. [PMID: 26425320 PMCID: PMC4568615 DOI: 10.4103/2008-322x.163773] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose: To evaluate multifocal electroretinogram (mfERG) changes in eyes with diabetic macular edema (DME) and investigate any possible correlation with optical coherence tomography (OCT) features and visual acuity (VA). Methods: Twenty-nine right eyes of 29 subjects with DME due to non-proliferative diabetic retinopathy and 30 eyes of 30 normal subjects were evaluated. All patients underwent a complete ophthalmic examination. Sixty-one scaled hexagon mfERG responses were recorded. Components of the first order kernel of N1, N2, and P1 in five concentric rings centered on the fovea, were measured in both groups. Correlation and regression analyses were performed among VA, central macular thickness (CMT) based on OCT, mfERG amplitude, and latency of the N1, N2 and P1 waves. Results: Significant differences were observed in all mfERG parameters in five-ring regions of the retina between eyes with DME versus controls (P < 0.05). There were significant correlations among VA with N2 (P = 0,001, b = 0.73) and P1 amplitudes (P = 0.001, b = −0.84) in the central macular area, and there was a borderline association between VA and CMT (P = 0.042, b = 0.392). Conclusion: Amplitudes of mfERG components (N1, P1, and N2) are significantly reduced and their latencies are delayed in eyes with DME indicating functional impairment in the outer retina. The mfERG total amplitude was significantly correlated with VA even more than CMT, therefore the combined use of OCT and mfERG for macular evaluation may better evaluate visual status in DME patients.
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Affiliation(s)
- Neda Mazahery Tehrani
- Department of Optometry, Faculty of Rehabilitation, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Riazi-Esfahani
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Ebrahim Jafarzadehpur
- Department of Optometry, Faculty of Rehabilitation, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Mirzajani
- Department of Optometry, Faculty of Rehabilitation, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Talebi
- Department of Audiology, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abdulrahim Amini
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Mehdi Mazloumi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Ramak Roohipoor
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Mohammad Riazi-Esfahani
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Science, Tehran, Iran
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Lung JCY, Swann PG, Wong DSH, Chan HHL. Global flash multifocal electroretinogram: early detection of local functional changes and its correlations with optical coherence tomography and visual field tests in diabetic eyes. Doc Ophthalmol 2012; 125:123-35. [PMID: 22828871 DOI: 10.1007/s10633-012-9343-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Accepted: 07/03/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE To investigate the correlations of the global flash multifocal electroretinogram (MOFO mfERG) with common clinical visual assessments--Humphrey perimetry and Stratus circumpapillary retinal nerve fiber layer (RNFL) thickness measurement in type II diabetic patients. METHODS Forty-two diabetic patients participated in the study: Ten were free from diabetic retinopathy (DR), while the remainder suffered from mild to moderate nonproliferative diabetic retinopathy. Fourteen age-matched controls were recruited for comparison. MOFO mfERG measurements were made under high- and low-contrast conditions. Humphrey central 30-2 perimetry and Stratus OCT circumpapillary RNFL thickness measurements were also performed. Correlations between local values of implicit time and amplitude of the mfERG components [direct component (DC) and induced component (IC)], and perimetric sensitivity and RNFL thickness were evaluated by mapping the localized responses for the three subject groups. RESULTS MOFO mfERG was superior to perimetry and RNFL assessments in showing differences between the diabetic groups (with and without DR) and the controls. All the MOFO mfERG amplitudes (except IC amplitude at high contrast) correlated better with perimetry findings (Pearson's r ranged from 0.23 to 0.36, p < 0.01) than did the mfERG implicit time at both high and low contrasts across all subject groups. No consistent correlation was found between the mfERG and RNFL assessments for any group or contrast conditions. The responses of the local MOFO mfERG correlated with local perimetric sensitivity but not with RNFL thickness. CONCLUSION Early functional changes in the diabetic retina seem to occur before morphological changes in the RNFL.
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Affiliation(s)
- J C Y Lung
- Laboratory of Experimental Optometry Neuroscience, School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
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