Document Detail


Multifocal electroretinograms predict onset of diabetic retinopathy in adult patients with diabetes.
MedLine Citation:
PMID:  20926810     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The authors' previous models predicted local formation of diabetic retinopathy (DR) in adults with diabetes and existing retinopathy. Here they derived a multivariate model for local prediction of DR onset in patients with no previous retinopathy.
METHODS: Seventy-eight eyes from 41 diabetes patients were tested annually for several years. The presence or absence of DR at the last study visit was the outcome measure, and measurements of risk factors from the previous visit were used for prediction. Logistic regression was used to assess the relationship between DR development and 7 factors: multifocal ERG (mfERG) implicit time (IT) Z-score, sex, diabetes duration, blood glucose, HbA1c, age, and diabetes type. Thirty-five retinal zones, spanning 45°, were constructed from the mfERG stimulus elements. The maximum IT Z-score for each zone was calculated based on data from 50 control subjects. ROC curve analysis, using fivefold cross-validation, was used to determine the model's predictive properties.
RESULTS: Mild DR developed in 80 of 2730 retinal zones (3%) in 29 of 78 eyes (37%). Multivariate analysis showed mfERG IT to be predictive for DR development in a zone after adjusting for diabetes type. The multivariate model has a sensitivity of 80% and a specificity of 74%.
CONCLUSIONS: mfERG IT is a good predictor of DR onset, 1 year later, in patients with diabetes without DR. It can be used to assess the risk for DR development in these patients and may be a valuable outcome measure in evaluation of novel prophylactic therapeutics directed at impeding DR.
Authors:
Wendy W Harrison; Marcus A Bearse; Jason S Ng; Nicholas P Jewell; Shirin Barez; Dennis Burger; Marilyn E Schneck; Anthony J Adams
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Validation Studies     Date:  2011-02-09
Journal Detail:
Title:  Investigative ophthalmology & visual science     Volume:  52     ISSN:  1552-5783     ISO Abbreviation:  Invest. Ophthalmol. Vis. Sci.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-10     Completed Date:  2011-04-01     Revised Date:  2011-08-03    
Medline Journal Info:
Nlm Unique ID:  7703701     Medline TA:  Invest Ophthalmol Vis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  772-7     Citation Subset:  IM    
Affiliation:
School of Optometry, Group in Vision Science, University of California at Berkeley, Berkeley, California 94720-2020, USA. wwh@berkeley.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Glucose / analysis
Diabetes Mellitus, Type 1 / complications
Diabetes Mellitus, Type 2 / complications
Diabetic Retinopathy / diagnosis*,  etiology,  physiopathology
Electroretinography*
Female
Hemoglobin A, Glycosylated
Humans
Male
Middle Aged
Models, Statistical
Predictive Value of Tests
ROC Curve
Retina / physiopathology*
Risk Factors
Sensitivity and Specificity
Young Adult
Grant Support
ID/Acronym/Agency:
EY 02271/EY/NEI NIH HHS
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Hemoglobin A, Glycosylated; 0/hemoglobin A1c protein, human
Comments/Corrections

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