Evaluation of the functional state of the retina in patients with diabetic macular edema by modern research methods and their correlation

March 5, 2018
766
Specialities :
Resume

Aim — to evaluate the functional state of the retina in patients with diabetic macular edema (DME) using modern research methods. Materials and methods. We examined 20 patients, 20 eyes (the average age — 57.6±12.4 years). All patients were diagnosed with DME. Рatients in addition to standard research methods were carried out a multifocal electroretinography (mf-ERG), optical coherence tomography (OCT) and microperimetry. Results. The deformation of the retinal profile was identified on the OCT. The average thickness of the retina was 347±10.6 µm. It was established that the average density of the bioelectric response of the macular area of the retina in patients with macular edema is sharply reduced and amounts to 46.37 nV/deg. The average photosensitivity according to the microperimetry was 14.8 dB. These data indicates a decrease of the functional activity and photosensitivity of the retina. The results of the correlation analysis found a negative correlation (r=–0.442) between the morphological changes in the central zone of the retina according to the OCT and functional data according to the mf-ERG as well as a negative correlation between the data of the OCT and microperimetry (r=–0.587). It was noted a positive correlation (r=0.356) between the photosensitivity according to the microperimetry and functional activity of the retina according to the mf-ERG. Conclusions. It can be considered that in patients with DME there is an increase of the thickness of the retina, accompanied by depression of the amplitudes of mf-ERG and decreased photosensitivity. The regularity between the morphological parameters of the foveal zone, its bioelectric activity and photosensitivity was detected.

M.I. Kerimov, N.A. Shahbazova, U.S. Ismailova, G.Ch. Javadova

Key words: diabetic retinopathy, multifocal electroretinography, optical coherence tomography, microperimetry.

Published: 06.03.2018

References:

  • Mansurin N.B., Shamshinova A.M. (2009) Lokalnaya i multifokalnaya elektroretinografiya v diagnostike diabeticheskoy retinopatii. Vestn. oftalmol., 1: 36–39.
  • Alkuraya H., Kangave D., Abu El-Asrar A.M. (2005) The correlation between optical coherence tomographic features and severity of retinopathy, macular thickness and visual acuity in diabetic macular edema. Int. Ophthalmol., 26: 93–99.
  • American Academy of Ophthalmology (2017) Diabetic Retinopathy (www.aao.org/preferred-practice-pattern/diabetic-retinopathy-ppp-updated-2017).
  • Bearse M.A., Ozawa G.Y. (2014) Multifocal electroretinography in diabetic retinopathy and diabetic macular edema. Cur. Diab. Rep., 14(9): 526–533.
  • Early Treatment Diabetic Retinopathy Study Research Group (1991) Classification of diabetic retinopathy from fluorescein angiograms. ETDRS report number 11. Early Treatment Diabetic Retinopathy Study Research Group. Ophthalmology, 98(5 Suppl.): 807–822.
  • Flynn H.W., Smiddy W.E. (2000) Diabetes and ocular disease: past, present and future therapies: ophthalmology monographs 14. The Foundation of the American Academy of ophthalmology, 334 p.
  • Grenga P., Lupo S., Domanico D. et al. (2008) Efficacy of intravitreal triamcinolone acetonide in long standing diabetic macular edema. A microperimetry and optical coherence study. Retina, 28: 1270–1275.
  • Han Y., Bearse M.A., Schneck M.E. et al. (2004) Multifocal electroretinogram delays predict sites of subsequent diabetic retinopathy. Invest. Ophthalmol. Vis. Sci., 45: 948–954.
  • Hood D., Bach M., Bridell M. et al. (2008) ISCEV guidelines for clinical multifocal electroretinography — 2007 edition. Doc. Ophthalmol., 116(1): 1–11.
  • Hood D.C. (2000) Assessing retinal function with the multifocal technique. Prog. Retin. Eye Res., 19(5): 607–646.
  • Midena E. (2006) Microperimetry. Arch. Soc. Esp. Oftalmol., 81: 183–186.
  • Nagesh B.N., Takkar B., Azad S., Azad R. (2016) Optical Coherence Tomography and Multifocal Electroretinography in Diabetic Macular Edema: A Neurovascular Relation With Vision. Ophthalmic Surg. Lasers Imaging Retina, 47(7): 626–631.
  • Okada K., Yamamoto S., Mizunoya S. et al. (2006) Correlation of retinal sensitivity measured with fundus-related microperimetry to visual acuity and retinal thickness in eyes with diabetic macular edema. Eye, Lond., 20: 805–809.
  • Prokofyeva E., Zrenner E. (2012) Epidemiology of major eye diseases leading to blindness in Europe: a literature review. Ophthalmic. Res., 47(4): 171–188.
  • Scholl S., Kirchhof J., Augustin A.J. (2010) Pathophysiology of macular edema. Int. J. Ophthalmol., 224(1): 8–15.
  • Vujosevic S., Mdena E., Pilotto E. et al. (2006) Diabetic macular edema: correlation between microperimetry and optical coherence tomography findings. Invest. Ophthamol. Vis. Sci., 47: 3044–3051.