Early and localized retinal dysfunction in patients with type 1 diabetes mellitus studied by multifocal electroretinogram

Acta Diabetol. 2018 Nov;55(11):1191-1200. doi: 10.1007/s00592-018-1209-9. Epub 2018 Aug 28.


Aims: To investigate the function of localized retinal areas in highly selected type 1 diabetes mellitus patients (DM1) with no or mild signs of diabetic retinopathy (NO DR and NPDR, respectively) and its correlation with age, diabetes duration and glycemic control.

Methods: Multifocal electroretinograms (mfERG) were recorded in 35 eyes of 18 NO DR patients and 38 eyes of 19 NPDR patients. Thirty-one eyes of 17 normal subjects were enrolled as controls. N1-P1 response amplitude densities (RADs) and P1 implicit times (ITs) from isolated (R1: 0°-2.5°, R2: 2.5°-5°, R3: 5°-10°) and combined (R1 + R2, R2 + R3 and R1 + R2 + R3) annular rings and from four retinal sectors (nasal, N; temporal, T; superior, S and inferior, I) with increasing eccentricities up to 10° (S1, S2, S3, S1 + S2, S1 + S2 + S3) were measured. The statistical differences between DM1 groups and controls were tested by ANOVA. The electrophysiological data were correlated with age, duration of diabetes and glycated hemoglobin (HbA1c) level using the Pearson's test.

Results: MfERG RADs, but not ITs, from all isolated and combined rings and sectors up to 10° of foveal eccentricity were statistically different between DM1 groups compared to controls. No significant differences were found between NO DR and NPDR patients. The mfERG abnormalities of the central retinal areas were correlated significantly with age in both DM1 groups and with diabetes duration mainly in NPDR group.

Conclusions: In DM1 patients, localized retinal dysfunction, described by reduced mfERG RAD, can be observed also in the absence of clinical signs of DR and it is related to aging.

Keywords: Diabetes; MfERG; Outer retina; Photoreceptors; Retinal function.

MeSH terms

  • Adolescent
  • Adult
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetic Retinopathy / physiopathology*
  • Electroretinography / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retina / physiopathology