The electroretinogram (ERG) elicited by alternating gratings at constant mean luminance (pattern ERG) is a focal response reflecting the activity of the directly stimulated retinal area. In addition, pattern ERG is related, unlike the flash ERG, to ganglion cell activity. Therefore, this technique may be used to evaluate the integrity of inner retinal layers in the macular region. In this study, the steady-state pattern ERG, in response to alternating gratings (1.7 cycles/deg spatial frequency; 9° field size) temporally modulated at 8 Hz, was recorded in 42 type I (insulin-dependent) diabetic patients with zero to four microaneurysms on fluorescein angiography and a duration of disease <11 yr. No patient had concomitant ocular or systemic complications. Mean pattern-ERG amplitude was significantly reduced in patients compared with age-matched control subjects (analysis of variance, F = 25.6, P < 0.0001). Significant differences were observed between control and diabetic subjects without retinopathy (Scheffe Ftest, P < 0.0001), between control and retinopathic subjects (Scheffe F test, P < 0.0001), and between diabetic patients without retinopathy and those with early retinopathy (Scheffé F test, P < 0.02). Pattern-ERG amplitude was inversely correlated with duration of diabetes (r = 0.22, P < 0.05). Our results suggest a macular dysfunction in early diabetes resulting from metabolic and/or vascular injuries in the neurosensory retina.
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Original Articles|
April 01 1990
Evidence for Early Impairment of Macular Function With Pattern ERG in Type I Diabetic Patients
Salvatore Caputo, MD;
Salvatore Caputo, MD
Departments of Internal Medicine and Ophthalmology, Catholic University
Rome
Institute of Neurophysiology, National Council of Research
Pisa, Italy
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Mauro A S Di Leo, MD;
Mauro A S Di Leo, MD
Departments of Internal Medicine and Ophthalmology, Catholic University
Rome
Institute of Neurophysiology, National Council of Research
Pisa, Italy
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Benedetto Falsini, MD;
Benedetto Falsini, MD
Departments of Internal Medicine and Ophthalmology, Catholic University
Rome
Institute of Neurophysiology, National Council of Research
Pisa, Italy
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Giovanni Ghirlanda, MD;
Giovanni Ghirlanda, MD
Departments of Internal Medicine and Ophthalmology, Catholic University
Rome
Institute of Neurophysiology, National Council of Research
Pisa, Italy
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Vittorio Porciatti, PhD;
Vittorio Porciatti, PhD
Departments of Internal Medicine and Ophthalmology, Catholic University
Rome
Institute of Neurophysiology, National Council of Research
Pisa, Italy
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Angelo Minella, MD;
Angelo Minella, MD
Departments of Internal Medicine and Ophthalmology, Catholic University
Rome
Institute of Neurophysiology, National Council of Research
Pisa, Italy
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Aldo V Greco, MD
Aldo V Greco, MD
Departments of Internal Medicine and Ophthalmology, Catholic University
Rome
Institute of Neurophysiology, National Council of Research
Pisa, Italy
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Address correspondence and reprint requests to Dr. Salvatore Caputo, Institute di Clinica Medica, Universita Cattolica del S. Cuore, Largo A. Gemelli, 8, 00168 Rome, Italy.
Diabetes Care 1990;13(4):412–418
Article history
Received:
February 03 1989
Revision Received:
November 01 1989
Accepted:
November 01 1989
PubMed:
2318101
Citation
Salvatore Caputo, Mauro A S Di Leo, Benedetto Falsini, Giovanni Ghirlanda, Vittorio Porciatti, Angelo Minella, Aldo V Greco; Evidence for Early Impairment of Macular Function With Pattern ERG in Type I Diabetic Patients. Diabetes Care 1 April 1990; 13 (4): 412–418. https://doi.org/10.2337/diacare.13.4.412
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