title: Multifocal electroretinography (mfERG) in insulin dependent diabetics with and without clinically apparent retinopathy.
abstract: OBJECTIVE
  To study the retinal function, using multifocal electroretinography (mfERG), in diabetic patients with mild and moderate retinopathy, and in diabetics without clinically apparent retinopathy.
  
  
  METHODS
  Thirty-one patients with insulin dependent diabetes mellitus, eleven without any clinically apparent retinopathy, twelve with mild retinopathy and eight with moderate retinopathy, were studied. Ophthalmologic examination included testing of visual acuity, fundus inspection, fundus photography and mfERG. Sixteen subjects without eye disease and with normal visual acuity were used as controls for comparison of mfERG results.
  
  
  RESULTS
  The patients had a mean diabetes duration of 23+/-9 years. All patients and controls had a visual acuity of 1.0. In the first order component of the mfERG there were significantly higher ring amplitudes in the diabetics compared to the controls (p=0.001). In the second-order component of the mfERG, there was a significantly prolonged implicit time in the diabetics who had retinopathy compared to those without any retinopathy (p=0.026). The third positive waveform in the ring amplitudes of the second-order component, were absent in 15/31 of patients with diabetes, but were easily distinguished in all the controls; p<0.001. This waveform was absent in 6/11 patients without retinopathy.
  
  
  CONCLUSIONS
  Patients with insulin dependent diabetes have specific abnormalities in both the first and the second-order component of the mfERG. These abnormalities reflect both vascular changes in the retina and, probably simultaneously, pathology in inner retinal function, also in the diabetics without clinically apparent retinopathy.
authors.affiliation: Department of Ophthalmology, Helsingborg Hospital, S 251 87, Helsingborg, Sweden. maria.tyrberg@helsingborgslasarett.se
authors.forename: Maria
authors.initials: M
authors.lastname: Tyrberg
authors.forename: Vesna
authors.initials: V
authors.lastname: Ponjavic
authors.forename: Monica
authors.initials: M
authors.lastname: Lövestam-Adrian
mesh_terms: D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000503:physiopathology*; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000503:physiopathology*; D004596:Electroretinography / Q000379:methods; D006801:Humans; D008875:Middle Aged; D012720:Severity of Illness Index