Electroretinogram predicts the severity of diabetic polyneuropathy

In patients with diabetes, neuroretinal dysfunction, which can be assessed using electroretinogram parameters, appears to progress even in patients without diabetic retinopathy. These changes are linked to the progression of diabetic polyneuropathy (DPN), according to study results published in the Journal of Diabetes Investigation. Research also suggests that electroretinogram parameters recorded with a handheld device successfully predict DPN severity.

Although DPN is known to develop in the early stages of diabetes, no common diagnostic protocol is currently available. A team of researchers in Japan conducted a study examining the correlation between neuroretinal dysfunction and DPN progression to confirm whether a handheld flicker electroretinogram could detect early peripheral nervous system dysfunction in patients with diabetes.

A total of 184 patients were included in the study; 119 patients were men and 164 patients had type 2 diabetes. Using the International Clinical Classification System, 15.8% of patients had non-proliferative diabetic retinopathy and 14.1% of patients had proliferative diabetic retinopathy.

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Researchers characterized the correspondence of the electroretinogram data with the stages of DPN diagnosed using Baba’s classification of DPN severity (BC) to investigate whether electroretinography helps with DPN diagnosis. The results of a multiple regression analysis suggested that moderate to severe DPN was effectively diagnosed (area under the recipient’s operating curve 0.692, sensitivity 56.5%, specificity 78.3%, positive predictive value 70.6%, negative predictive value 66.1 %, positive likelihood ratio 2.60, negative likelihood rate 0.56).

In patients with no apparent diabetic retinopathy, there was a significant association between the implicit time and amplitude of the electroretinogram and parameters of vascular dysfunction such as the pulse wave velocity of the humerus-ankle and the intima-media thickness.

“The electroretinogram data could reflect the neural and vascular impairment of the retina in patients with diabetes,” said the researchers. “Although DPN and neuroretinal dysfunction could have similar neuropathological backgrounds, further research should be done to clarify the relationship in the future.”


Kawai M, Himeno T, Shibata Y, et al. Neuroretinal dysfunction revealed by a flicker electroretinogram was correlated with dysfunction of peripheral nerves and parameters of atherosclerosis in patients with diabetes. J diabetes examination. 2021; 12 (7): 1236-1243. doi: 10.1111 / jdi.13465

This article originally appeared on Ophthalmology Advisor


Diabetes neuropathy

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