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Multifocal electroretinogram in diabetic macular edema and its correlation with different optical coherence tomography features

International Ophthalmology volume 40, pages 571–581 (2020)Cite this article

Abstract

Purpose

To evaluate multifocal electroretinogram (mfERG) parameters in eyes with diabetic macular edema (DME) and its correlation with vision and optical coherence tomography (OCT) features.

Methods

Fifty-four eyes of 27 subjects with DME due to nonproliferative diabetic retinopathy were evaluated. MfERG responses were measured in three concentric rings. Macular thickness was measured by OCT in each segment of the three concentric rings, and mfERG rings were superimposed on the macular thickness map. The correlation between macular thickness in specific points of the thickness map and changes of the mfERG parameters in the corresponding points of the mfERG field map was evaluated and the relationship between the OCT and mfERG changes and changes of best-corrected visual acuity (BCVA) was investigated. The central foveal B-scans of SD-OCT were used to evaluate any correlation between the external limiting membrane (ELM) status, ellipsoid zone (EZ) status, presence of cysts or disorganization of retinal inner layers (DRIL), and mfERG parameters at the central corresponding area.

Results

The mean of BCVA was 0.5 ± 0.3 in logMAR, and the central macular thickness was 392.6 ± 123.4 microns. The central ring P1 and N2 amplitudes had a significant correlation with BCVA in univariate and multivariate analyses (P = 0.001 for both, r = − 0.346 and r = − 0.646, respectively). There was a significant correlation between retinal thickness and the N1 amplitude in the central ring (P = 0.02, r = − 0.343). Outer retinal layer disruption (ELM and EZ) correlated with prolonged P1 implicit time at the corresponding location (P = 0.005, r = 0.068). The presence of the DRIL was associated with reduced P1 and N2 amplitudes (P = 0.037, r = − 0.284 and P = 0.019, r = − 0.562, respectively). A significant correlation was also found between the presence of cysts and a lower central P1 amplitude (P = 0.033, r = − 0.376).

Conclusion

In diabetic patients, discrete changes of some parameters in the central ring of the mfERG field map (e.g., P1 and N2 amplitudes) have a significant correlation with both structural OCT abnormalities in the corresponding points of the thickness map (like DRIL, intraretinal cyst and ELM/EZ disruption) and BCVA. Predictive models such as those described in this report may make it possible to identify the relationship between specific anatomical and functional characteristics in diabetic retinopathy.

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Affiliations

  1. Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, South Kargar Street, Tehran, Iran

    Hassan Khojasteh, Hamid Riazi-Esfahani, Elias Khalili Pour, Hooshang Faghihi, Fariba Ghassemi, Fatemeh Bazvand, Raziyeh Mahmoudzadeh, Mirataollah Salabati & Masoud Mirghorbani

  2. Department of Ophthalmology, Gavin Herbert Eye Institute, University of California Irvine, Irvine, CA, USA

    Mohammad Riazi Esfahani

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  1. Hassan Khojasteh
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  2. Hamid Riazi-Esfahani
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Correspondence to Hamid Riazi-Esfahani.

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Khojasteh, H., Riazi-Esfahani, H., Khalili Pour, E. et al. Multifocal electroretinogram in diabetic macular edema and its correlation with different optical coherence tomography features. Int Ophthalmol 40, 571–581 (2020). https://doi.org/10.1007/s10792-019-01215-4

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Keywords

  • Diabetic macular edema
  • Multifocal electroretinogram (mfERG)
  • Optical coherence tomography (OCT)
  • Biomarkers