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Zone-wise examination of optical coherence tomography features and their correspondence to multifocal electroretinography in eyes with nonproliferative diabetic retinopathy

  • Retinal Disorders
  • Published:
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Abstract

Purpose

To examine (1) the retinal structure by optical coherence tomography (OCT) and function by means of multifocal electroretinography (mfERG) in eyes with and without nonproliferative diabetic retinopathy (NPDR) (2) for correspondence between local retinal function and OCT zones with retinal lesions.

Methods

One hundred and thirty-two eligible participants (30 with nonproliferative DR (NPDR) and 102 with diabetes with no DR) underwent comprehensive ophthalmic examination, optical coherence tomography for retinal thickness measures, mfERG, and ultra-wide field fundus photography. OCT Early Treatment Diabetic Retinopathy Study (ETDRS) grid was overlaid on to mfERG plots.

Results

Those with NPDR had significantly thicker full retinal measures in the nine (ETDRS) zones compared to no DR. mfERG P1 latencies in rings 1–6 were significantly delayed, while the response densities in rings 4–6 were lower in the NPDR group. Significant negative correlation was noted between OCT thickness and mfERG P1 response densities in many ETDRS zones. Significant positive correlation was noted between P1 latencies and OCT thickness in a few zones. The combination of cystic spaces, microaneurysms, and hard exudates were present in all zones and were associated with a decrease in P1 response densities compared to no lesions. Reduced P1 response densities were associated with a sporadic delay in the mfERG latencies and vice versa. The number of lesions did not show correspondence to the mfERG measures.

Conclusions

In eyes with NPDR, retinal function is differentially correlated with the DR lesions on OCT and can be assessed using multimodal imaging modalities.

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Data availability

Data are contained within the article and are included in the form of a Microsoft excel sheet (supplementary material).

Code availability 

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Funding

This work was supported by the Wellcome Trust/DBT India Alliance Early Career Fellowship [grant number IA/CPHE/16/1/502670] awarded to Dr Sangeetha Srinivasan.

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Authors and Affiliations

  1. Vision Research Foundation, Chennai, India

    Sangeetha Srinivasan

  2. NIHR Moorfields Biomedical Research Centre, London, UK

    Sobha Sivaprasad

  3. Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, India

    Girija Munusamy, Rajiv Raman & Muna Bhende

  4. Dr. Mohan’s Diabetes Specialties Centre and Madras Diabetes Research Foundation, Chennai, India

    Ramachandran Rajalakshmi & Ranjit Mohan Anjana

  5. Weill Cornell Medicine-Qatar, Education City, Doha, Qatar

    Rayaz A. Malik

  6. Central Manchester University Hospitals Foundation Trust, Manchester, UK

    Rayaz A. Malik

  7. National Centre for Disease Informatics and Research (NCDIR) & Indian Council of Medical Research (ICMR), Bangalore, India

    Vaitheeswaran Kulothungan

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  1. Sangeetha Srinivasan
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Contributions

SS, RRN, and MPB contributed to the study concepts and study design and obtained funding and patient examination; SS, RRN, MPB, and GM were responsible for data acquisition; SS and GM were responsible for data analysis; SS was responsible for statistical analysis; SS and MPB were responsible for manuscript preparation and editing. All authors critically reviewed the manuscript. SS and MPB act as guarantors.

Corresponding author

Correspondence to Sangeetha Srinivasan.

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Ethics approval

The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Institutional Review Board was approved by the Ethics Committee of Vision Research Foundation [Approval no: 642–2017-P, date of approval: 11.1.2018], Chennai, India.

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Srinivasan, S., Sivaprasad, S., Munusamy, G. et al. Zone-wise examination of optical coherence tomography features and their correspondence to multifocal electroretinography in eyes with nonproliferative diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol 260, 827–837 (2022). https://doi.org/10.1007/s00417-021-05446-z

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