A Diagnostic Model for Screening Diabetic Retinopathy Using the Hand-Held Electroretinogram Device RETeval.

To construct a proper model to screen for diabetic retinopathy (DR) with the RETeval. This was a cross-sectional study. Two hundred thirty-two diabetic patients and seventy controls were recruited. The DR risk assessment protocol was performed to obtain subjects' DR risk score using the RETeval. Afterwards, the receiver operating characteristic (ROC) curve was used to determine the best cutoff for diagnosing DR. Random forest and decision tree models were constructed. With increasing DR severity, the DR score gradually increased. When the DR score was used to diagnose DR, the ROC curve had an area under the curve of 0.881 (95% confidence interval: 0.836-0.927, P < 0.001), with a best cutoff value of 22.95, a sensitivity of 74.3% (95 CI: 66.0%~82.6%), and a specificity of 90.6% (95 CI: 83.7% ~94.8%). The top four risk factors selected by the random forest were used to construct the decision tree for diagnosing DR, which had a sensitivity of 93.3% (95% CI: 86.3%~97.0%) and a specificity of 80.3% (95% CI: 72.1% ~86.6%). The DR risk assessment protocol combined with the decision tree model was innovatively used to evaluate the risk of DR, improving the sensitivity of diagnosis, which makes this method more suitable than the current protocol for DR screening.

Deng X ，Li Z ，Zeng P ，Wang J ，Liang J ，Lan Y ... -  《Frontiers in Endocrinology》

Screening for diabetic retinopathy in diabetic patients with a mydriasis-free, full-field flicker electroretinogram recording device.

Zeng Y ，Cao D ，Yang D ，Zhuang X ，Yu H ，Hu Y ，Zhang Y ，Yang C ，He M ，Zhang L ... -  《-》

Role of a mydriasis-free, full-field flicker ERG device in the detection of diabetic retinopathy.

Değirmenci MFK ，Demirel S ，Batıoğlu F ，Özmert E ... -  《-》

Screening for diabetic retinopathy using new mydriasis-free, full-field flicker ERG recording device.

Fukuo M ，Kondo M ，Hirose A ，Fukushima H ，Ikesugi K ，Sugimoto M ，Kato K ，Uchigata Y ，Kitano S ... -  《Scientific Reports》

Neuroretinal dysfunction revealed by a flicker electroretinogram correlated with peripheral nerve dysfunction and parameters of atherosclerosis in patients with diabetes.

Diabetic polyneuropathy (DPN) develops in the early stage of diabetes. However, no common diagnostic protocol has yet been established. Here, to verify that the flicker electroretinogram using a hand-held device can detect the early dysfunction of the peripheral nervous system in patients with diabetes, we investigated the correlation between the progression of DPN and neuroretinal dysfunction. In total, 184 participants with type 1 or 2 diabetes underwent a flicker electroretinogram (ERG) using a hand-held device RETeval™ and nerve conduction study. Participants were also evaluated for intima-media thickness, ankle-brachial index, toe brachial index and brachial-ankle pulse wave velocity. Parameters of the nerve conduction study were used to diagnose the severity according to Baba's classification. A multiple regression analysis was used to examine the associations of ERG parameters with the severity of DPN categorized by Baba's classification. Diagnostic properties of the device in DPN were evaluated using a receiver operating characteristic curve. A multiple regression model to predict the severity of DPN was generated using ERG. In the model, moderate-to-severe DPN was effectively diagnosed (area under the receiver operating characteristic 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 ratio 0.56). In the patients without diabetic retinopathy, the implicit time and amplitude in ERG significantly correlated with the parameters of the nerve conduction study, brachial-ankle pulse wave velocity and intima-media thickness. Electroretinogram parameters obtained by the hand-held device successfully predict the severity of DPN. The device might be useful to evaluate DPN.

Kawai M ，Himeno T ，Shibata Y ，Hirai N ，Asada-Yamada Y ，Asano-Hayami E ，Ejima Y ，Kasagi R ，Nagao E ，Sugiura-Roth Y ，Nakai-Shimoda H ，Nakayama T ，Yamada Y ，Ishikawa T ，Morishita Y ，Kondo M ，Tsunekawa S ，Kato Y ，Nakamura J ，Kamiya H ... -  《-》