Application Of OCTA And ERG In Early Fundus Screening In Diabetic Patients

Objective:To compare the fundus screening of type 2 diabetes patients with normal people through using OCTA and handheld full-field flickerERG and to find out early sensitivity indicators.Methods:Observational cross-sectional study.52 eyes of T2DM patients without clinical DR and 52 normal eyes were included in the study.The general condition and best corrected visual acuity(BCVA)of each subject were obtained by detailed medical history collection and optic optometry.The ERG inspections was performed by a handheld mydrias-free full-field flickerERG(RETevalTM),the vessel density of SCPs DCP,and FD300 is accomplished by optical coherence tomography(OCTA).The parameters of general condition,BCVA,OCTA and ERG of two groups were compared,and correlated the retinal vessel density with implicit times and amplitudes.At the same time,multivariate analysis was performed with diabetes duration and vision acuityResults:The number of smokers and the patients with hypertension in the NDR group were higher than those in the control group.The vessel density of whole imageSCP,foveaSCP,perifoveaSCP,foveaDCP,and FD300 were lower than control group,and the 16Tds and 32Tds implicit times were also delayed compared with the normal group.At the same time,we found that the delayed implicit times was correlated to the reduction of FD300,whole image SCP,parafoveaSCP,perifoveaSCP,whole imageDCP and perifoveaDCP.Patients with longer duration of diabities seem to have more effect om vessel density of SCP.The visual acuity of NDR patients was negatively correlated with the 16Tds and 32Tds implicit times,and positively correlated with the vessel density of FD300 and DCP.The regression equation was obtained by multiple linear regression analysis of visual acuity and related parameters:ETDRs=57.507+0.524*FD300,the model was statistically significant(F=24.469,p=0.000),model R=0.573,R2=0.329 Adjust R2=0.315.Conclusion:1?Early retinal functional and structural impairments have already started before the occurance of diabetic retinopathy inpatients with type 2 diabetes.2?Delayed implicit time,decreased vessel density of FD300 and DCP can cause visual acuity decline in NDR patients.After regression analysis,FD300 is the most important factor to effct vision3?The longer the duration of diabetes is,the lower the SCP vessel density will be.4?As a handheld,mydriasis-free,fast flickerERG inspection device,RETevalTM is more suitable for early-stage fundus screening of large-scale DM patients than traditional ERG devices.