Local diabetic retinopathy prediction by multifocal ERG delays over 3 years
Local diabetic retinopathy prediction by multifocal ERG delays over 3 years
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DOI：
10.1167/iovs.07-1157
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发表时间：
2008-04-01
影响因子：
4.4
通讯作者：
Adams, Anthony J.
中科院分区：
文献类型：
--
作者：
Ng, Jason S.;Bearse, Marcus A., Jr.;Adams, Anthony J.
目的.通过主要使用多焦视网膜电图（mfERG）的隐式时间（IT）来推导和验证用于预测非增殖性糖尿病视网膜病变（NPDR）病变将在3年内发展的局部视网膜区域的模型。18名糖尿病患者在基线和3年随访时进行了检查。在每次访视时进行眼科检查，包括眼底照片和mfERG检测。从103元素刺激阵列构建了35个视网膜区，每个区基于30名年龄相似的对照受试者被分配了最大IT z分数。使用Logistic回归研究视网膜病变的发展与基线mfERG IT延迟和其他糖尿病健康变量的关系。受试者工作特征（ROC）曲线用于评估模型。在1208个视网膜区中，77个视网膜病变，其中25个视网膜病变复发。多变量分析得出基线mfERG IT、糖尿病病程和血糖浓度是视网膜病变复发的最重要预测因素。mfERG IT不能预测一过性视网膜病变。基于多变量模型预测视网膜病变复发的ROC曲线的曲线下面积为0.95，敏感性为88%，特异性为98%。10倍交叉验证证实了该模型的高灵敏度和特异性。使用基于mfERG隐式时间的多变量模型可以很好地预测3年内复发性视网膜病变的发展。多焦视网膜电图延迟是有希望的候选措施，用于预防或减缓NPDR进展的新疗法的试验。
PURPOSE. To derive and validate a model for use in predicting local retinal areas in which nonproliferative diabetic retinopathy (NPDR) lesions will develop over a 3-year period, by using primarily the implicit time ( IT) of the multifocal electroretinogram (mfERG).METHODS. Eighteen diabetic patients were examined at baseline and at three annual follow-ups. Ophthalmic examinations, including fundus photographs and mfERG testing, were performed at each visit. Thirty-five retinal zones were constructed from the 103-element stimulus array, and each zone was assigned the maximum IT z-score within it based on 30 agesimilar control subjects. Logistic regression was used to investigate the development of retinopathy in relation to baseline mfERG IT delays and additional diabetic health variables. Receiver operating characteristic ( ROC) curves were used to evaluate the models.RESULTS. Retinopathy developed in 77 of the 1208 retinal zones, of which 25 had recurring retinopathy. Multivariate analyses yielded baseline mfERG IT, duration of diabetes, and blood glucose concentration as the most important predictors of recurring retinopathy. mfERG ITs were not predictive of transient retinopathy. ROC curves based on the multivariate model for the prediction of recurring retinopathy resulted in an area under the curve of 0.95, sensitivity of 88%, and specificity of 98%. Ten-fold cross- validation confirmed the high sensitivity and specificity of the model.CONCLUSIONS. The development of recurring retinopathy over a 3-year period can be well predicted by using a multivariate model based on mfERG implicit time. Multifocal ERG delays are promising candidate measures for trials of novel therapeutics directed at preventing or slowing the progression of NPDR.