Fluorescein-ERG, a sensitive method for the detection of vascular damage in diabetic patients

The purpose of this paper was to provide evidence for the reintroduction of simultaneously performed fluorescein angiography and electroretinography i n the detection of diabetic retinopathy. ERG observations were made in conj unction with fluorescein angiography of 13 patients suffering from type I d iabetes mellitus for five to 13 years. Only patients without any fluorescei n leakage during angiography and without any morphologic changes in the fun dus were involved in the study. Gold foil electrodes were used for recordin g. A stroboscopic lamp provided flashing light stimulation through a monoch romatic blue filter. Intravenous fluorescein administration caused an immed iate reduction in the ERG response. This reduction was seen both in the con trol subjects and in diabetes patients. In the control group, the reduction was over in 30-45 min, while in the diabetes group a considerable amplitud e elevation was seen in all recordings between 15 and 60 min post-fluoresce in. In the adaptation control group, where only repeated ERG recordings wer e employed every 15 min, a slight decrease in the a wave and a slight eleva tion of the b wave were observed during the whole recording period. No comp laints or side-effects were detected during the observations. As all the pa tients displayed a normal fluorescein angiography besides elevated b wave a fter fluorescein administration, and this elevation was seen exclusively in the diabetic group, our study raises the possibility that this diagnostic method can be used in the detection of diabetic retinopathy.