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Systematic Assessment of Clinical Methods to Diagnose and Monitor Diabetic Retinal Neuropathy

PURPOSE: Diabetic retinal neuropathy refers to retinal neural tissue damage occurring before the structural retinal changes of diabetic retinopathy and fulfils many of the criteria for causality for the subsequent vasculopathy. Developing reliable means of measuring neuronal damage in diabetes may b...

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Autores principales: Jenkins, K. Sean, Steel, Jason C., Layton, Christopher J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6311844/
https://www.ncbi.nlm.nih.gov/pubmed/30647965
http://dx.doi.org/10.1155/2018/8479850
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author Jenkins, K. Sean
Steel, Jason C.
Layton, Christopher J.
author_facet Jenkins, K. Sean
Steel, Jason C.
Layton, Christopher J.
author_sort Jenkins, K. Sean
collection PubMed
description PURPOSE: Diabetic retinal neuropathy refers to retinal neural tissue damage occurring before the structural retinal changes of diabetic retinopathy and fulfils many of the criteria for causality for the subsequent vasculopathy. Developing reliable means of measuring neuronal damage in diabetes may be important in efforts to prevent retinopathy of a clinically significant and irreversible stage. This study aimed at systematically assessing current clinical measurements of diabetic retinal neuropathy so that future studies may utilise a consensual battery of tests in studying this poorly understood disease state between a healthy retina and one that is retinopathic. METHODS: A systematic search of the medical literature since 1984 was performed on PUBMED and EMBASE, and the evidence supporting each identified method as an indicator for clinically important diabetic retinal neuropathy was graded relatively as compelling, medium, or weak according to criteria assessing its relationship to subsequent diabetic retinopathy, quality of supporting studies, and published reproducibility. RESULTS: The systematic search yielded 6432 results. Subsequent assessment by two independent investigators identified 601 multiple subject studies in humans assessing clinical aspects of the retinal structure, function, or psychophysics in the prediabetic retina. The 933 separate instances of clinical methods assessed as being supported by relatively “compelling” evidence included colour vision changes, flash ERG b-wave latency, flash multifocal b-wave latency, scotopic b-wave and oscillatory potentials in ERG, and contrast sensitivity. CONCLUSION: The results showed moderately poor quality of extant evidence and indicate the best clinical methods for assessing diabetic retinal neuropathy that remain to be confirmed. This is the first systematic assessment of the medical literature aiming at assessing the breadth and validity of these methods and represents an early step in identifying and developing clinical endpoints for use in trials designed to identify at-risk patients or prevent diabetic retinopathy.
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spelling pubmed-63118442019-01-15 Systematic Assessment of Clinical Methods to Diagnose and Monitor Diabetic Retinal Neuropathy Jenkins, K. Sean Steel, Jason C. Layton, Christopher J. J Ophthalmol Research Article PURPOSE: Diabetic retinal neuropathy refers to retinal neural tissue damage occurring before the structural retinal changes of diabetic retinopathy and fulfils many of the criteria for causality for the subsequent vasculopathy. Developing reliable means of measuring neuronal damage in diabetes may be important in efforts to prevent retinopathy of a clinically significant and irreversible stage. This study aimed at systematically assessing current clinical measurements of diabetic retinal neuropathy so that future studies may utilise a consensual battery of tests in studying this poorly understood disease state between a healthy retina and one that is retinopathic. METHODS: A systematic search of the medical literature since 1984 was performed on PUBMED and EMBASE, and the evidence supporting each identified method as an indicator for clinically important diabetic retinal neuropathy was graded relatively as compelling, medium, or weak according to criteria assessing its relationship to subsequent diabetic retinopathy, quality of supporting studies, and published reproducibility. RESULTS: The systematic search yielded 6432 results. Subsequent assessment by two independent investigators identified 601 multiple subject studies in humans assessing clinical aspects of the retinal structure, function, or psychophysics in the prediabetic retina. The 933 separate instances of clinical methods assessed as being supported by relatively “compelling” evidence included colour vision changes, flash ERG b-wave latency, flash multifocal b-wave latency, scotopic b-wave and oscillatory potentials in ERG, and contrast sensitivity. CONCLUSION: The results showed moderately poor quality of extant evidence and indicate the best clinical methods for assessing diabetic retinal neuropathy that remain to be confirmed. This is the first systematic assessment of the medical literature aiming at assessing the breadth and validity of these methods and represents an early step in identifying and developing clinical endpoints for use in trials designed to identify at-risk patients or prevent diabetic retinopathy. Hindawi 2018-12-13 /pmc/articles/PMC6311844/ /pubmed/30647965 http://dx.doi.org/10.1155/2018/8479850 Text en Copyright © 2018 K. Sean Jenkins et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Jenkins, K. Sean
Steel, Jason C.
Layton, Christopher J.
Systematic Assessment of Clinical Methods to Diagnose and Monitor Diabetic Retinal Neuropathy
title Systematic Assessment of Clinical Methods to Diagnose and Monitor Diabetic Retinal Neuropathy
title_full Systematic Assessment of Clinical Methods to Diagnose and Monitor Diabetic Retinal Neuropathy
title_fullStr Systematic Assessment of Clinical Methods to Diagnose and Monitor Diabetic Retinal Neuropathy
title_full_unstemmed Systematic Assessment of Clinical Methods to Diagnose and Monitor Diabetic Retinal Neuropathy
title_short Systematic Assessment of Clinical Methods to Diagnose and Monitor Diabetic Retinal Neuropathy
title_sort systematic assessment of clinical methods to diagnose and monitor diabetic retinal neuropathy
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6311844/
https://www.ncbi.nlm.nih.gov/pubmed/30647965
http://dx.doi.org/10.1155/2018/8479850
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