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...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2018-01-01
|
| Series: | Journal of Ophthalmology |
| Online Access: | http://dx.doi.org/10.1155/2018/8479850 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849684587373920256 |
|---|---|
| author | K. Sean Jenkins Jason C. Steel Christopher J. Layton |
| author_facet | K. Sean Jenkins Jason C. Steel Christopher J. Layton |
| author_sort | K. Sean Jenkins |
| collection | DOAJ |
| 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. |
| format | Article |
| id | doaj-art-ba3c175f32184d5594f53e12e7ff14ff |
| institution | DOAJ |
| issn | 2090-004X 2090-0058 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Ophthalmology |
| spelling | doaj-art-ba3c175f32184d5594f53e12e7ff14ff2025-08-20T03:23:26ZengWileyJournal of Ophthalmology2090-004X2090-00582018-01-01201810.1155/2018/84798508479850Systematic Assessment of Clinical Methods to Diagnose and Monitor Diabetic Retinal NeuropathyK. Sean Jenkins0Jason C. Steel1Christopher J. Layton2Faculty of Medicine, Greenslopes Clinical School, University of Queensland, Brisbane, AustraliaCentral Queensland University, School of Health, Medical and Applied Science, Rockhampton, QLD, AustraliaFaculty of Medicine, Greenslopes Clinical School, University of Queensland, Brisbane, AustraliaPurpose. 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.http://dx.doi.org/10.1155/2018/8479850 |
| spellingShingle | K. Sean Jenkins Jason C. Steel Christopher J. Layton Systematic Assessment of Clinical Methods to Diagnose and Monitor Diabetic Retinal Neuropathy Journal of Ophthalmology |
| 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 |
| url | http://dx.doi.org/10.1155/2018/8479850 |
| work_keys_str_mv | AT kseanjenkins systematicassessmentofclinicalmethodstodiagnoseandmonitordiabeticretinalneuropathy AT jasoncsteel systematicassessmentofclinicalmethodstodiagnoseandmonitordiabeticretinalneuropathy AT christopherjlayton systematicassessmentofclinicalmethodstodiagnoseandmonitordiabeticretinalneuropathy |