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 in the detection of diabetic retinopathy. ERG observations were made in conjunction with fluorescein angiography of 13 patients suffering from type I diabetes mellitus for five to 13 years. Only patients without any fluorescein leakage during angiography and without any morphologic changes in the fundus were involved in the study. Gold foil electrodes were used for recording. A stroboscopic lamp provided flashing light stimulation through a monochromatic blue filter. Intravenous fluorescein administration caused an immediate reduction in the ERG response. This reduction was seen both in the control subjects and in diabetes patients. In the control group, the reduction was over in 30-45 min, while in the diabetes group a considerable amplitude elevation was seen in all recordings between 15 and 60 min post-fluorescein. In the adaptation control group, where only repeated ERG recordings were employed every 15 min, a slight decrease in the a wave and a slight elevation of the b wave were observed during the whole recording period. No complaints or side-effects were detected during the observations. As all the patients displayed a normal fluorescein angiography besides elevated b wave after 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.