The scotopic electroretinogram to blue flashes and pattern reversal visual evoked potentials in insulin dependent...

Pattern reversal visual evoked responses (PR-VEPs), the electroretinogram (ERG) to blue flashes of light in dark adaptation, the steady state ERG to 40 Hz flicker, and alterations in pupil diameter following dark adaptation were studied in 56 juvenile onset diabetics, 34 of whom had no ophthalmoscopic or photographic evidence of diabetic retinopathy (DR-group). The remaining 22 had mild background retinopathy (DR+group). Normal data was obtained from 24 subjects matched for age and sex with diabetics. Skin electrodes were used for all recordings. The scotopic 'b' wave of the ERG was significantly lower in amplitude in the DR- diabetics and it was even more reduced in the DR+group. The PR-VEP was significantly delayed in diabetics but there was no difference between the two groups. The steady state ERG was not significantly different between normals and diabetics. These findings indicate that retinal and more central abnormalities develop early in diabetics. Detection of objective electrophysiological abnormalities may be used to identify persons at risk of developing retinopathy and to monitor the effects of treatment.