Acta Diabetologica

, Volume 55, Issue 11, pp 1191–1200 | Cite as

Early and localized retinal dysfunction in patients with type 1 diabetes mellitus studied by multifocal electroretinogram

  • Lucia ZiccardiEmail author
  • Vincenzo Parisi
  • Fabiana Picconi
  • Antonio Di Renzo
  • Marco Lombardo
  • Simona Frontoni
  • Mariacristina Parravano
Original Article



To investigate the function of localized retinal areas in highly selected type 1 diabetes mellitus patients (DM1) with no or mild signs of diabetic retinopathy (NO DR and NPDR, respectively) and its correlation with age, diabetes duration and glycemic control.


Multifocal electroretinograms (mfERG) were recorded in 35 eyes of 18 NO DR patients and 38 eyes of 19 NPDR patients. Thirty-one eyes of 17 normal subjects were enrolled as controls. N1-P1 response amplitude densities (RADs) and P1 implicit times (ITs) from isolated (R1: 0°–2.5°, R2: 2.5°–5°, R3: 5°–10°) and combined (R1 + R2, R2 + R3 and R1 + R2 + R3) annular rings and from four retinal sectors (nasal, N; temporal, T; superior, S and inferior, I) with increasing eccentricities up to 10° (S1, S2, S3, S1 + S2, S1 + S2 + S3) were measured. The statistical differences between DM1 groups and controls were tested by ANOVA. The electrophysiological data were correlated with age, duration of diabetes and glycated hemoglobin (HbA1c) level using the Pearson’s test.


MfERG RADs, but not ITs, from all isolated and combined rings and sectors up to 10° of foveal eccentricity were statistically different between DM1 groups compared to controls. No significant differences were found between NO DR and NPDR patients. The mfERG abnormalities of the central retinal areas were correlated significantly with age in both DM1 groups and with diabetes duration mainly in NPDR group.


In DM1 patients, localized retinal dysfunction, described by reduced mfERG RAD, can be observed also in the absence of clinical signs of DR and it is related to aging.


Diabetes MfERG Photoreceptors Outer retina Retinal function 



The authors thank Dr. Valter Valli Fiore for technical help in executing electrophysiological recordings and for collecting data. The contribution by Fondazione Bietti in this paper was supported by the Ministry of Health and Fondazione Roma.


No funding was received for this research.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements, proprietary interest), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national, local ethics committee: Comitato Etico Centrale IRCCS Lazio, Sezione IFO/Fondazione Bietti, Rome, Italy) and with the Helsinki Declaration of 1975, as revised in 2008.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

592_2018_1209_MOESM1_ESM.docx (164 kb)
Supplementary material 1 (DOCX 164 KB)
592_2018_1209_MOESM2_ESM.docx (142 kb)
Supplementary material 2 (DOCX 142 KB)
592_2018_1209_MOESM3_ESM.docx (23 kb)
Supplementary material 3 (DOCX 23 KB)


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Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2018

Authors and Affiliations

  1. 1.IRCCS-Fondazione BiettiRomeItaly
  2. 2.Department of Systems MedicineUniversity of Rome Tor VergataRomeItaly
  3. 3.Unit of Endocrinology, Diabetes and MetabolismS. Giovanni Calibita Fatebenefratelli HospitalRomeItaly
  4. 4.Vision Engineering Italy srlRomeItaly

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