COMPARATIVE CHARACTERISTICS OF THE EFFECTIVENESS OF DIFFERENT METHODS OF EARLY DIAGNOSTICS OF DIABETIC RETINOPATHY

Introduction. Diabetic retinopathy (DR) pathogenesis presumes functional deterioration of neuronal part of retina along with morphological disturbances which are manifested in the microaneurism (MA) appearance.

The aim of investigation was to investigate results of different methods of early diagnostics of DR which are based on the detection of both functional and morphological manifestations.

Material and methods. 52 patients with the diabetic retinopathy (20 units in accordance to ETDRS scale — 43 patients and 9 patients with 35 units severity of DR) were diagnosed with different methods. 17 patients suffered from diabetes mellitus, type 2 (10 units in accordance to EDTRS scale) were used as a control group. The effectiveness of diagnostics was estimated via recalculations of the sensitivity, specificity and prognostic negative and positive indices, which have been determined under conditions of different methods of diagnostics application: multiscale textural gradient methods (MTGM), estimation of color difference — DE, contrast space sensitivity (CSS), electroretinography (ERG) with oscillatory potential characteristics determination (OP1), and scotopic glial index (Кr), optical density of macular pigment (ODMP), and restoring of а evoked visual potential after photostress determination.

Results. The sensitivity of diagnostics via DE determination exceeded analogous indices, which have been determined after diagnostics with the determination of CSS (by 36.6%; p<0,001); OP1 (by 32.9%; p<0.001); and recovery after photostress (by 37.4%; p<0.001). Also it exceeded the indices which have been seen under conditions of recalculation of Kr and ODMP by 15.0% and 17.3% correspondently (p>0.05). Positive prognostic index after diagnostics with DE investigation exceeded such ones in groups with CSS (by 17.0%; p<0.05); ОP1 (by 20.6%; p<0.05); ODMP (by 24.7%; p<0.01), and photostress (by 20.1%; p<0.05). Negative prognostic index in the group with color difference determination also exceeded such ones in other groups — CSS (by 44.2%; p<0.001); ОP1 (by 42.5%; p<0.001); ODMP (by 30.9%; p<0.01), and photostress (by 41.7%; p<0.01). All investigated indices in case of diagnostic criteria DE recalculation were bigger when compared with corresponded ones determined after diagnostics with MTGM recalculation (p>0.05).

Conclusions. The specificity and sensitivity of the method of early DR diagnostics with DE determination is higher when compared with other methods of diagnostics excluding methods of glial scotopic index and optical density of macular pigment determination. Also effectiveness of diagnostics with DE determination did not demonstrate significant advantage when compared with the method of multiscale textural gradient determination.