The pattern-electroretinogram in glaucoma and ocular hypertension. A cross-sectional and longitudinal study

Area of Science:

• Ophthalmology
• Neuroscience
• Visual Electrophysiology

Background:

• The pattern electroretinogram (PERG) assesses retinal ganglion cell function.
• Glaucoma and ocular hypertension (OHT) are significant causes of vision loss.
• Early detection and intervention are crucial for managing glaucoma and OHT.

Purpose of the Study:

• To evaluate the diagnostic capability of PERG in differentiating normal eyes, glaucoma, and OHT.
• To determine if PERG can predict future visual field damage in OHT patients.
• To assess the utility of PERG in guiding treatment decisions for OHT.

Main Methods:

• PERG was recorded in 65 normal, 52 glaucoma, and 28 OHT eyes using specific checkerboard patterns and sizes.
• Discriminant analysis was employed to classify eyes based on PERG results.
• OHT patients were followed for 5-35 months to correlate PERG findings with visual field changes.

Main Results:

• Glaucoma eyes showed significantly reduced PERG amplitudes compared to normal eyes, particularly for smaller check sizes (0.8 degrees).
• Discriminant analysis achieved high sensitivity (82.7%) and specificity (90.8%) in classifying normal versus glaucoma eyes.
• Nineteen of 28 OHT eyes were classified as pathological by PERG; these eyes showed a greater decline in visual field sensitivity during follow-up.

Conclusions:

• PERG effectively distinguishes between normal and glaucomatous eyes, with smaller check sizes offering better discrimination.
• PERG can identify OHT patients at higher risk of developing visual field loss.
• PERG serves as a valuable tool for predicting visual field deterioration and informing treatment strategies in OHT management.