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Updated: Jul 19, 2026
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Assessing Early Stage Open-Angle Glaucoma in Patients by Isolated-Check Visual Evoked Potential
Published on: May 25, 2020
Pattern ERG as an early glaucoma indicator in ocular hypertension: a long-term, prospective study
Michael Bach1, Anke S Unsoeld, Heiko Philippin
1Universitäts-Augenklinik, Killianstrasse 5, 79106 Freiburg, Germany. michael.bach@uni-freiburg.de
Investigative Ophthalmology & Visual Science
|October 27, 2006
Summary
Pattern electroretinogram (PERG) can predict glaucoma development in ocular hypertension (OHT) patients up to a year in advance. This helps identify individuals needing preventative treatment, avoiding unnecessary interventions for non-converters.
Area of Science:
- Ophthalmology
- Neuroscience
- Medical Diagnostics
Background:
- Ocular hypertension (OHT) has a low annual conversion rate to glaucoma (approx. 1%).
- Early identification of glaucoma converters is crucial for timely intervention and resource allocation.
- Distinguishing between non-converters and potential converters avoids unnecessary treatment side effects and costs.
Purpose of the Study:
- To evaluate the pattern electroretinogram (PERG) as an early indicator of glaucomatous dysfunction.
- To assess PERG's ability to predict conversion from OHT to glaucoma.
Main Methods:
- Prospective study of 95 eyes from 54 OHT patients with elevated intraocular pressure and normal visual fields/optic discs.
- Median follow-up of 8.2 years, with regular PERG and visual field testing.
- PERG analysis included responses to 0.8 and 16-degree checkerboard stimuli and their ratio.
Main Results:
- Glaucomatous visual field defects developed in 8 eyes.
- Receiver-operating characteristic (ROC) analysis showed increasing predictive ability of PERG for conversion.
- One year before conversion, the PERG ratio's ROC area was 0.78 (80% sensitivity, 71% specificity).
Conclusions:
- The PERG is a valuable tool for predicting glaucoma development in OHT patients.
- PERG can identify individuals at risk of conversion at least one year prior to clinical manifestation.
- This predictive capability aids in personalized treatment strategies for OHT.
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