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Assessing Early Stage Open-Angle Glaucoma in Patients by Isolated-Check Visual Evoked Potential
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Published on: May 25, 2020

Photopic negative response versus pattern electroretinogram in early glaucoma.

Dunja Preiser1, Wolf A Lagrèze, Michael Bach

  • 1Section Visual Function, Department of Ophthalmology, University of Freiburg, Germany.

Investigative Ophthalmology & Visual Science
|January 12, 2013
PubMed
Summary
This summary is machine-generated.

Photopic negative response (PhNR) and pattern electroretinogram (PERG) detect glaucoma by measuring retinal ganglion cell function. Ratios of these responses are more effective than amplitudes for diagnosing glaucoma in early and advanced stages.

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Area of Science:

  • Ophthalmology
  • Neuroscience
  • Electrophysiology

Background:

  • Retinal ganglion cell (RGC) dysfunction is a hallmark of glaucoma.
  • Photopic negative response (PhNR) and pattern electroretinogram (PERG) are electrophysiological measures of RGC function.
  • Both PhNR and PERG are known to be reduced in glaucoma patients.

Purpose of the Study:

  • To compare the diagnostic performance of PhNR and PERG in different stages of glaucoma.
  • To evaluate both amplitude and ratio measures for PhNR and PERG.
  • To assess the utility of combining PhNR and PERG for glaucoma detection.

Main Methods:

  • Included were 11 eyes with preperimetric glaucoma, 18 with manifest glaucoma, and 26 normal controls.
  • PhNR and steady-state PERG were recorded.
  • Analysis included PhNR amplitude, PhNR/b-wave ratio, PERG amplitude, and PERG ratio (0.8°/16°).

Main Results:

  • PhNR identification was reliable at flash strengths ≥1 cd·s/m(2).
  • Both PhNR and PERG amplitudes and ratios were reduced in preperimetric and manifest glaucoma compared to normals.
  • Receiver operating characteristic (ROC) analysis showed that ratios performed better than amplitudes, particularly when combining PhNR and PERG for diagnosis.

Conclusions:

  • Both PhNR and PERG are effective electrophysiological tools for glaucoma detection.
  • Ratio measures of PhNR and PERG demonstrate superior diagnostic accuracy compared to amplitude measures.
  • Combining PhNR and PERG provides high diagnostic accuracy across glaucoma stages, with PhNR offering advantages in suboptimal optical conditions.