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Multifocal Electroretinograms
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Pattern Electroretinogram Detects Localized Glaucoma Defects.

Tommaso Salgarello1, Andrea Giudiceandrea1,2, Luigi Calandriello1,2

  • 11Institute of Ophthalmology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.

Translational Vision Science & Technology
|September 18, 2018
PubMed
Summary
This summary is machine-generated.

Pattern electroretinogram (PERG) accurately detects localized vision loss in open-angle glaucoma patients. This objective test is valuable for confirming perimetric defects, especially in non-verbal or cognitively impaired individuals.

Keywords:
electroretinogramglaucomahemifieldhemiretinalocalized defect

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Area of Science:

  • Ophthalmology
  • Neuroscience

Background:

  • Open-angle glaucoma can cause localized visual field defects.
  • Accurate detection of these functional losses is crucial for timely intervention.
  • Standard automated perimetry (SAP) and optical coherence tomography (OCT) are common diagnostic tools.

Purpose of the Study:

  • To evaluate the clinical ability of pattern electroretinogram (PERG) to detect functional losses in the affected hemifield of open-angle glaucoma patients with localized perimetric defects.

Main Methods:

  • Hemifield steady-state PERGs (h-PERGs) were recorded in glaucoma patients with localized or diffuse defects, and in normal subjects.
  • Standard automated perimetry (SAP) and spectral-domain optical coherence tomography (SD-OCT) for retinal nerve fiber layer (RNFL) thickness were also performed.
  • h-PERG amplitudes, perimetric deviations, and RNFL thicknesses were analyzed.

Main Results:

  • h-PERG amplitudes, perimetric deviations, and RNFL thicknesses showed significant losses in the affected hemifields of localized glaucoma patients (P < 0.001).
  • h-PERG amplitude ratios (affected/unaffected hemifield) were significantly lower in localized glaucoma compared to normal or diffuse glaucoma groups (P < 0.001).
  • Receiver operating characteristic (ROC) curve analysis showed high diagnostic accuracy for h-PERG amplitude ratios (AUCs of 0.93 and 0.91).

Conclusions:

  • h-PERG assessment demonstrates high diagnostic accuracy for confirming localized glaucomatous defects identified by perimetry.
  • This objective measure is particularly useful for patients unable to perform reliable visual field testing.
  • h-PERG serves as a sensitive tool to corroborate focal losses detected via SAP and/or RNFL thickness analysis.