Check-size specific changes of pattern electroretinogram in patients with early open-angle glaucoma

The pattern electroretinogram was recorded in patients with initial stages of visual field defects due to open-angle glaucoma and in age-matched normal subjects. Both normal subjects and glaucoma patients had a visual acuity above 0.8. Counterphasing checkerboard patterns were used as visual stimuli with a range of check sizes from 0.8 degree to 15 degrees at 7.8 reversals/s. Whereas the amplitude in glaucoma patients was nearly normal for large check sizes, it was significantly reduced for small check sizes (p = 0.003). Possibly two separate mechanisms that generate the pattern electroretinogram for small and large checks are differentially affected; they may be related to the magnocellular and parvocellular systems. The difference between normals and glaucoma patients was even more significant when the ratios of the amplitudes at small and large check sizes were compared (p less than 0.0002). When this ratios is used, the amplitude variability can be partly overcome and the pattern electroretinogram can be a sensitive indicator of ganglion cell function.