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Pattern Electroretinograms in Preperimetric and Perimetric Glaucoma.

Kyoung In Jung1, Sooji Jeon1, Da Young Shin1

  • 1Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.

American Journal of Ophthalmology
|February 23, 2020
PubMed
Summary

Pattern electroretinogram (PERG) N95 amplitudes effectively grade visual function in early glaucoma. PERG N95 amplitude shows promise for detecting glaucomatous damage, especially in preperimetric stages.

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Area of Science:

  • Ophthalmology
  • Neuroscience
  • Medical Imaging

Background:

  • Glaucoma is a progressive optic neuropathy characterized by vision loss.
  • Early detection of glaucoma is crucial for preserving visual function.
  • Pattern electroretinogram (PERG) is a functional test used to assess the inner retinal function.

Purpose of the Study:

  • To evaluate the utility of pattern electroretinogram (PERG) for detailed visual function assessment in preperimetric and early perimetric glaucoma.
  • To determine if PERG parameters can differentiate between healthy individuals and glaucoma patients at various stages.

Main Methods:

  • A cross-sectional observational study included 26 normal subjects, 113 preperimetric glaucoma patients, and 52 early perimetric glaucoma patients.
  • Structural measurements utilized spectral-domain optical coherence tomography (SD-OCT) for retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL) thickness.
  • Functional assessment was performed using a commercial ERG stimulator to record PERG responses, specifically the N95 amplitude.

Main Results:

  • Retinal layer thicknesses (RNFL and GCIPL) were significantly reduced in preperimetric and perimetric glaucoma groups compared to controls (P < .001).
  • PERG N95 amplitude was highest in controls, decreased in preperimetric glaucoma, and was lowest in perimetric glaucoma (P < .001).
  • In preperimetric glaucoma with RNFL defects, PERG N95 amplitude demonstrated superior diagnostic performance (AUC=0.779) compared to Mean Deviation (MD) (AUC=0.533, P=.005).

Conclusions:

  • PERG N95 amplitude decreases progressively with glaucoma severity, offering a graded assessment of visual function.
  • PERG N95 amplitude serves as a valuable complementary tool for detecting early glaucomatous damage, particularly in preperimetric stages.
  • While PERG N95 amplitude shows clinical utility, other PERG parameters may have limited diagnostic value in preperimetric glaucoma due to lower performance.