Pattern reversal electroretinogram (PRERG) abnormalities in ocular hypertension: correlation with glaucoma risk...

Area of Science:

• Ophthalmology
• Neuroscience
• Medical Diagnostics

Background:

• Current glaucoma diagnostic tools like tonometry, ophthalmoscopy, and perimetry do not reliably predict which ocular hypertension (OHT) patients will progress to primary open-angle glaucoma (POAG).
• Early detection of POAG is crucial to prevent irreversible visual field loss.
• The human pattern reversal electroretinogram (PRERG) measures neural activity in the retina and has shown amplitude reductions in optic nerve diseases.

Purpose of the Study:

• To investigate if patients with OHT exhibit reduced PRERG amplitudes.
• To determine the correlation between PRERG results and standard clinical parameters used in glaucoma diagnosis.

Main Methods:

• Steady-state PRERG was recorded from 130 OHT patients and 47 age-matched visual normals (AMVNs).
• PRERG was elicited using high-contrast, phase-alternating checkerboard patterns.
• PRERG amplitudes were compared between groups and correlated with age, diastolic blood pressure (DBP), intraocular pressure (IOP), and cup-to-disc (C/D) ratio.

Main Results:

• OHT patients demonstrated a statistically significant reduction in PRERG amplitude compared to AMVNs (p < 0.05).
• Approximately 11.5% of OHT patients had PRERG amplitudes more than 2.0 standard deviations below the AMVN mean.
• PRERG amplitude correlated positively with DBP and negatively with age.
• No significant correlation was found between PRERG amplitude and IOP, C/D ratio, or systolic blood pressure.

Conclusions:

• Reduced PRERG amplitude in OHT patients suggests potential neurophysiological changes preceding glaucoma development.
• PRERG may serve as a complementary diagnostic tool for identifying OHT patients at higher risk of progressing to POAG.
• The lack of correlation with standard clinical indices highlights PRERG's unique contribution to glaucoma assessment.