Pattern-reversal electroretinograms and high-pass resolution perimetry in suspected or early glaucoma

Twenty-one patients, age 28 to 78 years, with elevated intraocular pressure (IOP) in one or both eyes, were examined with pattern-reversal electroretinograms (PERG), high-pass resolution perimetry (HRP), and conventional computer-assisted perimetry (CAP). Among the 42 eyes, 33 were hypertensive (IOP greater than or equal to 22 mmHg) and nine were normotensive (IOP less than or equal to 20 mmHg). The optic disc was judged abnormal in 14 of the hypertensive and one of the normotensive eyes. Fourteen abnormal PERGs and 19 abnormal HRPs were observed in the 33 hypertensive eyes. Conventional CAP gave abnormal results in three of the hypertensive eyes. Seven of the nine normotensive eyes were normal in all examinations. HRP was abnormal in one of the normotensive eyes and conventional CAP was abnormal in another. Thus, PERG and HRP showed a high incidence of optic nerve dysfunction in suspected or early glaucoma. These new methods should be clinically useful for diagnosis and management of conditions with increased IOP.