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A modified analysis protocol for the PhNR test.

William H Ridder¹, Jeffrey D Farmer²

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Summary

This summary is machine-generated.

A modified photopic negative response (PhNR) protocol demonstrated improved diagnostic accuracy for glaucoma. This enhanced method offers greater sensitivity and specificity in detecting glaucomatous damage compared to the standard protocol.

Keywords:

Electroretinogram Glaucoma Photopic negative response (PhNR)Receiver operating characteristic (ROC) curves

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Area of Science:

Ophthalmology
Neuroscience
Medical Imaging

Background:

Glaucoma patients often exhibit abnormal photopic negative response (PhNR) results.
The International Society for Clinical Electrophysiology of Vision (ISCEV) established an extended protocol for PhNR in 2018.

Purpose of the Study:

To compare the diagnostic performance of the ISCEV extended PhNR (I-PhNR) protocol with a modified PhNR (M-PhNR) protocol.
To evaluate the M-PhNR protocol's effectiveness in detecting glaucomatous damage.

Main Methods:

Thirty subjects (12 glaucoma patients, 10 glaucoma suspects, 8 normal controls) underwent PhNR testing using a Diagnosys E3 mobile system.
The M-PhNR protocol incorporated a 5-45 Hz bandpass filter and an objective sweep-selection parameter, differing from the standard I-PhNR protocol.
Measurements included PhNR relative to baseline, a-wave and b-wave amplitudes, and their ratios, analyzed using coefficients of variation, receiver operating characteristic (ROC) curves, and t-tests.

Main Results:

The M-PhNR protocol significantly reduced intra-subject and inter-subject coefficients of variation for glaucoma subjects.
Receiver operating characteristic (ROC) curves showed a larger area under the curve (AUC) for the M-PhNR protocol compared to the I-PhNR.
The M-PhNR protocol demonstrated superior sensitivity and specificity in identifying glaucoma.

Conclusions:

The M-PhNR protocol effectively reduces data variability, leading to improved diagnostic accuracy for glaucoma.
The M-PhNR protocol shows significant promise as a superior diagnostic tool for glaucoma detection compared to the I-PhNR protocol.