Dark adapted and progressively light adapted electroretinograms (ERGs) were recorded from 34 normals and from 45 glaucoma patients. To enhance the oscillatory potentials (OP) the ERGs were highpass-filtered. The OP were characterized by two indices: their root-mean-square value and the inter-flash interval for which the maximal amplitude was obtained. In most of the glaucomatous OP, 50 of 81 eyes, both indices were abnormal, in 22 one parameter was abnormal and only in 9 were both parameters normal. In 13 of the 14 OP recorded from the opposite ('normal') eye of patients with unilateral glaucoma either one or both of the indices were abnormal. These findings indicate that the damage to the retina in glaucoma may extend more distally than the ganglion cell layer and that subclinical changes might be revealed by OP changes.
Pattern electroretrinography (PERG) was performed in 33 patients with chronic open-angle glaucoma (COAG), 18 ocular hypertensive (OH) patients, and 24 normal subjects. COAG patients exhibited significantly lower PERG amplitudes than did normal subjects (P8rps = 0.025; P16rps less than 0.0001). The OH patients fell into two distinct groups: those with normal PERG scores and those with lower than normal scores. OH patients with PERG scores significantly lower than control values demonstrated significantly larger cup-to-disc ratios (P = 0.002) and higher initial intraocular pressures (IOPs) than did OH patients with normal PERG scores (P = 0.021). In the 11 OH patients in whom spectral sensitivity measurement was available, statistically significant correlations were found between the blue-cone sensitivity loss and the PERG amplitude (r8rps = 0.772, P8rps = 0.0053 and r16rps = 0.699, P16rps = 0.0167, respectively. Our results demonstrate reduced PERG amplitude in high-risk OH patients and further illustrate the correlation between PERG amplitude and blue-cone spectral sensitivity in OH subjects. Confirmation of the roles of PERG and spectral sensitivity in the detection of early glaucoma requires longitudinal study.
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