Correlation between Photopic Negative Response and Retinal Nerve Fiber Layer Thickness and Optic Disc Topography in Glaucomatous Eyes

Machida, Shigeki; Gotoh, Yasutaka; Toba, Yoshiharu; Ohtaki, Aki; Kaneko, Masaru; Kurosaka, Daijiro

doi:10.1167/iovs.07-0887

Cited by 96 publications

(96 citation statements)

References 23 publications

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“…The a-wave amplitude was measured from the baseline to the trough of the a-wave. The b-wave amplitude was measured from the trough of the a-wave to the peak of the b-wave as described by Machida et al 4 The PhNR amplitude also was expressed as a ratio of the PhNR to b-wave amplitude to reduce intersession variability and increase the specificity of the effect to the inner retinal function. 16 The photopic full-field ERG was repeated 1 to 2 months later by the same masked observer.…”

Section: Recording Of Phnrmentioning

confidence: 99%

Intraocular Pressure Lowering Is Associated with an Increase in the Photopic Negative Response (PhNR) Amplitude in Glaucoma and Ocular Hypertensive Eyes

Niyadurupola¹,

Luu²,

Nguyen³

et al. 2013

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. The aim of our study was to determine whether IOP lowering in glaucomatous and ocular hypertensive (OHT) eyes leads to an improvement in the full-field photopic negative response (PhNR) of the electroretinogram. METHODS.A prospective nonrandomized interventional cohort study was conducted. Patients with OHT or glaucomatous optic neuropathy were recruited, and photopic full-field electroretinograms (ERG) were performed at baseline and then repeated 1 to 2 months later. The change in PhNR amplitude was compared between those eyes that had a significant lowering in IOP (defined as >25% decrease from baseline or to a predetermined target IOP) during follow-up and those that did not. RESULTS.From a cohort of 30 eyes, 18 eyes had a significant reduction in IOP during follow-up (n ¼ 18) and 12 eyes had no significant change in IOP (<25% reduction in IOP, n ¼ 12). A significant increase in PhNR amplitude and the PhNR/b-wave amplitude ratios was observed in the reduced IOP group, but not in the IOP stable group for the two flash intensities used (2.25 and 3.00 cd.s/m 2 ).CONCLUSIONS. The full-field PhNR amplitude provides a potentially reversible measure of inner retinal function that improves after IOP lowering. Further study now is required to assess its use as a measure of optic nerve health in glaucoma patients.(Invest Ophthalmol Vis Sci.

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Section: Recording Of Phnrmentioning

confidence: 99%

Intraocular Pressure Lowering Is Associated with an Increase in the Photopic Negative Response (PhNR) Amplitude in Glaucoma and Ocular Hypertensive Eyes

Niyadurupola¹,

Luu²,

Nguyen³

et al. 2013

Invest. Ophthalmol. Vis. Sci.

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“…1,2 A number of studies suggest that the PhNR in the photopic ERG originates primarily from activity of RGCs and their axons. [1][2][3][4][5][6][7][8][9] In clinical studies using full-field ERGs, the PhNR amplitude was reduced in various diseases that involves RGC damageFfor example, glaucoma, [3][4][5] retinal vascular disease, 6,7 and optic nerve diseases. [8][9][10] Several researchers measured PhNR by using focal macular ERG in humans and monkeys.…”

Section: Introductionmentioning

confidence: 99%

“…[11][12][13][14][15] Focal macular PhNR detected early glaucoma with higher sensitivity and specificity than full-field PhNR. 5,15 Most patients with acute idiopathic demyelinating optic neuritis have good visual acuity. However, 5-10% of patients recover poorly, 16 and many more patients notice residual qualitative deficits.…”

Section: Introductionmentioning

confidence: 99%

Focal macular photopic negative response in patients with optic neuritis

Nakamura

Miyamoto

Yokota

et al. 2011

Eye

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Purpose To investigate, by focal macular electroretinography (ERG), the change of photopic negative response (PhNR) in the recovery of visual function in patients with optic neuritis. Methods Focal macular ERG was recorded from nine patients with acute optic neuritis (38.6±10.2 years). The photostimulator device projected 151 visual angle spotlight onto the macula. Focal macular ERG recording was performed at the onset and at 1 month and 6 months after the onset of optic neuritis. The results were compared between each recording for seven of the patients. Results All patients decreased in the vision below 20/100 and had central scotoma. Vision improved more than 20/20 within 1 month and full-visual field recovered within 6 months after the onset in all patients. The amplitude of the a-wave, b-wave, and PhNR of focal macular ERG at the onset was significantly attenuated in eyes with optic neuritis (66.8±15.5, 65.8±17.7, and 65.2±14.4% of normal control, respectively). The amplitude of the a-wave and b-wave increased gradually after steroid pulse therapy. The increase in a-wave amplitude was significant at 6 months (P ¼ 0.046), whereas the PhNR amplitude did not show any significant change over 6 months after the onset of optic neuritis. Conclusions Our results suggest that inflammation at the onset of optic neuritis leads to functional deficits that extend to at least the inner nuclear layers of the retina, and that all but the ganglion cell layers of retina recover.

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“…17,18,20 Normalizing (''PhNR/b-wave ratio'') has also been suggested. 21 In the present study, we compared PhNR and PERG regarding their sensitivity and specificity to detect preperimetric and manifest glaucoma. The ultimate aim is to develop a methodology that identifies those patients with an elevated IOP who will convert to glaucoma.…”

mentioning

confidence: 99%

Photopic Negative Response versus Pattern Electroretinogram in Early Glaucoma

Preiser¹,

Lagrèze

Bach³

et al. 2013

Invest. Ophthalmol. Vis. Sci.

110

103

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PURPOSE. Photopic negative response (PhNR) and pattern electroretinogram (PERG) are electrophysiological markers of retinal ganglion cell function; both are reduced in glaucoma. We compared PhNR and PERG in different stages of the disease.METHODS. Eleven eyes with preperimetric glaucoma (glaucomatous optic disc with normal field); 18 with manifest glaucoma; and 26 normals were included. We obtained PhNR (flash strength from 0.1-4 cdÁs/m 2 ) and steady-state PERG and analyzed PhNR amplitude (baseline to 72 ms trough); PhNR/ b-wave ratio; PERG amplitude; and PERG ratio (0.88/168).RESULTS. Identification of PhNR structure was only reliable ‡1 cdÁs/m 2 flash strength; amplitude and receiver operating characteristics (ROC) area under curve (AUC) changed little from 1 to 4 cdÁs/m 2 . Both PhNR and PERG (amplitude and ratio) were reduced in preperimetric and more so in manifest glaucoma. AUCs based on PhNR/PERG amplitudes were not significantly different from chance in preperimetric glaucoma (AUCs 0.61/0.59), but were significant in manifest glaucoma (0.78/0.76); ratios were significant in both glaucoma groups (0.80/0.73 and 0.80/0.79). In spite of that, PhNR ratio and PERG ratio were not significantly correlated (r ¼ 0.22 across all groups); an ROC based on a combination of both reached AUCs of 0.85/0.90 for preperimetric/manifest glaucoma.CONCLUSIONS. Both PhNR and PERG performed similarly to detect glaucoma; for both, ratios performed better than amplitudes. The PhNR has the advantage of not requiring clear optics and refractive correction; the PERG has the advantage of being recorded with natural pupils. (Invest Ophthalmol Vis Sci.

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Correlation between Photopic Negative Response and Retinal Nerve Fiber Layer Thickness and Optic Disc Topography in Glaucomatous Eyes

Abstract: The PhNR amplitudes correlate with the decrease in function and morphology of retinal neurons in eyes with OAG. The linear relationship between the PhNR and the structural parameters indicates that inner retinal function declines proportionately with neural loss in eyes with glaucoma.

Cited by 96 publications

References 23 publications

Intraocular Pressure Lowering Is Associated with an Increase in the Photopic Negative Response (PhNR) Amplitude in Glaucoma and Ocular Hypertensive Eyes

Intraocular Pressure Lowering Is Associated with an Increase in the Photopic Negative Response (PhNR) Amplitude in Glaucoma and Ocular Hypertensive Eyes

Focal macular photopic negative response in patients with optic neuritis

Photopic Negative Response versus Pattern Electroretinogram in Early Glaucoma

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