Decoding PERG: a Neuro-Ophthalmic Retinal Ganglion Cell Function Review

Monsalve, Pedro

doi:10.1007/s40135-019-00199-9

“…The ON event is followed by secondary neurodegenerative processes for retrograde trans-synaptic degeneration [ 2 ] that involve retinal ganglion cells (RGCs) and their axons [ 3 ] forming the innermost retinal layers (IML). In MS patients, an IML dysfunction has been observed by recording abnormal bioelectrical responses with pattern electroretinogram (P-ERG) [ 4 , 5 , 6 ] that is a well-known reliable electrophysiological technique for assessing IML function [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Functional Assessment of Outer and Middle Macular Layers in Multiple Sclerosis

Ziccardi

¹

,

Barbano

²

,

Boffa

³

et al. 2020

JCM

View full text Add to dashboard Cite

The involvement of macular preganglionic elements’ function, during the neurodegenerative process of multiple sclerosis (MS), is controversial. In this case-control observational and retrospective study, we assessed multifocal electroretinogram (mfERG) responses from 41 healthy Controls, 41 relapsing-remitting MS patients without optic neuritis (ON) (MS-noON Group) and 47 MS patients with ON: 27 with full recovery of high-contrast best corrected visual acuity (BCVA) (MS-ON-G Group) and 20 with poor recovery (between 0.2 and 1 LogMAR) of BCVA, (MS-ON-P Group). In the latter Group, Sd-OCT macular volumes and thicknesses of whole and inner and outer retina were measured. MfERG N1 and P1 implicit times (ITs), and N1-P1 response amplitude densities (RADs), were measured from concentric rings (R) with increasing foveal eccentricity: 0–5° (R1), 5–10° (R2), 10–15° (R3), 15–20° (R4), 20–25° (R5), and from retinal sectors (superior, nasal, inferior and temporal) between 0–15° and 0–25°. In the MS-ON-P Group, mean mfERG RADs detected from R1 (0–5°) and from the central nasal sector (0–15°) were significantly reduced (p < 0.01) with respect to those of the Control, MS-noON and MS-ON-G Groups. No other significant differences between Groups for any mfERG parameters were found. All Sd-OCT measurements, apart from the inner retina macular volume in the central 1 mm, were significantly reduced in MS-ON-P patients compared to Controls. The functional impairment in the MS-ON-P Group was associated but not correlated with structural changes of the outer and inner retinal layers in corresponding retinal Areas and Sectors. Our results suggest that in MS, exclusively after ON with poor recovery of BCVA, the neurodegenerative process can induce dysfunctional mechanisms involving photoreceptors and bipolar cells of the fovea and of the more central nasal macular area.

show abstract

“…In this study, we used ss-PERG technology with the reversal frequency of 15 reversals/second, providing better diagnostic capabilities in early glaucoma [40,41]. ss-PERG has been considered to provide a higher amplitude, improved latency response, and improved sensitivity over ts-PERG [42][43][44][45].…”

Section: Associations Between Perg and Rim Area After Controlling For Discmentioning

confidence: 99%

Pattern Electroretinogram Parameters Are Associated with Optic Nerve Morphology in Preperimetric Glaucoma after Adjusting for Disc Area

Tirsi

¹

,

Gliagias

²

,

Moehringer³

et al. 2021

Journal of Ophthalmology

View full text Add to dashboard Cite

Purpose. We examined the relationships between pattern electroretinogram and optical coherence tomography derived optic nerve head measurements, after controlling for disc area. Methods. Thirty-two eyes from 20 subjects with preperimetric glaucoma underwent pattern electroretinogram and optical coherence tomography. Pattern electroretinogram parameters (Magnitude, MagnitudeD, and MagnitudeD/Magnitude ratio) and optic nerve head measurements (rim area, average cup to disc ratio, vertical cup to disc ratio, cup volume, retinal nerve fiber layer thickness sectors, and Bruch’s membrane opening-minimum rim width thickness sectors) were analyzed after controlling for disc area. Results. Magnitude and MagnitudeD were significantly associated with rim area (r ≥ 0.503, p ≤ 0.004 ). All pattern electroretinogram parameters significantly correlated with Bruch’s membrane opening-minimum rim width sectors—temporal superior and nasal inferior (r = 0.400, p = 0.039 )—and retinal nerve fiber layer sectors—superior, nasal superior, and inferior (r ≥ 0.428, p ≤ 0.026 ). Magnitude and MagnitudeD explained an additional 26.8% and 25.2% of variance in rim area (B = 0.174 (95% CI: 0.065, 0.283), p = 0.003 , and B = 0.160 (95% CI: 0.056, 0.265), p = 0.004 ), respectively. MagnitudeD and MagnitudeD/Magnitude ratio explained an additional 13.4% and 12.8% of the variance in Bruch’s membrane opening-minimum rim width global (B = 38.921 [95% CI: 3.872, 73.970], p = 0.031 , and B = 129.024 (95% CI: 9.589, 248.460), p = 0.035 ), respectively. All Bruch’s membrane opening-minimum rim width sectors and retinal nerve fiber layer sectors (nasal superior, nasal inferior, and inferior) were significantly correlated with rim area (r ≥ 0.389, p ≤ 0.045 ). Conclusion. PERG abnormalities can predict rim area loss in preperimetric glaucoma after controlling for disc area. We recommend controlling for disc area to increase diagnostic accuracy in early glaucoma.

show abstract

“…The ON event is followed by secondary neurodegenerative processes for retrograde trans-synaptic degeneration [2] that involve retinal ganglion cells (RGCs) and their axons [3] forming the innermost retinal layers (IML). In MS patients, an IML dysfunction has been observed by recording abnormal bioelectrical responses with pattern electroretinogram (P-ERG) [4][5][6] that is a well-known reliable electrophysiological technique for assessing IML function [7].…”

Section: Introductionmentioning

confidence: 99%

Functional Assessment of Outer and Middle Macular Layers in Multiple Sclerosis

Ziccardi¹,

Barbano²,

Boffa³

et al. 2020

Preprint

View full text Add to dashboard Cite

The involvement of macular function in its preganglionic elements, during the neurodegenerative process of multiple sclerosis (MS), is controversial. In this case-control observational and retrospective study, we assessed multifocal electroretinogram (mfERG) responses from 41 healthy Controls, 41 relapsing-remitting MS patients without optic neuritis (ON) (MS-noON Group), 47 MS patients with ON: 27 with full recovery of high-contrast best corrected visual acuity (BCVA) (MS-ON-G Group) and 20 with poor recovery of BCVA (MS-ON-P Group). MfERG N1 and P1 implicit times (ITs), and N1-P1 response amplitude densities (RADs) were measured from concentric rings (R) with increasing foveal eccentricity: 0-5° (R1), 5-10° (R2), 10-15° (R3), 15-20° (R4), 20- 25° (R5), and from retinal sectors [superior, nasal, inferior and temporal] between 0-15° and 0- 25°. In MS-ON-P Group, mean mfERG RADs detected from R1 (0-5°) and from the central nasal quadrant (0-15°) were significantly reduced (p<0.01) with respect to those of Control, MS-noON and MS-ON-G Groups. No other significant differences between Groups for any mfERG parameters were found. Our results suggest that in MS, exclusively after ON with poor recovery of BCVA, the neurodegenerative process can induce dysfunctional mechanisms involving photoreceptors and bipolar cells of the fovea and of the more central nasal macular area.

show abstract

Decoding PERG: a Neuro-Ophthalmic Retinal Ganglion Cell Function Review

Cited by 4 publications

References 50 publications

Functional Assessment of Outer and Middle Macular Layers in Multiple Sclerosis

Functional Assessment of Outer and Middle Macular Layers in Multiple Sclerosis

Pattern Electroretinogram Parameters Are Associated with Optic Nerve Morphology in Preperimetric Glaucoma after Adjusting for Disc Area

Functional Assessment of Outer and Middle Macular Layers in Multiple Sclerosis

Contact Info

Product

Resources

About