Non-invasive electrophysiology in glaucoma, structure and function—a review

Al-Nosairy, Khaldoon O.; Hoffmann, Michael B.; Bach, Michael

doi:10.1038/s41433-021-01603-0

Cited by 13 publications

(7 citation statements)

References 92 publications

(109 reference statements)

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“…There are numerous recent and anticipated developments in the field of visual electrophysiology. In 2021, a special section in this journal featured several relevant articles, each focusing on a particular aspect, summarising current knowledge, providing new insights and future directions [3,[17][18][19][20][21][22][23][24]. For the remainder of the current article, some advances, particularly relating to human ERGs, will be highlighted, categorised broadly into new devices, new stimulus protocols, and novel analyses.…”

Section: Some Current and Future Developmentsmentioning

confidence: 99%

Visual electrophysiology and “the potential of the potentials”

Mahroo

2023

Eye

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Visual electrophysiology affords direct, quantitative, objective assessment of visual pathway function at different levels, and thus yields information complementary to, and not necessarily obtainable from, imaging or psychophysical testing. The tests available, and their indications, have evolved, with many advances, both in technology and in our understanding of the neural basis of the waveforms, now facilitating more precise evaluation of physiology and pathophysiology. After summarising the visual pathway and current standard clinical testing methods, this review discusses, non-exhaustively, several developments, focusing particularly on human electroretinogram recordings. These include new devices (portable, non-mydiatric, multimodal), novel testing protocols (including those aiming to separate rod-driven and cone-driven responses, and to monitor retinal adaptation), and developments in methods of analysis, including use of modelling and machine learning. It is likely that several tests will become more accessible and useful in both clinical and research settings. In future, these methods will further aid our understanding of common and rare eye disease, will help in assessing novel therapies, and will potentially yield information relevant to neurological and neuro-psychiatric conditions.

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Section: Some Current and Future Developmentsmentioning

confidence: 99%

Visual electrophysiology and “the potential of the potentials”

Mahroo

2023

Eye

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“…Therefore, the ERG has become an important tool to evaluate the effect of different treatments for glaucoma, as both the pattern ERG (PERG) and the photopic negative response (PhNR) are sensitive markers of RGC dysfunction, which is characteristic of glaucoma. The PERG is a measure of the electrical activity of the RGC population of the central retina (more than 40% of the total RGC population), whereas the PhNR reflects generalized activity of the RGCs and their axons [ 21 , 22 , 23 , 24 , 25 , 26 ].…”

Section: Introductionmentioning

confidence: 99%

“…While it is known that ERG responses vary depending on the level of IOP, the data on changes in OCTA parameters are still uncertain [ 23 , 24 ]. Knowledge of the effects of preservative-free latanoprost on ocular blood flow, a possible mechanism responsible for the development and progression of glaucoma, and on the RGC function may help to better understand the pathophysiology of the disease and treatment strategies.…”

Section: Introductionmentioning

confidence: 99%

Retinal Ganglion Cell Function and Perfusion following Intraocular Pressure Reduction with Preservative-Free Latanoprost in Patients with Glaucoma and Ocular Hypertension

Daka,

Sustar Habjan,

Meglič

et al. 2024

JCM

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(1) Background: Given the global prevalence of glaucoma and the crucial role of intraocular pressure (IOP) reduction in the management of the disease, understanding the immediate effects on retinal structure and function is essential. (2) Methods: This study aimed to assess the effects of preservative-free latanoprost on morphological and functional parameters in treatment-naïve patients with ocular hypertension and open-angle glaucoma. (3) Results: This study showed a significant reduction in IOP by an average of 30.6% after treatment with preservative-free latanoprost. Despite the significant reduction in IOP, no statistically significant changes were observed in the electroretinogram (ERG) nor the optical coherence tomography/angiography (OCT/OCTA) parameters compared to baseline. An exploration of the correlation between IOP changes and various parameters revealed a significant association solely with the macular IPL/INL plexus vessel density (VD) measured with OCTA. (4) Conclusions: This finding suggests a possible association between IOP reduction and changes in the macular microcirculation and provides valuable insights into the differential effects of latanoprost. Acknowledging the study limitations, this study emphasizes the need for larger, longer-term investigations to comprehensively assess the sustained effects of preservative-free latanoprost on both IOP and retinal parameters. In addition, exploring systemic factors and conducting subgroup analyses could improve personalized approaches to glaucoma treatment.

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“…The goal of current glaucoma management is early detection of glaucomatous damage and prevention of visual disability through slowed progression and possible reversal. 31 The early detection of RGC structural damage is essential to allow for early intervention and treatment by modifying the only risk factor, an elevated IOP. Lowering this crucial factor will slowdown progressive damage, and hopefully, reverse RGC dysfunction and prevent their programmed apoptosis.…”

Section: Introductionmentioning

confidence: 99%

Retinal Ganglion Cell Functional Recovery after Intraocular Pressure Lowering Treatment Using Prostaglandin Analogs in Glaucoma Suspects: A Prospective Pilot Study

Sheha,

Tirsi,

Gliagias

et al. 2024

Journal of Current Glaucoma Practice

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A bstract Aim and background To evaluate the ability of pattern electroretinogram (PERG) to detect improvement of retinal ganglion cell (RGC) function in glaucoma suspects (GS) after medically reducing intraocular pressure (IOP) using prostaglandin analog drops. Materials and methods Six subjects (eight eyes) received topical IOP lowering treatment based on their clinical examination and were observed at Manhattan Eye, Ear & Throat Hospital over an average of 3.1 ± 2.2 months. During this time, participants underwent a full ophthalmologic exam and were evaluated with a Humphrey visual field analyzer (HFA) 24–2 [24–2 mean deviation (MD), 24–2 pattern standard deviation (PSD), and 24–2 visual field indices (VFI)], Diopsys NOVA PERG optimized for glaucoma [magnitude (Mag), magnitudeD (MagD), and magnitudeD/magnitude ratio (MagD/Mag ratio)] and optical coherence tomography (OCT)-derived average retinal nerve fiber layer thickness (avRNFLT) and average ganglion cell layer + inner plexiform layer (avGCL + IPL) thicknesses at baseline visit (pretreatment) and 3 months later (posttreatment). Goldman applanation tonometry was used to measure IOP at each visit. Paired sample t -tests were conducted to determine the statistical significance of the change in IOP, HFA indices, PERG parameters, and OCT thickness measurements between the two visits. Results Lowering IOP by 22.29% resulted in a significant increase (32.98 and 15.49%) in MagD [ t (7) = −3.174, 95% confidence interval (CI) = −0.53, −0.08, p = 0.016] and MagD/Mag ratio [ t (7) = −3.233, 95% CI = −0.20, −0.03, p = 0.014], respectively. There was a positive percentage change for all variables of interest, however, 24–2 MD, Mag, avRNFLT, and GCL+ IPLT did not reach statistical significance. Conclusion After reducing IOP by 22.29% for a duration of 3.1 months, the PERG parameters, MagD and MagD/Mag ratio, significantly improved by 32.98 and 15.49%, respectively. Clinical significance Pattern electroretinogram (PERG) may be a crucial tool for clinicians to locate a window of opportunity in which degenerating yet viable RGCs could be rescued from irreversible damage. We suggest consideration of PERG as a tool in early retinal ganglion cell (RGC) dysfunction detection as well as for monitoring IOP lowering treatment. How to cite this article Tirsi A, Gliagias V, Sheha H, et al. Retinal Ganglion Cell Functional Recovery after Intraocular Pressure Lowering Treatment Using Prostaglandin Analogs in Glaucoma Suspects: A Prospective Pilot Study. J Curr Glaucoma Pract 2023;17(4):178–190.

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Non-invasive electrophysiology in glaucoma, structure and function—a review

Cited by 13 publications

References 92 publications

Visual electrophysiology and “the potential of the potentials”

Visual electrophysiology and “the potential of the potentials”

Retinal Ganglion Cell Function and Perfusion following Intraocular Pressure Reduction with Preservative-Free Latanoprost in Patients with Glaucoma and Ocular Hypertension

Retinal Ganglion Cell Functional Recovery after Intraocular Pressure Lowering Treatment Using Prostaglandin Analogs in Glaucoma Suspects: A Prospective Pilot Study

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