Pattern electroretinogram changes in patients with primary open-angle glaucoma in correlation with visual field and optical coherence tomography changes

Abstract

Purpose: To study the pattern electroretinogram changes in primary open-angle glaucoma patients in correlation with visual field changes and optical coherence tomography measurements of retinal nerve fiber layer thickness in the peripapillary region in an attempt to evaluate the clinical value of pattern electroretinogram as an objective test of functional deficit in glaucoma. Patients and Methods: The study included 81 eyes of 81 participants: 50 primary open-angle glaucoma patients, 16 primary open-angle glaucoma suspects, and 15 controls. All subjects underwent visual field testing using 24-2 Humphrey standard automated perimetry, peripapillary retinal nerve fiber layer average thickness using the 3.4-mm circular scan of the Heidelberg OCT spectralis and pattern electroretinogram using CSO RetiMax device in accordance with the International Society for Clinical Electrophysiology of Vision guidelines. Results: We had three main groups: normal, glaucoma suspect, and primary open-angle glaucoma patients, and the last group included three subgroups: mild, moderate, and severe. There was significant difference in the visual field mean deviation, peripapillary retinal nerve fiber layer average thickness, and most pattern electroretinogram measured parameters between the three main groups and in between primary open-angle glaucoma subgroups. There was significant positive correlation between visual field mean deviation and the peripapillary retinal nerve fiber layer average thickness, P50 amplitude, and P50–N95 amplitude (p < 0.001, p = 0.018, and p < 0.001, respectively). Significant negative correlation was also found between peripapillary retinal nerve fiber layer average thickness and N95 amplitude (p < 0.001). Significant positive correlation was found between retinal nerve fiber layer average thickness and P50–N95 amplitude (p = 0.001). Significant negative correlation was found between peripapillary retinal nerve fiber layer average thickness and N95 amplitude (p = 0.001) and significant positive correlation of retinal nerve fiber layer average thickness with P50–N95 amplitude (p = 0.017) in primary open-angle glaucoma patients. Conclusion: Peripapillary retinal nerve fiber layer average thickness shows significant negative correlation with pattern electroretinogram N95 amplitude and a significant positive correlation with P50–N95 amplitude. In combination with optical coherence tomography, pattern electroretinogram can be used to objectively assess functional loss in glaucoma.

Diagnostic performance of multifocal photopic negative response, pattern electroretinogram and optical coherence tomography in glaucoma

“…In our present study, we observed mfPhNR/b-wave ratios to be significantly correlated with both PERG 0.8° amplitude and PERG ratio (r 2 = 0.11, P = 0.02). This supports the view that both measures they reflect similar damage sites and mechanisms, which is further corroborated by the cross-modal correlations of the electrophysiological measures with functional and anatomical measures we observed in accordance with previous conventional PhNR studies(Viswanathan et al 2001; Machida et al 2008; Kirkiewicz et al 2016), PERG studies(Parisi et al 2001; Toffoli et al 2002; Elgohary et al 2019) and another mfPhNR study(Kato et al 2015). In fact, the observed pRNFL changes were a predictor for both mfPhNR/b-wave ratio and PERG 0.8° amplitude.…”

Primary Open Angle Glaucoma Diagnosis Using Pattern Electroretinogram Parameters

“…Between Groups (II) and (III), P50 latency and N95 (latency, amplitude) did not differ substantially. In the same line, Elgohary et al 27 found that P50 peak time varied significantly between the GS and POAG groups, whereas N95 peak time varied significantly between the normal and POAG groups. Between the GS and POAG groups, there was a substantial difference in the PERG N95 amplitude.…”

Monitoring for glaucoma progression with SAP, electroretinography (PERG and PhNR) and OCT

“…Cross-sectional studies reported variable, usually weak to moderate correlation between PERG/PhNR and SAP/structural parameters [30][31][32][33][34] or even lack of correlation [25,35]. Different stages of disease (e.g.…”