Pattern Electroretinogram in Glaucoma Suspects: New Findings from a Longitudinal Study

Bode, Sebastian; Jehle, Thomas; Bach, Michael

doi:10.1167/iovs.10-6381

Cited by 86 publications

(93 citation statements)

References 36 publications

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“…37 For quantitative receiver operating characteristics (ROC) analysis, 38 the new ''pROC'' package 39 was employed; this runs faster than the version we had programmed previously. 16 In ophthalmological studies, one needs to deal with the ''eyes or patients'' problem 40,41 because the data from the two eyes often correlate, reducing the effective number of cases. We took the following approach here: when the two eyes of a manifest glaucoma patient did not differ in their GSS2 index 23,24 by more than 1, the values of the two eyes were averaged.…”

Section: Discussionmentioning

confidence: 99%

“…PERG changes have been reported to occur prior to visual field losses. 12,15,16,[44][45][46][47][48][49] In their longitudinal study, Bode et al 16 found that PERG detects glaucoma patients four years before visual field defects appear in standard automated perimetry. The present work suggests that the PhNR is altered prior to visual field in structurally defined glaucoma.…”

Section: Comparison Of Phnr and Perg In Other Studiesmentioning

confidence: 99%

“…13 Longitudinal studies revealed that the PERG ratio can distinguish glaucoma patients from ocular hypertension (OHT) patients up to four years before measurable visual field defects occur. [14][15][16] Another method to assess RGC function is the photopic negative response (PhNR), [17][18][19] a component of the full-field ERG. The PhNR is a relatively slow negative potential that occurs after the positive b-wave of the ERG; it reaches a trough around 70 ms.…”

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confidence: 99%

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Photopic Negative Response versus Pattern Electroretinogram in Early Glaucoma

Preiser¹,

Lagrèze

Bach³

et al. 2013

Invest. Ophthalmol. Vis. Sci.

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109

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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Section: Discussionmentioning

confidence: 99%

Section: Comparison Of Phnr and Perg In Other Studiesmentioning

confidence: 99%

mentioning

confidence: 99%

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Photopic Negative Response versus Pattern Electroretinogram in Early Glaucoma

Preiser¹,

Lagrèze

Bach³

et al. 2013

Invest. Ophthalmol. Vis. Sci.

Self Cite

109

103

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“…Pfeiffer followed 29 eyes with OHT for up to three years: five of 12 eyes with abnormal baseline PERG developed glaucomatous field defects, but no defects were observed among eyes with normal PERG (n=18) (63) . In a recent study involving 120 eyes of OHT patients followed for 10 years, glaucoma was detected by decreased PERG amplitudes four years before VF changes occurred (64) . These studies suggest that the presence of reduced PERG amplitudes in patients with OHT and in glaucoma suspects may be a predictor of glaucoma.…”

Section: Abnormalities In Perg Amplitudementioning

confidence: 99%

The role of pattern-reversal electroretinography in the diagnosis of glaucoma

Kreuz

Oyamada

Hatanaka

et al. 2014

Arquivos Brasileiros De Oftalmologia

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Pattern electroretinography is used to assess the function of the inner retinal la yers, particularly the retinal ganglion cell layer, using a reversing checkerboard or grating pattern that maintains a constant overall mean luminance over time. A normal transient response comprises a positive component of the wave (P50) followed by a longer negative component of the wave (N95). Glaucomatous optic neuropathy causes progressive loss of retinal ganglion cells, potentially detectable as abnormalities on examination, particularly in the N95 component. Therefore, pattern electroretinography may be useful in the diagnosis and evaluation of glaucoma. The present article is an updated review of published data regarding the use of pattern electroretinography for the detection of glaucoma-induced retinal changes. Keywords

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“…Therefore, to be clinically useful, results must be compared to a normative database and adjustments made for these factors. [71 •• , 78] Also, PERG requires a more skilled examiner than that for automated visual field tests [79]. A simplified PERG known as PERGLA (Pattern Electroretinogram for Glaucoma Detection; Glaid, Lace Elettronica, Pisa, Italy) rectifies some of the shortcomings of standard PERG.…”

Section: High-pass Resolution Perimetrymentioning

confidence: 99%

Functional Testing in Glaucoma Diagnosis

Sethi

Fay

Bollinger

2013

Curr Ophthalmol Rep

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The glaucomas are a group of diseases characterized by progressive optic neuropathy, often leading to partial or complete vision loss. Early recognition and careful monitoring for disease advancement are critical for prevention of vision loss. Frequently, asymptomatic defects in the patient's field of vision are key elements to diagnosis. Thus, it is important that the ophthalmologist stay informed regarding tools available for visual field assessment. This review will discuss the current functional testing modalities for glaucoma evaluation.

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Pattern Electroretinogram in Glaucoma Suspects: New Findings from a Longitudinal Study

Abstract: The PERG, especially the PERG ratio, detected glaucoma patients 4 years before visual field changes occurred, with a sensitivity/specificity of 75%/76%. Slope analysis required multiple visits, but provided little additional information in detecting converters.

Cited by 86 publications

References 36 publications

Photopic Negative Response versus Pattern Electroretinogram in Early Glaucoma

Photopic Negative Response versus Pattern Electroretinogram in Early Glaucoma

The role of pattern-reversal electroretinography in the diagnosis of glaucoma

Functional Testing in Glaucoma Diagnosis

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