Pattern Electroretinograms in Preperimetric and Perimetric Glaucoma

Jung, Kyoung In; Jeon, Soo Ji; Shin, Dong‐Hee; Lee, Jiyun; Park, Chan Kee

doi:10.1016/j.ajo.2020.02.008

Cited by 27 publications

(38 citation statements)

References 30 publications

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“…Furthermore, recent work demonstrated that preperimetric and perimetric glaucoma subjects had a decrease in the N95 peak amplitude, whereas only perimetric glaucoma subjects had a decrease in the P50 peak amplitude. 70,71 This finding further supports early OFF-pathway vulnerability in glaucoma.…”

Section: Clinical Use Of Erg In Glaucomasupporting

confidence: 65%

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Probing ON and OFF Retinal Pathways in Glaucoma Using Electroretinography

Kong

Santina

2020

Trans. Vis. Sci. Tech.

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Glaucoma is a progressive neurodegenerative disease involving damage and eventually death of retinal ganglion cells (RGCs) that comprise the optic nerve. This review summarizes current understanding of specific RGC type vulnerability in glaucoma and how electroretinography (ERG) may provide an objective measure of these functional perturbations. There is building evidence to suggest that ON RGCs, which respond to light increments, may be more resilient to elevated intraocular pressure and glaucoma, whereas OFF RGCs, which respond to light decrements, may be more susceptible. ERG experiments in nonhuman primates and mice have also shown that the ON-and OFFpathways can be separated using a variety of techniques such as pattern ERG and the photopic negative response. Another ERG paradigm of interest to separate the ON and OFF responses is a flicker stimulus at varying temporal frequencies. Response to lower temporal frequencies is associated with the ON-pathway, and ERG response to higher frequencies is associated with the OFF-pathway. In mice, experimental glaucoma models have shown greater decreases in ERG response at higher frequencies, suggesting that the OFF-pathway is more susceptible. We also summarize current clinical ERG protocols used for glaucoma and discuss innovations for developing new types of stimuli that can further separate the ON-and OFF-pathways. Applying these novel paradigms that distinguish ON-and OFF-pathways may ultimately improve glaucoma diagnostics and monitoring of glaucoma progression. Translational Relevance: Based on our current understanding of specific RGC type vulnerability in glaucoma, we explore how ERG may provide an objective measure of ON-versus OFF-pathway functional perturbations.

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Section: Clinical Use Of Erg In Glaucomasupporting

confidence: 65%

“…51 (B) PERG uses a checkerboard pattern that alternates, and glaucoma subjects have decreased P50 and N95 peaks. [68][69][70][71] (C) The PhNR also uses a rod-saturating light background. Glaucoma subjects have been shown to have a decreased PhNR amplitude.…”

Section: Specific Rgc Types Are More Susceptible To Injury From Elevamentioning

confidence: 99%

Probing ON and OFF Retinal Pathways in Glaucoma Using Electroretinography

Kong

Santina

2020

Trans. Vis. Sci. Tech.

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“…However, in other studies conducted on patients with early to moderate glaucoma, the AUC value for the amplitude of P50–N90 was 0.34 35 . Jung et al estimated the glaucoma detection ability of PERG in patients with pre-perimetric and early glaucoma 36 . In their study, the AUC values for the amplitude of P50–N95 in pre-perimetric glaucoma with and without retinal nerve fiber layer (RNFL) defects were 0.779 and 0.618, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…PERGs were measured by a Neuro-ERG system (Neurosoft, Ivanovo, Russia) using a previously described method 36 , 42 , that has been reported to have an excellent reproducibility 25 . The examination was conducted with full optical correction in a room with a constant background illumination of 50 lx.…”

Section: Methodsmentioning

confidence: 99%

The role of pattern electroretinograms and optical coherence tomography angiography in the diagnosis of normal-tension glaucoma

Lee

Son

Bae

et al. 2021

Sci Rep

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In this study, we investigated the correlation between pattern electroretinogram (PERG) and optical coherence tomography angiography (OCTA) parameters for diagnosis in patients with normal-tension glaucoma (NTG). Forty-nine normal individuals (49 eyes) and 60 patients with NTG (60 eyes) were enrolled. OCTA and PERG parameters, such as macular vessel density (VD) and the amplitude of N35–P50 and P50–N95, were measured. Correlation analyses were performed between the parameters, and the area under the curve (AUC) was used to identify their diagnostic ability for NTG. Macular VD and the amplitude of N35–P50 and P50–N95 showed significant differences between the normal individuals and patients with NTG. Correlation between P50 and N95 amplitude and macular VD was significant in the normal and early glaucoma groups. Macular VD showed a higher AUC value (0.730) than that of P50–N95 amplitude (0.645) in the early glaucoma group. In the moderate to severe glaucoma group, the AUC value of the amplitude of P50–N95 (0.907) was higher than that of macular VD (0.876). The results indicate that PERG and OCTA parameters may identify glaucoma in its early stage, based on the severity of glaucomatous damage in patients with NTG.

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“…Actually, it is known that in OAG patients, PERG and VEP obtained in response to particular visual stimuli (80% contrast, 15′ checks reversed at the rate of 2 reversals per second) may have a specificity of 100% to detect both RGC and visual pathway dysfunction (Parisi et al, 2006 ); in addition, reduced PERG amplitudes were significantly correlated with the reduction of RNFL thickness (RNFL-T; Parisi et al, 2001 , 2006 ; Ventura et al, 2006 ; Falsini et al, 2008 ; Jeon et al, 2019 ; Jung et al, 2020 ; Barbano et al, 2021 ), whereas the delayed VEP responses were (Moschos et al, 2012 ) or not (Parisi et al, 2001 ) correlated with the RNFL-T reduction.…”

Section: Introductionmentioning

confidence: 99%

Neural Conduction Along Postretinal Visual Pathways in Glaucoma

Parisi

Ziccardi

Tanga

et al. 2021

Front. Aging Neurosci.

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Purpose: This study was conducted in order to evaluate retinal ganglion cell (RCG) function and the neural conduction along the postretinal large and small axons and its correlation with retinal nerve fiber layer thickness (RNFL-T) in open-angle glaucoma (OAG) eyes.Methods: Thirty-seven OAG patients (mean age: 51.68 ± 9.83 years) with 24–2 Humphrey mean deviation (MD) between −2.5 and −20 dB and IOP <21 mmHg on pharmacological treatment (OAG group) and 20 age-matched controls (control group) were enrolled. In both groups, simultaneous pattern electroretinograms (PERG) and visual evoked potentials (VEP), in response to checks stimulating macular or extramacular areas (the check edge subtended 15′ and 60′ of visual arc, respectively), and RNFL-T (measured in superior, inferior, nasal, and temporal quadrants) were assessed.Results: In the OAG group, a significant (ANOVA, p < 0.01) reduction of 60′ and 15′ PERG P50-N95 and VEP N75-P100 amplitudes and of RNFL-T [overall (average of all quadrants) or temporal] with respect to controls was found; the values of 60′ and 15′ PERG P50 and VEP P100 implicit times and of retinocortical time (RCT; difference between VEP P100 and PERG P50 implicit times) were significantly (p < 0.01) increased with respect to control ones. The observed increased RCTs were significantly linearly correlated (Pearson’s test, p < 0.01) with the reduced PERG amplitude and MD values, whereas no significant linear correlation (p < 0.01) with RNFL-T (overall or temporal) values was detected.Conclusions: In OAG, there is an impaired postretinal neural conduction along both large and small axons (increased 60′ and 15′ RCTs) that is related to RGC dysfunction, but independent from the RNFL morphology. This implies that, in OAG, the impairment of postretinal neural structures can be electrophysiologically identified and may contribute to the visual field defects, as suggested by the linear correlation between the increase of RCT and MD reduction.

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Pattern Electroretinograms in Preperimetric and Perimetric Glaucoma

Cited by 27 publications

References 30 publications

Probing ON and OFF Retinal Pathways in Glaucoma Using Electroretinography

Probing ON and OFF Retinal Pathways in Glaucoma Using Electroretinography

The role of pattern electroretinograms and optical coherence tomography angiography in the diagnosis of normal-tension glaucoma

Neural Conduction Along Postretinal Visual Pathways in Glaucoma

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