Steady-State Pattern Electroretinography in Eyes with Glaucoma and High Myopia

Lim, Xian Hui; Nongpiur, Monisha E.; Najjar, Raymond P.; Hoang, Quan V.; Miléa, Dan; Wong, Chee Wai; Husain, Rahat; Htoon, Hla Myint; Aung, Tin; Perera, Shamira; Wong, Tina

doi:10.2147/opth.s336903

Cited by 4 publications

(3 citation statements)

References 38 publications

(65 reference statements)

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“…On the other hand, eyes with glaucoma and high myopia displayed attenuations in the PLR that agree with retinal ganglion cell dysfunction reported using steady-state pattern ERG in eyes with high myopia and glaucoma, 45–47 and reverberate established glaucomatous pupillometric alterations. 31–34,37 The maximum constriction to blue light assessed at high irradiances (14.4 Log photons/cm 2 /s), the PIPR 6s and PIPR AUC 0-12s to blue light, and net PIPR were all reduced in glaucomatous high myopes, indicating ipRGC dysfunction.…”

Section: Discussionsupporting

confidence: 88%

Handheld chromatic pupillometry can reliably detect functional glaucomatous damage in eyes with high myopia

Finkelstein

Nongpiur

Husain

et al. 2022

Preprint

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Purpose: To assess pupillary light responses (PLRs) in eyes with high myopia and evaluate the ability of handheld chromatic pupillometry (HCP) to identify glaucomatous functional loss in eyes with high myopia. Design: Cross-sectional study with prospective data collection. Methods: Participants included 28 emmetropes (EM), 24 high myopes without glaucoma (HM), and 17 high myopes with confirmed glaucoma (HMG), recruited at the Singapore National Eye Center. Monocular PLRs were evaluated using a custom-built handheld pupillometer that recorded changes in horizontal pupil radius in response to 9 seconds of exponentially increasing blue (469.1nm) and red (640.1nm) lights. Fifteen pupillometric features were compared between groups. A logistic regression model (LRM) was used to distinguish HMG eyes from non-glaucomatous eyes (EM and HM). Results: All pupillometric features were similar between EM and HM groups. Phasic constriction to blue (P<0.001) and red (P=0.006) lights, and maximum constriction to blue light (P<0.001) were reduced in HMG compared to EM and HM. Pupillometric features of melanopsin function (PIPR AUC 0-12s (P<0.001) and PIPR 6s (P=0.01) to blue light) were reduced in HMG. Using only three pupillometric features, the LRM could classify glaucomatous from non-glaucomatous eyes with an AUC of 0.89 (95%CI: 0.77-1.00), sensitivity 94.1% (82.4%-100.0%) and specificity 78.8% (67.3%-90.4%). Conclusions: PLRs to ramping-up light stimuli are unaltered in highly myopic eyes without other diagnosed ocular conditions. Conversely, HCP can distinguish glaucomatous functional loss in highly myopic eyes and may be a useful tool to detect/confirm the presence of glaucoma in patients with high myopia.

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Section: Discussionsupporting

confidence: 88%

Handheld chromatic pupillometry can reliably detect functional glaucomatous damage in eyes with high myopia

Finkelstein

Nongpiur

Husain

et al. 2022

Preprint

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“…We have previously reported similar findings in the PLR to red light in eyes with moderate myopia at the high irradiances used in this study, and attributed these differences to confounding longitudinal chromatic aberrations. 39 On the other hand, eyes with glaucoma and high myopia displayed attenuations in the PLR that agree with retinal ganglion cell dysfunction reported using steady-state pattern ERG in eyes with high myopia and glaucoma, [45][46][47] and reverberate established glaucomatous pupillometric alterations. [31][32][33][34]37 The maximum constriction to blue light assessed at high irradiances (14.4 Log photons/cm²/s), the PIPR 6s and PIPR AUC 0-12s to blue light, and net PIPR were all reduced in glaucomatous high myopes, indicating ipRGC dysfunction.…”

Section: Discussionsupporting

confidence: 86%

Handheld chromatic pupillometry can reliably detect functional glaucomatous damage in eyes with high myopia

Finkelstein,

Nongpiur,

Husain

et al. 2023

Br J Ophthalmol

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Background/aimsTo assess pupillary light responses (PLRs) in eyes with high myopia (HM) and evaluate the ability of handheld chromatic pupillometry (HCP) to identify glaucomatous functional loss in eyes with HM.MethodsThis prospective, cross-sectional study included 28 emmetropes (EM), 24 high myopes without glaucoma (HM) and 17 high myopes with confirmed glaucoma (HMG), recruited at the Singapore National Eye Center. Monocular PLRs were evaluated using a custom-built handheld pupillometer that recorded changes in horizontal pupil radius in response to 9 s of exponentially increasing blue (469.1 nm) and red (640.1 nm) lights. Fifteen pupillometric features were compared between groups. A logistic regression model (LRM) was used to distinguish HMG eyes from non-glaucomatous eyes (EM and HM).ResultsAll pupillometric features were similar between EM and HM groups. Phasic constriction to blue (p<0.001) and red (p=0.006) lights, and maximum constriction to blue light (p<0.001) were reduced in HMG compared with EM and HM. Pupillometric features of melanopsin function (postillumination pupillary response, PIPR area under the curve (AUC) 0–12 s (p<0.001) and PIPR 6 s (p=0.01) to blue light) were reduced in HMG. Using only three pupillometric features, the LRM could classify glaucomatous from non-glaucomatous eyes with an AUC of 0.89 (95% CI 0.77 to 1.00), sensitivity 94.1% (95% CI 82.4% to 100.0%) and specificity 78.8% (95% CI 67.3% to 90.4%).ConclusionPLRs to ramping-up light stimuli are unaltered in highly myopic eyes without other diagnosed ocular conditions. Conversely, HCP can distinguish glaucomatous functional loss in eyes with HM and can be a useful tool to detect/confirm the presence of glaucoma in patients with HM.

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“…Subjects aged 20–80, with BCVA (best corrected visual acuity) greater than or equal to 20/40, spherical refraction within 6.0 D and cylinder correction within 3.0 D were included to circumvent the effects of refractive errors on PERG parameters. 26 Furthermore, only subjects with no VF loss (stage zero), based on the Glaucoma Staging System (GSS 2), were enrolled. 27 The following criteria were considered for exclusion: Participants with fixation losses, false positive or negative rates exceeding 20%, history of ocular surgery except uncomplicated cataract extraction, or trauma.…”

Section: Methodsmentioning

confidence: 99%

Posterior Pole Asymmetry Analysis as a Diagnostic Tool in Glaucoma Suspects: An Electrophysiological Approach

Tirsi¹,

Shah²,

Gliagias³

et al. 2023

OPTH

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Spectral domain optical coherence tomography (SD-OCT) with posterior pole asymmetry analysis (PPAA) provides a mapping of posterior pole retinal thickness with asymmetry analysis between hemispheres of each eye. We investigated whether these structural abnormalities were correlated with functional retinal ganglion cell (RGC) loss, quantified by steady state pattern electroretinogram (ssPERG), in glaucoma suspects (GS). Methods: Twenty GS (34 eyes) were enrolled in a prospective study at the Manhattan Eye, Ear, and Throat Hospital. All subjects underwent ophthalmological examination, including Humphrey visual field, Spectralis Glaucoma Module Premium Edition (GMPE) SD-OCT PPAA, and ssPERG testing. The ability of ssPERG parameters (Magnitude [Mag, µv], MagnitudeD [MagD, µv], and MagD/ Mag ratio) to predict PPAA thickness (total, superior, and inferior thickness, [µm]) was tested via adjusted multivariate linear regression analysis.

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Steady-State Pattern Electroretinography in Eyes with Glaucoma and High Myopia

Cited by 4 publications

References 38 publications

Handheld chromatic pupillometry can reliably detect functional glaucomatous damage in eyes with high myopia

Handheld chromatic pupillometry can reliably detect functional glaucomatous damage in eyes with high myopia

Handheld chromatic pupillometry can reliably detect functional glaucomatous damage in eyes with high myopia

Posterior Pole Asymmetry Analysis as a Diagnostic Tool in Glaucoma Suspects: An Electrophysiological Approach

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