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The pattern electroretinogram in glaucoma patients with confirmed visual field deficits.
Invest Ophthalmol Vis Sci. 2005 Jul; 46(7):2411-8.IO

Abstract

PURPOSE

To better understand the relationship between the amplitude of the pattern electroretinogram (PERG) and visual loss, measured with static automated perimetry.

METHODS

Transient PERGs were recorded in 15 patients (31-77 years) and 16 normal individuals (26-65 years). An eye was considered to have glaucomatous damage only if there was an abnormal disc, an abnormal 24-2 Humphrey visual field result (pattern stand deviation, glaucoma hemifield test, and cluster) and an abnormal multifocal visual evoked potential. All the worse (more affected) eyes of the patients and six of the better eyes met these criteria. The N95 amplitude of the PERG was measured from the positive peak (P50) at approximately 50 ms to the trough at approximately 95 ms. The ratio of N95 to P50-the N95 amplitude divided by the P50 amplitude-was also measured.

RESULTS

First, the PERG was within normal limits for 4 (26.7%) of the worse eyes. Overall, 6 (28.6%) of the 21 eyes that met the criteria for glaucomatous damage had normal PERGs on both PERG measures. Because the normal individuals were younger than the patients, an even larger number of normal PERGs might be expected with an age-appropriate control group. Second, the N95 amplitude was nonlinearly related to visual field sensitivity when sensitivity was plotted on a linear plot. Small field losses were associated with disproportionately large losses in PERG amplitude. Third, the PERG from both eyes of a patient were very similar, even when the visual fields suggested very different levels of damage.

CONCLUSIONS

These results are consistent with the view that very early damage can affect the PERG, even before the visual field shows a loss. At the same time, it is clear that patients with clear glaucomatous damage can have normal-appearing PERGs. An explanation is proposed to account for these findings.

Authors+Show Affiliations

Department of Psychology, Columbia University, New York, New York 10027, USA. dch3@columbia.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15980229

Citation

Hood, Donald C., et al. "The Pattern Electroretinogram in Glaucoma Patients With Confirmed Visual Field Deficits." Investigative Ophthalmology & Visual Science, vol. 46, no. 7, 2005, pp. 2411-8.
Hood DC, Xu L, Thienprasiddhi P, et al. The pattern electroretinogram in glaucoma patients with confirmed visual field deficits. Invest Ophthalmol Vis Sci. 2005;46(7):2411-8.
Hood, D. C., Xu, L., Thienprasiddhi, P., Greenstein, V. C., Odel, J. G., Grippo, T. M., Liebmann, J. M., & Ritch, R. (2005). The pattern electroretinogram in glaucoma patients with confirmed visual field deficits. Investigative Ophthalmology & Visual Science, 46(7), 2411-8.
Hood DC, et al. The Pattern Electroretinogram in Glaucoma Patients With Confirmed Visual Field Deficits. Invest Ophthalmol Vis Sci. 2005;46(7):2411-8. PubMed PMID: 15980229.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The pattern electroretinogram in glaucoma patients with confirmed visual field deficits. AU - Hood,Donald C, AU - Xu,Li, AU - Thienprasiddhi,Phamornsak, AU - Greenstein,Vivienne C, AU - Odel,Jeffrey G, AU - Grippo,Tomas M, AU - Liebmann,Jeffrey M, AU - Ritch,Robert, PY - 2005/6/28/pubmed PY - 2005/8/12/medline PY - 2005/6/28/entrez SP - 2411 EP - 8 JF - Investigative ophthalmology & visual science JO - Invest Ophthalmol Vis Sci VL - 46 IS - 7 N2 - PURPOSE: To better understand the relationship between the amplitude of the pattern electroretinogram (PERG) and visual loss, measured with static automated perimetry. METHODS: Transient PERGs were recorded in 15 patients (31-77 years) and 16 normal individuals (26-65 years). An eye was considered to have glaucomatous damage only if there was an abnormal disc, an abnormal 24-2 Humphrey visual field result (pattern stand deviation, glaucoma hemifield test, and cluster) and an abnormal multifocal visual evoked potential. All the worse (more affected) eyes of the patients and six of the better eyes met these criteria. The N95 amplitude of the PERG was measured from the positive peak (P50) at approximately 50 ms to the trough at approximately 95 ms. The ratio of N95 to P50-the N95 amplitude divided by the P50 amplitude-was also measured. RESULTS: First, the PERG was within normal limits for 4 (26.7%) of the worse eyes. Overall, 6 (28.6%) of the 21 eyes that met the criteria for glaucomatous damage had normal PERGs on both PERG measures. Because the normal individuals were younger than the patients, an even larger number of normal PERGs might be expected with an age-appropriate control group. Second, the N95 amplitude was nonlinearly related to visual field sensitivity when sensitivity was plotted on a linear plot. Small field losses were associated with disproportionately large losses in PERG amplitude. Third, the PERG from both eyes of a patient were very similar, even when the visual fields suggested very different levels of damage. CONCLUSIONS: These results are consistent with the view that very early damage can affect the PERG, even before the visual field shows a loss. At the same time, it is clear that patients with clear glaucomatous damage can have normal-appearing PERGs. An explanation is proposed to account for these findings. SN - 0146-0404 UR - https://www.unboundmedicine.com/medline/citation/15980229/The_pattern_electroretinogram_in_glaucoma_patients_with_confirmed_visual_field_deficits_ L2 - https://iovs.arvojournals.org/article.aspx?doi=10.1167/iovs.05-0238 DB - PRIME DP - Unbound Medicine ER -