Comparing focal and global responses on multifocal electroretinogram with retinal nerve fibre layer thickness by spectral domain optical coherence tomography in glaucoma

Rao, Aparna; Singh, Abhishek Kumar; Mukherjee, Sujoy; Chowdhury, Mahasweta

doi:10.1136/bjophthalmol-2014-305323

Cited by 7 publications

(6 citation statements)

References 20 publications

(30 reference statements)

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“…We chose Multifocal ERG over pattern ERG to detect multiple local retinal responses as the latter does not provide the measure of pathological changes in localized retinal areas. [ 19 20 21 ] Assessment of these parameters was performed at baseline before starting therapy, at 3 months and 1 year of starting therapy (9 months of cessation of VPA, to look for a legacy effect of the drug). Liver function tests were measured before starting VPA and at 3 rd month.…”

Section: Methodsmentioning

confidence: 99%

Therapeutic potential of valproic acid in advanced glaucoma: A pilot study

Mahalingam

Chaurasia

Gowtham

et al. 2018

Indian J Ophthalmol

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Purpose:Oral valproic acid (VPA) used as an anticonvulsant has been shown to improve contrast threshold sensitivities in patients receiving it on long-term. This study aimed to evaluate the efficacy of oral VPA in improving visual function in eyes with advanced stage glaucoma.Methods:In this prospective randomized study, 31 patients (n = 31 eyes) with advanced stage glaucoma (with an intraocular pressure <16 mmHg) in at least one eye received oral VPA 500 mg once a day for 3 months and 33 patients (n = 33 eyes) continued on glaucoma therapy. Patients were followed up at 3 and 12 months (to evaluate the legacy effect of the drug). Blood VPA concentrations were measured at 3 months. Following parameters were assessed at baseline, 3 months and 12 months: log of the minimum angle of resolution (LogMAR) visual acuity, mean deviation on visual fields, and multifocal electroretinogram (ERG).Results:Median LogMar visual acuity in the VPA group improved from 0.3 at baseline to 0.18 and 0.18 at 3 and 12 months, respectively (P < 0.01). In comparison, the median visual acuity in control group at baseline was 0.18 and showed neither worsening nor improvement over 3 and 12 months (P = 0.56). The improvement in VPA group was significant compared to the control group (P < 0.01; Wilcoxon Signed-rank test). An improvement in one line was experienced in 11 out of 31 eyes in the VPA group compared to 1 out of 33 eyes among controls (P = 0.003). No significant improvement was noted in the mean deviation, and the multifocal ERG (Latency and amplitudes) in the VPA-treated patients. The average blood VPA concentration measured at 3 months of therapy was 26 ± 8.9 μg/ml (range 8–55 μg/ml) which is much lower than that achieved during anticonvulsant therapy. None of the patients complained of any adverse effects that required stopping VPA therapy.Conclusion:A 3 months oral VPA therapy results in some improvement in visual acuity in a subgroup of eyes with advanced glaucoma and the effect was seen to persist 9 months after the drug was stopped.

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Section: Methodsmentioning

confidence: 99%

Therapeutic potential of valproic acid in advanced glaucoma: A pilot study

Mahalingam

Chaurasia

Gowtham

et al. 2018

Indian J Ophthalmol

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“…The multifocal ERG (mfERG) measures responses from multiple retinal locations from a single recording. [ 50 70 71 72 73 74 75 76 77 ] It is primarily generated by the photoreceptor and bipolar cells of the retina. The stimulus in mfERG constitutes an array of either 61 or 103 white and black hexagons alternating in a semi-random sequence with the fixation target located at the center (Fig.…”

Section: Tests For Assessing Ganglion Cell Functionmentioning

confidence: 99%

“…The structure–function analysis can be enhanced in glaucoma when mfERG test is combined with OCT and SAP. [ 74 75 ] Moon et al . [ 72 ] studied the relationship between visual field defects and mfERG optic nerve head component (ONHC) in 39 glaucoma patients and 30 healthy controls.…”

Section: Tests For Assessing Ganglion Cell Functionmentioning

confidence: 99%

“…Rao et al . [ 74 ] compared mfERG responses to retinal nerve fiber layer (RNFL) thickness in glaucoma patients and found that RNFL thickness significantly correlated with the P1N2 amplitude of mfERG. It is now recognized that N2P1 amplitude on mfERG may be an essential parameter for monitoring early and moderate glaucoma.…”

Section: Tests For Assessing Ganglion Cell Functionmentioning

confidence: 99%

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Visual function tests for glaucoma practice - What is relevant?

Rao

Padhy²,

Pal³

et al. 2022

Indian Journal of Ophthalmology

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Glaucoma represents one of the most important ocular diseases causing irreversible ganglion cell death. It is one of the most common causes of visual impairment and morbidity in the elderly population. There are various tests for measuring visual function in glaucoma. While visual field remains the undisputed method for screening, diagnosis, and monitoring disease progression, other tests have been studied for their utility in glaucoma practice. This review discusses some of the commonly used tests of visual function that can be routinely used in clinics for glaucoma management. Among the various modalities of testing visual function in glaucoma, this review highlights the tests that are most clinically relevant.

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“…In combination with the topographic map of retinal functions enabled by the multifocal setting, multifocal Pattern ERG suggests a benefit in the assessment of glaucoma patients (Harrison et al, 2006;Stiefelmeyer, Neubauer, Berninger, Arden, & Rudolph, 2004). Reduced amplitudes are associated with visual field defects as well as nerve fiber layer thickness and can even be found before manifest glaucoma occurs (Bach, 2001;Bach & Hoffmann, 2008;Bach & Poloschek, 2013;Bach et al, 2006;Rao, Singh, Mukherjee, & Chowdhury, 2015). Various modifications of the mfERG stimulation such as fast flicker, low contrast, slow sequence, global flash, two flash, and luminance modulation have been developed in recent years in order to improve validity and effectiveness in the diagnosis of glaucoma (Chan, 2005;Chu, Chan, & Brown, 2006Chu et al, 2012;Kramer et al, 2013;Ledolter, Monhart, Schoetzau, Todorova, & Palmowski-Wolfe, 2015;Palmowski-Wolfe, Allgayer, Vernaleken, Schötzau, & Ruprecht, 2006;Palmowski-Wolfe, Todorova, Orguel, Flammer, & Brigell, 2007).…”

Section: Clinical Applicationmentioning

confidence: 99%

M-sequences in ophthalmic electrophysiology

Müller

Meigen

2016

Journal of Vision

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The aim of this review is to use the multimedia aspects of a purely digital online publication to explain and illustrate the highly capable technique of m-sequences in multifocal ophthalmic electrophysiology. M-sequences have been successfully applied in clinical routines during the past 20 years. However, the underlying mathematical rationale is often daunting. These mathematical properties of m-sequences allow one not only to separate the responses from different fields but also to analyze adaptational effects and impacts of former events. By explaining the history, the formation, and the different aspects of application, a better comprehension of the technique is intended. With this review we aim to clarify the opportunities of m-sequences in order to motivate scientists to use m-sequences in their future research.

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Comparing focal and global responses on multifocal electroretinogram with retinal nerve fibre layer thickness by spectral domain optical coherence tomography in glaucoma

Cited by 7 publications

References 20 publications

Therapeutic potential of valproic acid in advanced glaucoma: A pilot study

Therapeutic potential of valproic acid in advanced glaucoma: A pilot study

Visual function tests for glaucoma practice - What is relevant?

M-sequences in ophthalmic electrophysiology

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