Evaluation of retinal ganglion cell function after intraocular pressure reduction measured by pattern electroretinogram in patients with primary open-angle glaucoma

Abstract

Background To evaluate retinal ganglion cell (RGC) function after intraocular pressure (IOP) reduction measured by pattern electroretinogram (PERG) in patients with newly diagnosed, non-treated preperimetric and early stages of primary open-angle glaucoma (POAG).MethodsTwenty-four eyes from 24 patients with POAG: 11 eyes with preperimetric glaucoma and 13 eyes with early glaucoma received Ganfort ® (bimatoprost + timolol) once a day for a period of 1 month. Before and after the treatment, following measurements were analyzed: IOP, mean ocular perfusion pressure (MOPP), peak time of P50 and amplitude of P50 and N95 waves in PERG (ISCEV standard 2012). Correlations between PERG P50 and N95 waves, IOP and MOPP were calculated.ResultsAfter therapy, IOP significantly decreased in all eyes, on average 31%. Significant increase in MOPP in all eyes on average 14% was detected. PERG amplitude of P50 and N95 waves increased in 75 and 79% eyes, respectively, on average P50 by 28% and N95 by 38%. There were no significant interactions between the change of PERG parameters in time and stage of glaucoma.ConclusionsSignificant IOP-lowering therapy can improve RGC function measured by PERG, in patients with preperimetric and early stages of POAG.

XEN Gel Stent in the management of primary open-angle glaucoma

“…In an experimental study in an animal model, the IOP reduction of 38% was associated with the increase in PERG wave amplitudes by 83% [32]. It is worth noting that in the above-mentioned studies, a significant improvement of RGCs function in PERG was associated with a reduction in IOP by 31% [24], 30% [31] and 38% [32]. In our study, the average decrease in IOP was only 18%.…”

“…3 Scatterplots of delta IOP as a function of delta PERG P50 in all patients (n = 20). a 1 month after surgery, b 3 months after surgery, c 6 months after surgery, d 9 months after surgery, e 12 months after surgery amplitude and the P50 implicit time [22][23][24]. The N95 is considered the most specific for glaucoma, as it is generated exclusively by the retinal ganglion cells (RGCs), whereas the P50 is formed as a result of a joint contribution of RGCs (70%), cones and cone bipolar cells (30%) [25,26].…”

Short-Term Steady-State Pattern Electroretinography Changes Using a Multi-Pressure Dial in Ocular Hypertensive, Glaucoma Suspect, and Mild Open-Angle Glaucoma Patients: A Randomized, Controlled, Prospective, Pilot Study

“…These findings indicate that ss-pERG may have utility in screening for early stages of glaucomatous disease, and MPD may emerge as a novel approach to treating the functional changes observed in glaucomatous eyes before progression to RGC structural changes. The acute change in ss-pERG parameters following IOP reduction observed in this study is akin to what occurs in glaucomatous eyes in response to IOP-lowering drops [5,19] and surgery [21,22].…”

“…Prior studies evaluating ss-pERG show functional abnormalities in ocular hypertension (OHT), glaucoma suspect, and open angle glaucoma (OAG) patients prior to clinically evident structural RGC changes [5][6][7][8][9][10][11][12][13][14][15]. Clinical standards for ss-pERG yield reliable information [16][17][18] and are beneficial as an adjunct in stratifying risk/managing glaucoma suspects [11,19]. Additionally, intraocular pressure (IOP)-lowering medications [19,20] and surgery [21,22] in OAG patients with uncontrolled IOP have shown RGC function improvements in response to treatment, as measured by ss-pERG.…”

“…Clinical standards for ss-pERG yield reliable information [16][17][18] and are beneficial as an adjunct in stratifying risk/managing glaucoma suspects [11,19]. Additionally, intraocular pressure (IOP)-lowering medications [19,20] and surgery [21,22] in OAG patients with uncontrolled IOP have shown RGC function improvements in response to treatment, as measured by ss-pERG.…”