Role of Pattern Electroretinogram in Ocular Hypertension and Early Glaucoma

Turkey, Eman; Elsanabary, Zeinab; Elshazly, Laila Hassan M.; Osman, Moataz Hamed

doi:10.1097/ijg.0000000000001325

Cited by 13 publications

(10 citation statements)

References 37 publications

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“…Previous reports have shown latency delay and/or a reduced amplitude of the P50 and N95 peak in glaucoma. 21,22 The latencies of the peaks did not differ between progressors and nonprogressors in the present study. The N95 amplitude is presumably related to the RGC action potential, with changes clearly evident at the N95 peak.…”

Section: Discussioncontrasting

confidence: 61%

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Predicting Visual Field Progression by Optical Coherence Tomography Angiography and Pattern Electroretinography in Glaucoma

Lee

Kim

Jung

et al. 2022

Journal of Glaucoma

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Précis: Reduced P50-N95 amplitude on pattern electroretinography (PERG) and the presence of microvasculature dropout (MvD) on optical coherence tomography angiography (OCT-A) at baseline were significant factors associated with visual field (VF) progression in predominantly normal tension glaucoma (NTG) patients. Objective: We investigated the baseline demographics and ocular characteristics that predict future progression in glaucoma patients, including PERG and OCT-A parameters. Methods: One Hundred forty eyes with open angle glaucoma that were prospectively enrolled and followed up for at least 3 years, and underwent at least 5 serial VF tests were included. Baseline PERG was performed, and N35, P50, and N95 latencies and amplitudes were obtained. Superficial vessel density at the macula and complete loss of microvasculature within the deep retinal layer of the parapapillary region (MvD) were evaluated from baseline OCT-A images. Eyes with a glaucomatous VF defect in either both hemifields within 24 points of a central 10 degrees of fixation, and with no VF abnormality in the nasal periphery outside 10 degrees of fixation, were considered to have isolated central scotoma. During follow-up, detected disc hemorrhage (DH) was recorded. Parameters associated with VF progression were determined using linear regression analysis of the mean deviation (MD) values, in combination with an event-based analysis using the Glaucoma Progression Analysis (GPA) software from the Humphrey Field Analyzer. “Likely progression” using GPA was considered to have glaucoma progression. Results: Of the 140 eyes, 107 (76.4%) were NTG and 57 (40.7%) exhibited glaucoma progression as defined by Humphrey VF GPA. The MD slopes were −0.43±1.11 dB/y in the progressors and 0.59±1.27 dB/y in the nonprogressors (P<0.001). Glaucoma patients with progression showed frequent MvD on OCT-A, isolated central scotoma, frequent DH, and reduced baseline P50-N95 amplitude compared with patients without progression. Age at diagnosis (P=0.038) and baseline P50-N95 amplitude (P=0.019) showed significant associations with the MD slope. The presence of MvD on OCT-A (P<0.001) and baseline P50-N95 amplitude (P=0.037) were significantly associated with VF progression on GPA. Conclusions: The presence of MvD and retinal ganglion cell dysfunction by PERG at baseline, DH or central scotoma were significant factors associated with VF progression in predominantly NTG patients. These patients should be monitored more closely.

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Section: Discussioncontrasting

confidence: 61%

“…Among PERG parameters, the P50-N95 amplitude was significantly associated with progression in the present study. Previous reports have shown latency delay and/or a reduced amplitude of the P50 and N95 peak in glaucoma 21,22. The latencies of the peaks did not differ between progressors and nonprogressors in the present study.…”

Section: Discussioncontrasting

confidence: 55%

Predicting Visual Field Progression by Optical Coherence Tomography Angiography and Pattern Electroretinography in Glaucoma

Lee

Kim

Jung

et al. 2022

Journal of Glaucoma

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“…Ophthalmic examination of the POAG/ PCG afflicted patient, including optical coherence tomography (OCT) (Quigley et al, 1989) and visual field tests (Harwerth and Quigley, 2006;Sasaoka et al, 2008;Sponsel et al, 2014), reveal that significant damage has occurred at the ONH (Burgoyne et al, 2005) causing increased optic disc cupping (Downs et al, 2011), that the retinal nerve fiber layer (RNFL) has thinned (due to RGC axon loss) (Harwerth and Quigley, 2006;Soto et al, 2011;Yu et al, 2015;Tu et al, 2019); and scotomas (dead zones) developed in the visual field (Harwerth and Quigley, 2006;Sasaoka et al, 2008;Sponsel et al, 2014). The level of IOP increase is well correlated with optic nerve damage (Chauhan and Drance, 1992;Guo et al, 2005;Yohannan and Boland, 2017;Torres and Hatanaka, 2019) and decrease in retinal function (Parisi, 2003;Kasi et al, 2019;Torres and Hatanaka, 2019;Turkey et al, 2019). The patient's vision loss begins to accelerate and immediate treatment is required to retard further visual impairment (Karaca et al, 2020).…”

Section: Ocular Hypertension/primary Open-angle Glaucoma and Factors Involved In Retinal/optic Nerve Damagementioning

confidence: 99%

Therapeutic Drugs and Devices for Tackling Ocular Hypertension and Glaucoma, and Need for Neuroprotection and Cytoprotective Therapies

Sharif

2021

Front. Pharmacol.

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Damage to the optic nerve and the death of associated retinal ganglion cells (RGCs) by elevated intraocular pressure (IOP), also known as glaucoma, is responsible for visual impairment and blindness in millions of people worldwide. The ocular hypertension (OHT) and the deleterious mechanical forces it exerts at the back of the eye, at the level of the optic nerve head/optic disc and lamina cribosa, is the only modifiable risk factor associated with glaucoma that can be treated. The elevated IOP occurs due to the inability of accumulated aqueous humor (AQH) to egress from the anterior chamber of the eye due to occlusion of the major outflow pathway, the trabecular meshwork (TM) and Schlemm’s canal (SC). Several different classes of pharmaceutical agents, surgical techniques and implantable devices have been developed to lower and control IOP. First-line drugs to promote AQH outflow via the uveoscleral outflow pathway include FP-receptor prostaglandin (PG) agonists (e.g., latanoprost, travoprost and tafluprost) and a novel non-PG EP2-receptor agonist (omidenepag isopropyl, Eybelis®). TM/SC outflow enhancing drugs are also effective ocular hypotensive agents (e.g., rho kinase inhibitors like ripasudil and netarsudil; and latanoprostene bunod, a conjugate of a nitric oxide donor and latanoprost). One of the most effective anterior chamber AQH microshunt devices is the Preserflo® microshunt which can lower IOP down to 10–13 mmHg. Other IOP-lowering drugs and devices on the horizon will be also discussed. Additionally, since elevated IOP is only one of many risk factors for development of glaucomatous optic neuropathy, a treatise of the role of inflammatory neurodegeneration of the optic nerve and retinal ganglion cells and appropriate neuroprotective strategies to mitigate this disease will also be reviewed and discussed.

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“…The evoked response is constituted by a small negative wave preceding a broad positive wave followed by a broad negative component, these peaks are labelled by a letter indicating the polarity of the peak and a number indicating the peak culmination time (N35, P50, N95). In this study, we considered the N35 -P50 and P50 -N95 peak-topeak amplitude, as this is the component that undergoes the greatest changes in early-stage glaucoma [18][19][20].…”

Section: Inclusionmentioning

confidence: 99%

Neuroprotection in Primary Open-Angle Glaucoma: The Role of a Fixed Citicoline-Homotaurine-Vitamin E Combination

Cornelio¹,

Crisigiovanni²,

Limardo³

et al. 2021

IJOVS

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Glaucomatous optic neuropathy is a chronic degenerative neuropathy characterized by progressive damage of the retinal ganglion cells despite good compensation of intraocular pressure. The purpose of this study was to assess the effect of oral administration of a fixed combination of citicoline 500 mg + homotaurine 50 mg + vitamin E 12 mg (CIT/HOMO) on retinal ganglion cell function as examined by pattern electroretinogram (PERG) in subjects with primary open-angle glaucoma. A prospective, randomized, single-blind, balanced, crossover study was performed on a population of 40 patients with POAG-HT and fully-compensated IOP with topical hypotensive therapy. Recruited patients were allocated by balancing randomization to two treatment groups: -group A: patients continued current hypotensive eye-drop for 4 months and subsequently took 1 tablet of CIT/HOMO each morning for 4 months; -group B: patients took 1 tablet of CIT/HOMO each morning for 4 months in addition to current hypotensive eye-drop and subsequently continued with current hypotensive eye-drop alone for 4 months. Patients were examined at baseline (T0), after 4 (T1) and 8 months (T2). At every single time was performed a whole eye examination, 3 IOP measurements, 30.2 SITA Standard Humphrey visual field test, OCT cup/disc ratio and PERG glaucoma Hemifield test with central amplitude analysis. 38 patients completed the study for a total of 76 eyes. In both groups of patients tonometry, cup/disc ratio and visual field did not reveal any statistically significant difference. In both groups, adding the CIT/HOMO at hypotensive eye-drop resulted in an improvement in PERG after 4 months of therapy that disappeared when CIT/HOMO was withdrawn. Four months supplementation with a fixed combination of citicoline, homotaurine and vitamin E was seen to significantly increase the amplitude of the PERG bioelectric potential transmitted by the optical pathway to the visual cortex in subjects with primary open-angle glaucoma with compensated IOP and initial damage of the visual field and optic disc. During this study, the IOP remained compensated with the current hypotensive therapy and no deterioration was observed in the visual field or the cup/disc ratio.

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Role of Pattern Electroretinogram in Ocular Hypertension and Early Glaucoma

Cited by 13 publications

References 37 publications

Predicting Visual Field Progression by Optical Coherence Tomography Angiography and Pattern Electroretinography in Glaucoma

Predicting Visual Field Progression by Optical Coherence Tomography Angiography and Pattern Electroretinography in Glaucoma

Therapeutic Drugs and Devices for Tackling Ocular Hypertension and Glaucoma, and Need for Neuroprotection and Cytoprotective Therapies

Neuroprotection in Primary Open-Angle Glaucoma: The Role of a Fixed Citicoline-Homotaurine-Vitamin E Combination

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