Purpose
Previous studies have shown that the onset of high-contrast, fast reversing patterned stimuli induces rapid blood flow increase in retinal vessels in association with slow changes of the steady-state PERG signal. We tested the hypothesis that adaptive PERG changes of normal controls (NC) differed from those of glaucoma suspects (GS) and patients with early manifest glaucoma (EMG).
Methods
Subjects were 42 GS (SAP MD −0.89 ±1.8 dB), 22 EMG (MD −2.12 ±2.4 dB) with visual acuity of ≥20/20 and 16 age-matched NC from a previous study. The PERG signal was sampled every ~15 s over 4 minutes in response to gratings (1.6 cyc/deg, 100% contrast) reversing 16.28 times/s. Amplitude/phase values of successive PERG samples were fitted with a non-parametric LOWESS smoothing function to retrieve the initial and final values and calculate their difference (delta) and the residual standard deviation around the fitted function (SDr). The magnitude of PERG adaptive change compared to random variability was calculated as log10 of percentage coefficient of variation CoV=100*SDr ÷ |delta|. Grand-average PERGs were also obtained by averaging all samples of the same series.
Results
The grand-average PERG amplitude (ANOVA, p=0.02), but not phase (ANOVA, p=0.63), decreased with increasing severity of disease. Adaptive changes (log10 (CoV) of PERG amplitude were not significantly associated with disease severity (ANOVA, p=0.27), but adaptive changes (log10 (CoV) of PERG phase were (ANOVA, p=0.037; linear trend, p=0.011).
Conclusions
The steady-state PERG signal displayed slow adaptive changes over time that could be isolated from random variability. PERG adaptive changes differed from those of grand-average PERGs (corresponding the standard steady-state PERG), thus representing a new source of biological information about retinal ganglion cell function that may have potential in the study of glaucoma and optic nerve diseases.