The role of pattern-reversal electroretinography in the diagnosis of glaucoma

Introduction: Tuberculosis (TB) is a world health problem, especially in Indonesia as the third biggest country for new emerging TB patients. Ethambutol is one of the standard therapies to treat TB patients in Indonesia. Ethambutol has a side effect called ethambutol optic neuropathy which is hard to diagnose due to normal fundus appearance in most cases and therefore often detected late. Early detection is necessary so that permanent damage can be prevented. Examination pattern electroretinography (pERG) and multifocal electroretinography (mfERG) have the advantage to detect and confirm ocular toxicity by ethambutol after the clinical problem had emerged. It is not yet known neither pERG nor mfERG could detect any changes to detect ethambutol ocular toxicity before the clinical problem emerged. Methods: This study was a prospective clinical trial with 40 eyes samples and analyzed with paired t and Wilcoxon tests. The ocular examination was conducted using the Snellen chart, HRR Richmond Plates, Pelli Robson, pERG, and mfERG in tuberculosis category 1 patient with 2 months follow-up. Result: Visual acuity, color, and contrast sensitivity were normal in all patients for 2 months follow-up period. In pERG examination, the mean implicit time wave P50 was shortened by -1.27± 4.71 mS (p=0.049), and the mean amplitude wave N95 was reduced by -0.93± 4.49 ?V (p=0.038). Both were statistically significant. In the mfERG examination, we did not find any statistically significant changes in both wave N1 and P1. Conclusion: Changes in pattern ERG presented earlier compared to mfERG after ethambutol therapy for 2 months.

show abstract

“…Pattern ERG had earlier changes compared to mfERG. 4,[19][20][21][22][23][24][25][26][27][28][29][30]…”

Section: Discussionmentioning

confidence: 99%

Changes in Pattern and Multifocal Electroretinogram in Tuberculosis Patient with Ethambutol Therapy

Nusanti¹,

Prakoso

Sidik

et al. 2022

View full text Add to dashboard Cite

show abstract

“…9,10 The typical abnormalities to the optic disc, the thinning of the retinal ganglion cell and nerve fiber layers, and the typical visual field deficits all point to the diagnosis of glaucoma. 11 Diagnosis of glaucoma at the early stages is relatively challenging due to the disparity between the start of structural and functional impairment. 12 It has been demonstrated that structural alterations in the retinal layers precede visual field abnormalities, which are caused by retinal ganglion cell (RGC) redundancy.…”

Section: Introductionmentioning

confidence: 99%

“…12 It has been demonstrated that structural alterations in the retinal layers precede visual field abnormalities, which are caused by retinal ganglion cell (RGC) redundancy. [10][11][12][13] It is challenging to match axonal thinning with functional damage since the perimetric decibel scale and structural linear scale are different. [13][14][15][16] In recent years, many researchers have attempted to directly investigate RGC function utilizing electrophysiological investigations.…”

Section: Introductionmentioning

confidence: 99%

Primary Open Angle Glaucoma Diagnosis Using Pattern Electroretinogram Parameters

Alhagaa,

Mahmoud Badawi,

Abd Allah El-Morsy

2023

OPTH

View full text Add to dashboard Cite

Background Glaucoma is the most typical cause of permanent blindness. POAG, or primary open angle glaucoma, is the most common type. The pattern electroretinogram (PERG) has become a promising technique for detecting glaucoma early-on. The goal of this study was to assess the ability of PERG to diagnose POAG, especially in early, difficult-to-diagnose cases in comparison with other already established diagnostic methods. Methods 150 participants (300 eyes) were enrolled in a cross-sectional study at ophthalmology department at Menoufia University Hospital in August 2022 to February 2023. All recruited participants underwent comprehensive ophthalmological and PERG exams. The studied eyes were divided into three groups as 100 normal eyes (Group I), 100 eyes with preperimetric glaucoma (Group II), and 100 eyes with established perimetric glaucoma (Group III). Results OCT-RNFL average thickness had a significant positive correlation with P50 latency (r=0.289, p=0.041) or P50 amplitude (r=0.302, p=0.018) and N95 amplitude (r=0.640, p=0.001) among group (II). Also, RNFL thickness had negative correlation with P50 amplitude (r= −0.268, p=0.043) among group (III). RNFL thickness and P50 and N95 amplitude showed highest AUC values in detecting preperimetric glaucomatous eyes vs normal eyes (AUC=0.927, 0.952, 904), and for detecting established perimetric glaucomatous eyes vs normal eyes (AUC=1.00, 0.957, 0.983 respectively) compared with VF MD which showed AUC (0.458 and 0.901 respectively). Conclusion Glaucoma patients exhibit PERG alterations (comparable to RNFL thickness changes) so, it could be used as an accurate diagnostic method in POAG. Because PERG alterations occur before visual field abnormalities, it could be relied on as an early diagnostic tool in preperimetric glaucoma. We can use both RNFL thickness assessment by OCT with PERG parameters as complementary tests for accurate diagnosis of preperimetric glaucoma which represents the most difficult diagnostic challenge in glaucoma diagnosis.

show abstract

“…Over the past few years patients with early -stage glaucoma have been evaluated for abnormalities using electrophysiological tests, including different form of electroretinography (ERG) and visual evoked potential (VEP). (4) Pattern reversal visual evoked potential provides an objective and sensitive readout of the function of retinal ganglion cells (RGCs), and the latency of P100 can be used as a measure of early glaucomatous damage before RGCs death. (9) .…”

Section: Introductionmentioning

confidence: 99%

“…(3) Anatomical studies have documented that visual field defects usually develop only after the loss of 30% -50% of ganglion cells. (4) Optical coherence tomography (OCT) is a noninvasive technique that allows cross -sectional imaging of the retina and quantifies the thickness of the retinal nerve fiber layer (RNFL) around the optic nerve head. The degree of RNFL thickness reduction has been shown to correlate with visual field defects (5) .…”

Section: Introductionmentioning

confidence: 99%

Comparative evaluation of Optical Coherence Tomography (OCT) with Pattern Reversal Visual Evoked Potential (PRVEP) in early primary open angle glaucoma

Taksande¹,

Rawekar²,

Sune³

2017

IJB

View full text Add to dashboard Cite

Present study is to correlate the average retinal nerve fiber layer (RNFL) thickness and the visual function evaluated by electrophysiologic retinal and cortical responses assessed in primary open-angle glaucoma (POAG) eyes by a Case-control study. One hundred and sixty-one control and glaucoma patients (mean age, 55.18±5.19 years for study group and 54.45±4.81 years for control group) were selected in the study. Average Retinal Nerve fiber layer thickness was measured by optical coherence tomography. Retinal and visual pathway function was assessed by simultaneously recording pattern reversal visual evoked potentials (PRVEPs) Linear regression analyses were adopted to establish the correlation between average RNFL thickness and PRVEP parameters. Average Retinal Nerve fiber layer thickness were taken. PRVEP, P100 latency and N75-P100 amplitude were also measured. In POAG eyes, we found a significant (P< 0.01) reduction in average RNFL thickness with respect to the values observed in control eyes. PRVEP parameters showed a significant (p< 0.01) delay in p100 latency and reduced N75 p100 amplitude. Positive correlations between average RNFL values and PRVEP parameters were found. There is a positive correlation between PRVEP changes and average RNFL thickness, in POAG patients.

show abstract

The role of pattern-reversal electroretinography in the diagnosis of glaucoma

Cited by 8 publications

References 78 publications

Changes in Pattern and Multifocal Electroretinogram in Tuberculosis Patient with Ethambutol Therapy

Changes in Pattern and Multifocal Electroretinogram in Tuberculosis Patient with Ethambutol Therapy

Primary Open Angle Glaucoma Diagnosis Using Pattern Electroretinogram Parameters

Comparative evaluation of Optical Coherence Tomography (OCT) with Pattern Reversal Visual Evoked Potential (PRVEP) in early primary open angle glaucoma

Contact Info

Product

Resources

About