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Abstract #78353 Published in IGR 20-1
Pattern Electroretinogram Detects Localized Glaucoma Defects
Salgarello T; Giudiceandrea A; Calandriello L; Marangoni D; Colotto A; Caporossi A; Falsini BTranslational vision science & technology 2018; 7: 6
PURPOSE: We evaluated the clinical ability of pattern electroretinogram (PERG) to detect functional losses in the affected hemifield of open-angle glaucoma patients with localized perimetric defects. METHODS: Hemifield (horizontally-defined) steady-state PERGs (h-PERGs) were recorded in response to 1.7 c/deg alternating gratings from 32 eyes of 29 glaucomatous patients with a perimetric, focal one-hemifield defect, 10 eyes of 10 glaucomatous patients with a diffuse perimetric defect, and 18 eyes of 18 age-matched normal subjects. Standard automated perimetry (SAP) and spectral-domain optical coherence tomography (SD-OCT) for retinal nerve fiber layer (RNFL) thickness also were performed. h-PERG amplitudes and ratios, calculated corresponding hemifield perimetric deviations, as well as hemiretina RNFL thicknesses were analyzed. RESULTS: h-PERG amplitudes, perimetric deviations, and RNFL thicknesses showed losses ( < 0.001) when comparing affected with unaffected hemifields of localized glaucomatous eyes. No differences were found in h-PERG amplitudes between hemifields of normal or diffuse glaucomatous eyes. h-PERG amplitude ratios (affected/unaffected hemifield) in localized glaucoma were lower ( < 0.001) than the ratios from normal or diffuse glaucomatous eyes. The areas under the receiver operating characteristic curves for h-PERG amplitude ratios, comparing localized-defect glaucomatous eyes with normal or diffuse glaucomatous eyes, were 0.93 and 0.91, respectively. CONCLUSIONS: h-PERG assessment showed good diagnostic accuracy to confirm localized glaucomatous defects detected perimetrically. This test may be particularly useful in cognitively impaired patients or young/nonverbal patients unable to provide reliable visual fields. TRANSLATIONAL RELEVANCE: h-PERG provides a sensitive objective measure to confirm focal losses detected with SAP and/or RNFL thickness analysis.
1Institute of Ophthalmology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.
Full articleClassification:
6.7 Electro-ophthalmodiagnosis (Part of: 6 Clinical examination methods)
