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K. Kishor, M. Pinzon-Plazas, M. Sehi, D. S. Greenfield; Repeatability of Steady-State Pattern Electroretinogram in Normals, Glaucoma Suspects, and Glaucomatous Eyes. Invest. Ophthalmol. Vis. Sci. 2007;48(13):222.
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To examine the test-retest reproducibility of steady-state pattern electroretinogram (PERG) in a cross-sectional population.
Normal, glaucoma suspect, and glaucomatous eyes underwent complete ocular examination, standard automated perimetry, and PERG examination. Glaucoma was defined as cup/disc asymmetry between fellow eyes of greater than 0.2, rim thinning, notching, excavation, or RNFL defect associated with a reproducible SAP abnormality, and was staged according to the SAP mean deviation (MD) using the following criteria: early (MD > -6DB), moderate (MD -6 to -12dB) and advanced (MD < -12 dB). One randomly selected eye underwent PERG testing three times on a single day by the same operator. Outcome measures included PERG amplitude and phase. PERG measures represented an average of 600 artifact-free signal registrations. Coefficients of repeatability (CoR), coefficients of variability (CoV), and intraclass correlation coefficients (ICC) were calculated for each subject.
Seventy two eyes of 72 patients (33 normals, 21 suspects, 18 glaucoma) were enrolled (mean age 58.5±15.1). All eyes with glaucoma had associated SAP abnormalities (average MD = -6.4±5.4). The mean PERG amplitude (microvolts) in normals (0.90±0.32) was significantly (p<0.001) higher than suspects (0.57±0.23) and glaucomatous eyes (0.47±0.18). Mean PERG phase (pi-radian) were similar (p=0.6) amongst the groups (1.8±0.15 normal, 1.7±0.16 suspects, 1.8±0.16 glaucoma). In normal, suspect, and glaucomatous eyes respectively, the CoR of PERG amplitude was 0.1±0.2, 0.1±0.1, and 0.1±0.1; CoV in percentage was 11.3±8.8, 11.5±10.1, and 15.3±12.0, and ICC was 0.95, 0.97, and 0.96. The ICC of intra-session reproducibility for PERG amplitude was 0.96, 0.98, and 0.94 in patients with early, moderate, and advanced glaucoma respectively.
PERG provides a high level of reproducibility in normals, glaucoma suspects, and glaucomatous eyes and is unaffected by the severity of glaucomatous damage.
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