June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Pattern electroretinogram responses from the far-peripheral retina (ring and sector stimuli) in healthy eyes and in eyes with glaucoma
Author Affiliations & Notes
  • Shresta Patangay
    Bio-Engineering, University of Illinois at Chicago, Chicago, Illinois, United States
  • Jason C Park
    Ophthalmology & Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, United States
  • Elham Ghahari
    Ophthalmology & Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, United States
  • J Jason McAnany
    Ophthalmology & Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, United States
    Bio-Engineering, University of Illinois at Chicago, Chicago, Illinois, United States
  • Thasarat S Vajaranant
    Ophthalmology & Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, United States
  • John R Hetling
    Bio-Engineering, University of Illinois at Chicago, Chicago, Illinois, United States
    Ophthalmology & Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, United States
  • Footnotes
    Commercial Relationships   Shresta Patangay, None; Jason Park, None; Elham Ghahari, None; J Jason McAnany, None; Thasarat Vajaranant, None; John Hetling, None
  • Footnotes
    Support  UIC Chancellor's Innovation Fund
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 5875. doi:
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      Shresta Patangay, Jason C Park, Elham Ghahari, J Jason McAnany, Thasarat S Vajaranant, John R Hetling; Pattern electroretinogram responses from the far-peripheral retina (ring and sector stimuli) in healthy eyes and in eyes with glaucoma. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5875.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The pattern electroretinogram (pERG) response reflects, in part, ganglion cell function. Conventional pERG stimulates the central 20-30 degrees of visual field, however, early effects of glaucoma may occur outside of this region. Our hypothesis is that a test of ganglion cell function that probes the peripheral retina could prove more sensitive to the earliest stages of disease. Here a high-luminance pattern stimulus is presented to the far-peripheral retina (ppERG) and evaluated for relative efficacy in glaucoma compared to conventional pERG.

Methods : Seven normally-sighted subjects, four mid-stage patients (HVF mean deviation -3.7 to -7.0, at least one OCT sector outside normal limits), and one early-stage patient (HVF -2.2, one OCT sector borderline) were recruited. A hemispherical surface was used to present a reversing checkerboard pattern (10 degree checks, 4.6 reversals per second) to the peripheral retina, from approximately 20 degrees to the visual field limit in all directions (ring stimulus) or in three sectors that map to superior, nasal and inferior sectors at the optic nerve head. Pattern ON-luminance was approximately 15X the ISCEV-recommended minimum. Conventional pERG responses (ISCEV-recommended protocol) were recorded on the same day for comparison. Using amplitudes and implicit times of P and N waveform components, a cluster analysis was performed to evaluate sensitivity of each test.

Results : Sensitivity and specificity were 66.7% and 75.0%, respectively, for conventional pERG, and were both 100% for ppERG. The distance-from-healthy-mean measure used in the cluster analysis was nearly the same for normal and patient groups for the pERG test (mean +/- SD = 7.1+/-2.3 vs. 7.7+/-2.9), but provided strong separation for the ppERG test (6.7+/-1.9 vs. 27.2+/-11.0). Proof of concept for sector stimulation in healthy eyes was demonstrated.

Conclusions : High-luminance peripheral-field pattern stimulation shows promise as a test with high sensitivity to glaucoma, with possible advantage for early-stage disease. Sector stimulation may exploit the asymmetric damage associated with early glaucoma, and better correlate with retinal nerve fiber layer thickness measurements at the optic disk.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

 

Peripheral pattern ERG (ppERG) stimulus source. (A) Ring stimulus configuration. (B-C) Peripheral field sector stimuli that map to OCT sectors at the optic disk.

Peripheral pattern ERG (ppERG) stimulus source. (A) Ring stimulus configuration. (B-C) Peripheral field sector stimuli that map to OCT sectors at the optic disk.

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