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Olga A. Shif, Vittorio Porciatti, William J. Feuer, Lori M. Ventura; Progression of Retinal Ganglion Cell Dysfunction is Hindered with IOP-lowering Treatment in Early Normal Tension Glaucoma. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4172.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate progressive changes of retinal ganglion cell (RGC) function in early normal tension glaucoma (NTG) before and after IOP lowering treatment.
Fifteen NTG glaucoma suspects with mean age 54.9 ±11.8 years (28 eyes) and corrected visual acuity ≥20/20, were followed longitudinally over 6.44 ± 1.07 years, receiving 14.2 ± 2.9 measurements of IOP, Pattern Electroretinogram (PERG) and SAP. After an untreated period, patients received topical treatment for glaucoma based on standard clinical considerations. Rates of PERG/SAP change with time (slopes) for both the untreated and treated conditions were calculated for each eye using bi-linear regression analyses with the time of 1st treated visit as a known break point. IOP measurements were averaged over untreated and treated periods.
Medians of untreated and treated measurements were significantly (P<0.001) different for IOP (15.5 mm Hg vs. 14.1 mm Hg) and PERG amplitude slope (-8.4 % /year vs. 0.14% /year), but not for SAP-MD slope (-0.08 dB/year vs. -0.02 dB/year, P = 0.85). In 27 out of 28 eyes, PERG amplitude slopes became less negative after treatment. Eight eyes out of 28 tested (28%) had significant slope improvement after treatment (P<0.001, n=6; P<0.05, n=2). Correlation analysis showed that the steeper the progressive decline of PERG signal before treatment, the larger the magnitude of recovery after treatment (Pearson’s R = -0.83, P<0.001).
The results indicate that the PERG may detect progressive RGC dysfunction in early untreated NTG, as well as its potential reversibility after IOP lowering.
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