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G. Anselmi, D. Marangoni, M. Gari, P. Brusini, A. Colotto, T. Salgarello, A. Giudiceandrea, E. Balestrazzi, B. Falsini; Relationship of Steady-State Pattern Electroretinogram With Standard Automated Perimetry in Glaucoma: Diffuse and Localised Visual Field Defects. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5299.
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To evaluate the relationship of steady-state pattern electroretinogram (SS-PERG) with both diffuse and localized sensitivity losses at standard automated perimetry (SAP) in open angle glaucoma (OAG).
SS-PERGs were recorded according to a standard protocol1 from both eyes of 86 OAG patients (mean age 59± SD 14.4). Ninety-two ocular hypertension (OHT) patients (mean age 58±13.6), and 24 age-matched control subjects were also tested. SAPs were assessed with the Humphrey 30-2 protocol. Perimetric results were classified according to the Glaucoma Staging System 22 (GSS 2) which takes into account both extent and severity of defects, allowing classification of diffuse versus localized losses. In a subgroup of 18 OAG and 10 control eyes SS-PERGs were recorded from superior and inferior retinal hemifields (RHF) to assess correlation between PERG and localised perimetric losses, confined to one of the two RHFs.
SS-PERG amplitude losses were found, on average, in both OHT and OAG compared to control eyes. Losses were greater in OAG compared to OHT eyes. SS-PERG amplitude was correlated (Rsq = 0.193, p < 0.01) with SAP mean deviation. The relationship was best described by a power function predicting a 0.03 log units/dB amplitude loss. SS-PERG amplitude was correlated with GSS, with 87% and 100% rates of abnormalities in stages I/II and III/V, respectively. SS-PERGs were always abnormal in the affected RHFs and normal in the unaffected ones. Superior/inferior RHF amplitude ratio was highly sensitive (100%) in detecting localized defects .
The SS-PERG is highly correlated with SAP, and is sensitive for detecting early visual field loss in OAG. RHF analysis paradigm is specific for localized losses and could be an useful complement to the current PERG protocols for glaucoma diagnosis.31Falsini et al. Graefe's Arch Clin Exp Ophthalmol 2008.2Brusini and Filacorda J. Glaucoma, 2006.3Porciatti and Ventura, Ophthalmology, 2004.
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