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H. Philippin, A.S. Unsoeld, P. Maier, F. Staubach, H.S. Walter, J. Funk, M. Bach; Pattern ERG as Early Risk Indicator in Ocular Hypertension – A Long–Term Follow–Up Study . Invest. Ophthalmol. Vis. Sci. 2005;46(13):3757.
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Purpose: The conversion rate from untreated ocular hypertension (OHT) to glaucoma is only 1% a year. Identification of converters well before the development of glaucomatous visual field defects would help to limit preventive treatment to those who need it, and to avoid unnecessary side effects and expenditure in those who do not. We report on the results of a long–term follow–up study designed to assess the pattern electroretinogram (PERG) as an early indicator of glaucoma. Methods: 115 eyes of 60 consecutive patients with an intraocular pressure (IOP) of >23 mmHg plus specific additional risk factors or >25 mmHg, normal Octopus visual fields, no glaucomatous optic disc cupping, and a visual acuity >0.8 were included. Every 6 months during a median follow–up of 9.1 years the PERG and visual fields were obtained besides other standard diagnostics. PERGs were recorded in steady–state mode to checkerboard stimuli at 15 reversals/s, and the ratio of the amplitude at 0.8° over that at 16° checks was determined. Results: 11 eyes (1% a year) had developed glaucomatous visual field defects. ROC analysis of the PERG ratio yielded a specificity of 60% and a sensitivity of 70% (area 0.72) 2 years prior to development of visual field defects. Conclusions: The PERG can help to divide OHT patients into low and high risk for development of visual field defects. The PERG may thus help the clinician to decide which OHT patients should be treated and which can be observed.
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