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Annahita Amireskandari, Dimosthenis Mantopoulos, Frederick M Kapetansky, Mark A Slabaugh; Comparison of pattern ERG to structural and functional change in subjects with suspected glaucoma. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3944.
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© ARVO (1962-2015); The Authors (2016-present)
Detecting early progression remains a key clinical difficulty in the management of patients with suspected glaucoma. Current common techniques used in detection include structural tests such as optical coherence tomography (OCT) or Heidelberg retinal tomography (HRT) and functional tests such as visual fields. The pattern electroretinogram (PERG) is thought to work by selectively stimulating the inner retina and specifically the retinal ganglion cells to detect early cellular dysfunction that precedes even structural change. We aim to compare baseline PERG data in patients followed longitudinally with other standard testing strategies to see if differences in baseline testing could predict structural or functional change over time in a clinical setting.
A retrospective chart review of patients seen in an outpatient glaucoma clinic was performed. Patients were identified who had undergone a baseline PERG and then charts were reviewed to determine whether patients had gone on to progress by visual field (functional change) or HRT or OCT (structural change). Statistical analysis was performed using SPSS.
54 eyes of 29 patients were identified in whom baseline PERG was performed and complete follow up including functional and structural testing was available. 21 eyes of 12 patients progressed by functional testing and 20 eyes of 12 patients progressed by structural testing. In eyes progressing by functional testing, PERG amplitude was 0.3076 +/- 0.1733 microvolts versus 0.5152 +/- 0.1978 microvolts in those not progressing (p<0.005). In eyes progressing by structural testing, PERG amplitude was 0.2650 +/- 0.1345 microvolts versus 0.5341 +/- 0.1867 microvolts in those not progressing (p<0.005).
PERG appears to be effective at detecting patients who will go on to develop worsening glaucoma damage by more traditional structural or functional methods. Use of this technique in a clinical setting can provide valuable insight into which patients require closer monitoring and earlier treatment. More research is needed to delineate the role of PERG with other testing methods in a clinical setting.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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