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Andrew Tirsi, Jaime Soria, Anna Djougarian, Jung Min Lee, Lukas A Schwartz, Sung Chul Park, Peter H Derr, Alberto Gonzalez Garcia, Celso Tello; Electrophysiological Evidence of Early Retinal Ganglion Cell Dysfunction in Preperimetric Glaucoma Using Diopsys NOVA PERG Device and its Associations with Visual Field and OCT Parameters. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5100.
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© ARVO (1962-2015); The Authors (2016-present)
To determine whether retinal ganglion cell (RGC) dysfunction is associated with early structural change in preperimetric glaucoma (PrG). This is a prospective, observational cross-sectional study to correlate Diopsys NOVA PERG parameters with Humphrey visual field (HVF) tests and Cirrus SD OCT measurements in this population.
This study was performed at Manhattan Eye, Ear and Throat Hospital and subjects with normal HVF 24-2 test and suspicious optic nerve head were enrolled. Steady State Pattern Electroretinogram (ss PERG) were performed using the Diopsys NOVA device (Diopsys©, Inc. Pine Brook, NJ) with outcome measurements MagnitudeD and MagD/Mag Ratio for the contrast sensitivity (CS) and concentric stimulus fields (CSF) protocols; which were correlated with visual field 24-2 and 10-2 Mean Deviation (MD) and with OCT macular and RGC parameters from Cirrus SD OCT© (Carl Zeiss Meditec). Descriptive statistics and Pearson correlation were measured when appropriate.
We analyzed ten patients (20 eyes) with age between 28 to 78 years, and six females (60% Females). All ss PERG parameters from CS and CSF protocols had a positive correlation with the VF 24-2 MD (r>0.45, p<0.044). Similarly, we found a positive correlation with VF 10-2 MD in all CS ss PERG parameters and with MagnitudeD CSF parameters (r>0.5 and p<0.047). The Average RNFL Thickness had a positive correlation with all ss PERG parameters (r>0.62, p<0.003) and RNFL superior and inferior quadrants had a positive correlation with all CS and CSF ss PERG parameters (r>0.45, p<0.05). Macular OCT Volume Cube and Thickness Avg. Cube had a positive correlation with all CSF ss PERG parameters and with MagD/Mag Ratio CS ss PERG (r>0.56, p<0.01). Ganglion Cell Average GCL+IPL Thickness had a positive correlation with all ss PERG parameters (r>0.62, p<0.003) while Minimun GCL+IPL Thickness had a positive correlation with MagnitudeD in CS and CSF ss PERG parameters (r>0.47, p<0.039).
Previous studies have demonstrated an association between RGC dysfunction with Diopsys NOVA PERG parameters in glaucoma patients, and to our knowledge this is the first study that has shown such associations in PrG patients. Our results suggest that RGC dysfunction with thin macular volume may be critical in diagnosis of PrG.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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