June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Photopic negative response in idiopathic intracranial hypertension recorded using a handheld device
Author Affiliations & Notes
  • Antony Raharja
    Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
    Institute of Ophthalmology, University College London, London, United Kingdom
  • Shaun Leo
    Institute of Ophthalmology, University College London, London, United Kingdom
    Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
  • Isabelle Chow
    Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
    Section of Ophthalmology, King's College London, London, United Kingdom
  • Mathura Indusegaran
    Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
    Section of Ophthalmology, King's College London, London, United Kingdom
  • Christopher J Hammond
    Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
    Section of Ophthalmology, King's College London, London, United Kingdom
  • Omar A Mahroo
    Institute of Ophthalmology, University College London, London, United Kingdom
    Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
  • Sui H Wong
    Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
    Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
  • Footnotes
    Commercial Relationships   Antony Raharja, None; Shaun Leo, None; Isabelle Chow, None; Mathura Indusegaran, None; Christopher Hammond, None; Omar A Mahroo, None; Sui H Wong, None
  • Footnotes
    Support  Wellcome Trust (206619_Z_17_Z), Fight for Sight UK, Thomas Pocklington Trust
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 609. doi:
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      Antony Raharja, Shaun Leo, Isabelle Chow, Mathura Indusegaran, Christopher J Hammond, Omar A Mahroo, Sui H Wong; Photopic negative response in idiopathic intracranial hypertension recorded using a handheld device. Invest. Ophthalmol. Vis. Sci. 2021;62(8):609.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The photopic negative response (PhNR) is a late component of the light-adapted electroretinogram (ERG), and derives from retinal ganglion cells. We recorded PhNRs from idiopathic intracranial hypertension (IIH) patients and explored associations with severity.

Methods : ERGs were recorded, following mydriasis and exposure to room light, using conductive fibre electrodes with a portable device (RETeval, LKC technologies, MD USA). Red flashes (1.0 cd.s/m2) were delivered, at 3.4 Hz, on a 10 cd.s/m2 blue background (averages from 400 flash presentations). The device software gave PhNR amplitudes (at 72 ms or as a ratio to b-wave). ERGs were assessed for drift, noise and reproducibility. The eye with a better quality trace was chosen for PhNR analysis; if both were equally good, the eye with poorer visual field function was chosen. IIH severity was determined using optical coherence tomography-derived retinal nerve fibre layer (RNFL) thickness and Modified Frisen scale (MFS): mild (MFS1-2), severe (MFS≥3, RNFL thickness>150, or atrophic) or in remission (resolved with no atrophy). Patients without papilloedema deemed not to have IIH or any other eye conditions act as controls. P72 and p-ratio were compared in the four groups (Kruskal-Wallis), with each group also compared to control (Mann-Whitney).

Results : Of 99 patients, 86 (7 control, 79 IIH) were included; 13 were excluded (9 poor quality ERG, 4 alternative diagnosis). 91% of IIH patients were female; median (IQR) age was 33 (27-39), BMI 34.8 (30.4-40.0). 86% of controls were female; median (IQR) age was 52 (31-64), BMI 34.5 (32.3-42.2). P72 and p-ratio differed significantly across groups with a trend towards smaller PhNR amplitudes in more severe IIH, p=0.0417 and p=0.0389 respectively. Largest differences were observed between severe IIH and controls (median P72: -3.4 vs. -7.1, p=0.0096, and median p-ratio: 0.12 vs. 0.23, p=0.0073). Comparing severe and mild IIH groups, p-ratio differed significantly (0.12 vs. 0.17, p=0.014), but not P72 (-3.4 vs. -6.0, p=0.064). Patients in remission and controls exhibited non-significant differences (median P72: -5.0 vs. -7.1, p=0.19, and median p-ratio: 0.18 vs. 0.23, p=0.48).

Conclusions : We found associations between PhNR parameters and disease severity in a large IIH cohort. The PhNR could potentially provide additional assessment of disease severity in these patients.

This is a 2021 ARVO Annual Meeting abstract.

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