Objective: To assess the presence of normal or abnormal pattern electroretinogram (PERG) and visual evoked potential (VEP)-responses in patients with ocular hypertension or open-angle glaucoma (OAG). Design: Retrospec...Objective: To assess the presence of normal or abnormal pattern electroretinogram (PERG) and visual evoked potential (VEP)-responses in patients with ocular hypertension or open-angle glaucoma (OAG). Design: Retrospective,cross-sectional,case-control study. Participants: Eighty normal control subjects (mean age,51.77± 6.04 years; 80 eyes),68 ocular hypertension patients (mean age,51.58± 7.12; 68 eyes; intraocular pressure IOP < 18 mmHg under pharmacological treatment; Humphrey field analysis HFA 24/2 mean deviation MD >-2 decibels dB),and 84 OAG patients (mean age,52.77± 5.28; 84 eyes; IOP < 18 mmHg under pharmacological treatment; HFA24/2mean deviation between-2 and-23 dB)were enrolled. Methods: Simultaneous recording of PERGs and VEPs using high-contrast (80% ) 15 checkerboard stimuli reversed at the rate of 2 reversals per second. Main Outcome Measures: Pattern electroretinogram P50 and VEP P100 implicit times were considered delayed when exceeding the limit of mean values of controls plus 2 standard deviations (SDs). Pattern electroretinogram P50 to N95 and VEP N75 to P100 amplitudes were considered reduced when exceeding the limit of mean values of controls minus 2 SDs. Results: Pattern electroretinogram: P50 implicit times were delayed in 58 of 68 (85.30% ) ocular hypertension eyes and 83 of 84 (98.80% )OAG eyes; P50 toN95 amplitudes were reduced in 47 (69.12% ) ocular hypertension eyes and 84 (100% ) OAG eyes. Visual evoked potential: P100 implicit times were delayed in 58 (85.30% ) ocular hypertension eyes and 84 (100% ) OAG eyes; reduced N75 to P100 amplitudes were observed in 39 (57.35% ) ocular hypertension eyes and 73 (86.90% ) OAG eyes. Ocular hypertension eyes showed no significant correlations (Pearson test,P>0.01) between electrophysiological parameters and age,IOP before or under medical treatment,HFA,and corneal thickness values. Significant correlations (P<0.01) were observed in OAG eyes between electrophysiological results and HFA values. Pattern electroretinogram and VEP responses were normal in all control eyes. Conclusions: Combined PERG/VEP recordings identified a large percentage of ocular hypertension eyes with impairment of the innermost retinal layers,not withstanding normal optic disc morphology and normal HFA. In OAG eyes,PERG P50 to N95 amplitude and VEP P100 implicit time showed the highest sensitivity/specificity for the detection of a visual dysfunction. The presence of abnormal PERG and/or VEP responses did not allow a clearcut separation between ocular hypertension and OAG eyes.展开更多
To determine the existence of retinal ganglion cell dysfunction and associated risk factors in glaucoma suspects with increased optic disc cupping and normal visual field. Cross-sectional, observational study. Two hun...To determine the existence of retinal ganglion cell dysfunction and associated risk factors in glaucoma suspects with increased optic disc cupping and normal visual field. Cross-sectional, observational study. Two hundred glaucoma suspec t (GS) patients were identified based on optic disc abnormalities (vertical cup -to-disc ratios [C/D] >0.5; vertical C/D asymmetry ≥0.2; disc hemorrhages; no tching) in association with known glaucoma risk factors (positive family history , African American descent, increased intraocular pressure [IOP]), but normal vi sual fields. Forty-two patients had early manifest glaucoma (EMG). Sixteen norm al black subjects were added to update previous pattern electroretinogram (PERG) normative data and to establish a normal control (NC) group with a racial break down comparable with that of the study groups. Pattern electroretinograms were r ecorded simultaneously from both eyes using skin electrodes and automated analys is; visual fields were monitored with standard white-on-white automated perime try (SAP) central 24-2 program; vertical C/D was evaluated by an independent re ader from stereo disc photographs; and univariate and multivariate statistical a nalysis between PERG and other outcome measures was evaluated. Pattern electrore tinogram amplitude (μV), phase (π.rad), and interocular asymmetry in amplitude and phase (%); and SAP mean deviation (MD; decibels), vertical C/D, age (years ), IOP (mmHg), and race (black vs. nonblack). The PERG results were abnormal in at least 1 of the outcome measures in 52%of GS patients and 69%of EMG patients . The PERG amplitude was correlated weakly with both MD (P < 0.01) and vertical C/D (P=0.05). The correlation between PERG amplitude and MD and C/D was stronger (P < 0.001) for interocular differences rather than absolute measures. Interocu lar PERG amplitude asymmetry increased with severity of disease (EMG > GS > NC; P < 0.01). The PERG amplitude decline with age was steeper in patients with a mo re negative MD (P < 0.01) and in patients with a more negative MD and a larger v ertical C/D (P=0.06). Black race (but not family history) was associated with lo wer PERG amplitude (P=0.005) in GS and EMG patients, but not in normal controls (P=0.44). The correlation between PERG abnormality and known risk factors for gl aucoma indicates that PERG has a predictive potential for the development or pro gression of the disease, or both.展开更多
文摘Objective: To assess the presence of normal or abnormal pattern electroretinogram (PERG) and visual evoked potential (VEP)-responses in patients with ocular hypertension or open-angle glaucoma (OAG). Design: Retrospective,cross-sectional,case-control study. Participants: Eighty normal control subjects (mean age,51.77± 6.04 years; 80 eyes),68 ocular hypertension patients (mean age,51.58± 7.12; 68 eyes; intraocular pressure IOP < 18 mmHg under pharmacological treatment; Humphrey field analysis HFA 24/2 mean deviation MD >-2 decibels dB),and 84 OAG patients (mean age,52.77± 5.28; 84 eyes; IOP < 18 mmHg under pharmacological treatment; HFA24/2mean deviation between-2 and-23 dB)were enrolled. Methods: Simultaneous recording of PERGs and VEPs using high-contrast (80% ) 15 checkerboard stimuli reversed at the rate of 2 reversals per second. Main Outcome Measures: Pattern electroretinogram P50 and VEP P100 implicit times were considered delayed when exceeding the limit of mean values of controls plus 2 standard deviations (SDs). Pattern electroretinogram P50 to N95 and VEP N75 to P100 amplitudes were considered reduced when exceeding the limit of mean values of controls minus 2 SDs. Results: Pattern electroretinogram: P50 implicit times were delayed in 58 of 68 (85.30% ) ocular hypertension eyes and 83 of 84 (98.80% )OAG eyes; P50 toN95 amplitudes were reduced in 47 (69.12% ) ocular hypertension eyes and 84 (100% ) OAG eyes. Visual evoked potential: P100 implicit times were delayed in 58 (85.30% ) ocular hypertension eyes and 84 (100% ) OAG eyes; reduced N75 to P100 amplitudes were observed in 39 (57.35% ) ocular hypertension eyes and 73 (86.90% ) OAG eyes. Ocular hypertension eyes showed no significant correlations (Pearson test,P>0.01) between electrophysiological parameters and age,IOP before or under medical treatment,HFA,and corneal thickness values. Significant correlations (P<0.01) were observed in OAG eyes between electrophysiological results and HFA values. Pattern electroretinogram and VEP responses were normal in all control eyes. Conclusions: Combined PERG/VEP recordings identified a large percentage of ocular hypertension eyes with impairment of the innermost retinal layers,not withstanding normal optic disc morphology and normal HFA. In OAG eyes,PERG P50 to N95 amplitude and VEP P100 implicit time showed the highest sensitivity/specificity for the detection of a visual dysfunction. The presence of abnormal PERG and/or VEP responses did not allow a clearcut separation between ocular hypertension and OAG eyes.
文摘To determine the existence of retinal ganglion cell dysfunction and associated risk factors in glaucoma suspects with increased optic disc cupping and normal visual field. Cross-sectional, observational study. Two hundred glaucoma suspec t (GS) patients were identified based on optic disc abnormalities (vertical cup -to-disc ratios [C/D] >0.5; vertical C/D asymmetry ≥0.2; disc hemorrhages; no tching) in association with known glaucoma risk factors (positive family history , African American descent, increased intraocular pressure [IOP]), but normal vi sual fields. Forty-two patients had early manifest glaucoma (EMG). Sixteen norm al black subjects were added to update previous pattern electroretinogram (PERG) normative data and to establish a normal control (NC) group with a racial break down comparable with that of the study groups. Pattern electroretinograms were r ecorded simultaneously from both eyes using skin electrodes and automated analys is; visual fields were monitored with standard white-on-white automated perime try (SAP) central 24-2 program; vertical C/D was evaluated by an independent re ader from stereo disc photographs; and univariate and multivariate statistical a nalysis between PERG and other outcome measures was evaluated. Pattern electrore tinogram amplitude (μV), phase (π.rad), and interocular asymmetry in amplitude and phase (%); and SAP mean deviation (MD; decibels), vertical C/D, age (years ), IOP (mmHg), and race (black vs. nonblack). The PERG results were abnormal in at least 1 of the outcome measures in 52%of GS patients and 69%of EMG patients . The PERG amplitude was correlated weakly with both MD (P < 0.01) and vertical C/D (P=0.05). The correlation between PERG amplitude and MD and C/D was stronger (P < 0.001) for interocular differences rather than absolute measures. Interocu lar PERG amplitude asymmetry increased with severity of disease (EMG > GS > NC; P < 0.01). The PERG amplitude decline with age was steeper in patients with a mo re negative MD (P < 0.01) and in patients with a more negative MD and a larger v ertical C/D (P=0.06). Black race (but not family history) was associated with lo wer PERG amplitude (P=0.005) in GS and EMG patients, but not in normal controls (P=0.44). The correlation between PERG abnormality and known risk factors for gl aucoma indicates that PERG has a predictive potential for the development or pro gression of the disease, or both.
