To investigate the changes of pattern electroretinogram (PERG) after intraocul ar pressure lowering in glaucoma patients and normal controls. Interventional re trospective cross-sectional study. Twenty-five patients (...To investigate the changes of pattern electroretinogram (PERG) after intraocul ar pressure lowering in glaucoma patients and normal controls. Interventional re trospective cross-sectional study. Twenty-five patients (49 eyes) with ocular hypertension or glaucoma undergoing topical treatment to lower IOP served as a s tudy group; 22 patients (44 eyes) with ocular hypertension or glaucoma observed without treatment served as a control group for treated glaucoma patients; 9 nor mal subjects (18 eyes) receiving a 250-mg acetazolamide tablet served as a seco nd study group; and 17 normal subjects (34 eyes) from a previous study served as a second control group for treated normal subjects. Pattern electroretinograms were recorded simultaneously from both eyes using skin electrodes and automated analysis. Visual field (VF) analyses were performed with white-on-white standa rd automated perimetry (SAP). Intraocular pressure was measured with Goldmann ap planation tonometry; central corneal thickness was measured with pachymetry. Pat tern electroretinogram amplitude (microvolts), phase (π.rads), and test-retest variability (test 2-to-test 1 ratio, in decibels), SAP mean deviation (decibe ls), and IOP (millimeters of mercury). In 56%of right eyes and 21%of left eyes of the treated glaucoma subgroup, the PERG amplitude and/or phase improved beyo nd the 95%confidence intervals of the test-retest variability of the untreated glaucoma control group. Pattern electroretinogram improvement with IOP lowering occurred in both high-and low-tension glaucoma eyes. Eyes with severely impai red VFs showed little improvement in PERG; however, eyes of normal subjects trea ted with acetazolamide did not show significant PERG changes relative to the tes t-retest variability of normal controls. Retinal ganglion cell function can be at least partially restored after IOP reduction in glaucomatous eyes with early VF impairment.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To investigate the changes of pattern electroretinogram (PERG) after intraocul ar pressure lowering in glaucoma patients and normal controls. Interventional re trospective cross-sectional study. Twenty-five patients (49 eyes) with ocular hypertension or glaucoma undergoing topical treatment to lower IOP served as a s tudy group; 22 patients (44 eyes) with ocular hypertension or glaucoma observed without treatment served as a control group for treated glaucoma patients; 9 nor mal subjects (18 eyes) receiving a 250-mg acetazolamide tablet served as a seco nd study group; and 17 normal subjects (34 eyes) from a previous study served as a second control group for treated normal subjects. Pattern electroretinograms were recorded simultaneously from both eyes using skin electrodes and automated analysis. Visual field (VF) analyses were performed with white-on-white standa rd automated perimetry (SAP). Intraocular pressure was measured with Goldmann ap planation tonometry; central corneal thickness was measured with pachymetry. Pat tern electroretinogram amplitude (microvolts), phase (π.rads), and test-retest variability (test 2-to-test 1 ratio, in decibels), SAP mean deviation (decibe ls), and IOP (millimeters of mercury). In 56%of right eyes and 21%of left eyes of the treated glaucoma subgroup, the PERG amplitude and/or phase improved beyo nd the 95%confidence intervals of the test-retest variability of the untreated glaucoma control group. Pattern electroretinogram improvement with IOP lowering occurred in both high-and low-tension glaucoma eyes. Eyes with severely impai red VFs showed little improvement in PERG; however, eyes of normal subjects trea ted with acetazolamide did not show significant PERG changes relative to the tes t-retest variability of normal controls. Retinal ganglion cell function can be at least partially restored after IOP reduction in glaucomatous eyes with early VF impairment.
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.
