Early detection of glaucoma suspect by pattern electroretinogram

• Published in: Journal of Egyptian ophthalmological society Vol. 112; no. 1; pp. 34 - 38
• Main Authors: Hassan, Heba, Abdelrazek El-Shinawy, Reham, Salman, Abd El, Elsbaay, Marwa
• Format: Journal Article
• Language: English
• Published: Wolters Kluwer India Pvt. Ltd 01-01-2019; Medknow Publications and Media Pvt. Ltd; Wolters Kluwer Medknow Publications
• Subjects: Glaucoma; glaucoma suspect; optical coherence tomography; pattern electroretinogram; visual field; pattern electroretinogram; visual field; optical coherence tomography; glaucoma suspect
• ISSN: 2090-0686; 2314-6648
• DOI: 10.4103/ejos.ejos_74_18

Aim This study was intended to estimate the significance of pattern electroretinogram (PERG) in evaluation of the retinal ganglion cell function in patients with glaucoma.
Patients and methods An observational case-control study was done on 40 eyes of individuals whose age ranged between 30 and 65 years of age. They were divided into two equal groups. Control group had normal visual field and optical coherence tomography optic nerve, intraocular pressure (IOP) less than 21 mmHg, visual acuity more than 0.3, and cup disc ratio (C/D) less than 0.5. The case group was divided into two equal subgroups: group A had IOP more than 21 mmHg and C/D less than 0.5, and group B had IOP less than 21 mmHg and C/D more than 0.5. We excluded all cases with ocular or systemic diseases with negative effect on retinal function such as retinal detachment, retinitis pigmentosa, rheumatoid arthritis on hydroxychloroquine, diabetic patients on insulin or oral hypoglycemic, or cases with abnormal optic disc appearance such as optic disc drusen, coloboma, or tilted disc. All cases underwent full ophthalmological examination, including best-corrected visual acuity, complete anterior segment examination with slit-lamp biomicroscopy, and posterior segment examination using volk 90 D lens, along with IOP measurement using Goldmann applanation tonometer. Visual field assessment was done using Heidelberg Edge Perimeter, optical coherence tomography optic nerve using Heidelberg engineering, and glaucoma screening with ERG using glaucoma screening program.
Results There was a highly statistically significant difference between the groups regarding C/D and IOP. Regarding the PERG and different visual fields parameters, there was a highly statistically significant difference between the groups. There was a statistically significant negative correlation between PERG and both IOP and VF parameters in all different groups. No statistically significant correlation was found between PERG and C/D in all different groups.
Conclusion PERG has a prognostic value in recognition of retinal ganglion cell dysfunction, as an early indication for glaucoma development.