Abstract

Purpose: The pattern electroretinogram (PERG) is useful to detect retinal ganglion cell (RGC) damage in patients with glaucoma. Optical coherence tomography angiography (OCTA) measures retinal vessel density (VD), which is known to be reduced in glaucoma. There may be correlations between parameters of the PERG and OCTA in open-angle glaucoma (OAG). Methods: In total, 95 eyes of 95 OAG patients and 102 eyes of 102 normal controls were included in this study. N35, P50, and N95 latency along with P50 and N95 amplitude were obtained using the PERG. Retinal VD was measured around the peripapillary and macular area according to the ETDRS grid (concentric circles with diameters of 1, 3, and 6 mm), which is named a center (≤1 mm), an inner (1–3 mm), an outer (3–6 mm), and a full (≤6 mm) area. Pearson correlation analysis was done between parameters, and partial correlation analysis was done after adjusting confounding factors. Results: P50 amplitude, N95 amplitude, and VD of most measured areas were significantly lower in the OAG group compared to the normal group. N95 amplitude showed a statistically significant correlation with parameters of optical coherence tomography and visual field, peripapillary outer and full VD, and macular outer and full VD even after adjusting confounding factors. There was no significant correlation between parameters in the normal group. Conclusions: N95 amplitude was associated with structural and functional change including VD reduction in OAG. Microvascular alterations may be associated with dysfunctional changes of RGC recorded by the PERG in OAG.

Highlights

  • Glaucoma is characterized by progressive optic neuropathy with characteristic loss of optic nerve fibers and retinal ganglion cells (RGCs) [1]

  • The result of this study revealed that N95 amplitude is positively correlated with vessel density (VD) measured by Optical coherence tomography angiography (OCTA) in open-angle glaucoma (OAG) patients, especially of the peripapillary outer and full area and the macular outer and full area

  • Jung et al [24] showed that P50 and N95 amplitude were decreased and N95 latency was prolonged in preperimetric glaucoma compared to normal controls and that N95 amplitude was significantly related with retinal nerve fiber layer thickness (RNFL) and ganglion cell-inner plexiform layer (GCIPL) thickness

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Summary

Introduction

Glaucoma is characterized by progressive optic neuropathy with characteristic loss of optic nerve fibers and retinal ganglion cells (RGCs) [1]. Optical coherence tomography (OCT) and visual field (VF) have been standard methods to evaluate structural and functional change for decades. The pattern electroretinogram (PERG) has been investigated in a number of studies with glaucoma [2,3,4,5]. The PERG has the potential to detect dysfunctional RGCs without structural axonal loss, showing promising outcomes in differentiating glaucoma patients from normal controls [6,7]. A longitudinal study found that the PERG of a glaucoma suspect (GS) displayed longitudinal loss of signal [8] and had been changed four years before VF started to show the defects [9]

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