Pattern ERG as an early glaucoma indicator in ocular hypertension: a long-term, prospective study
| Autor: | Heiko Philippin, Anke S. Unsoeld, Jens Funk, Philip Maier, Hans S. Walter, Thomas G. Bomer, Flemming Staubach, Michael Bach |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
Retinal Ganglion Cells medicine.medical_specialty Intraocular pressure Visual acuity genetic structures Eye disease Vision Disorders Ocular hypertension Glaucoma Retinal Diseases Ophthalmology medicine Electroretinography Humans Longitudinal Studies Prospective Studies Intraocular Pressure Aged medicine.diagnostic_test business.industry Middle Aged medicine.disease eye diseases Visual field medicine.anatomical_structure Pattern Recognition Visual ROC Curve Disease Progression Ocular Hypertension sense organs medicine.symptom Visual Fields business Optic disc |
| Zdroj: | Investigative ophthalmologyvisual science. 47(11) |
| ISSN: | 0146-0404 |
| Popis: | Purpose The conversion rate from untreated ocular hypertension (OHT) to glaucoma is only approximately 1% per year. Discrimination of nonconverters and potential converters would help reserve preventative treatment for those who need it and thus avoid unnecessary side effects and expenditure for those who do not. This prospective study was designed to assess the pattern electroretinogram (PERG) as an early indicator of dysfunction preceding glaucoma. Methods Ninety-five eyes of 54 patients with intraocular pressure > or =25 mm Hg (or > or =23 mm Hg with additional risk factors), normal visual fields, normal optic disc cupping, and visual acuity > or =0.8 were evaluated. Every 6 months during a median follow-up of 8.2 years, the PERG and visual fields were obtained besides other standard diagnostics. PERGs were recorded in steady state mode in response to checkerboard stimuli at 15 reversals/s, and the amplitudes in response to check sizes of 0.8 degrees and 16 degrees as well as the ratio of the amplitude of responses to 0.8 degrees over that to 16 degrees checks were determined. Results Glaucomatous visual field defects developed in eight eyes. For the PERG to 0.8 degrees checks and for the PERG ratio, analysis of the receiver-operating characteristic (ROC) yielded steadily increasing ROC areas before conversion (i.e., an increasing ability of the PERG to predict nonconversion or conversion). One year before conversion, the ROC area of the PERG ratio was 0.78; at a threshold of 1.06 this corresponded to a sensitivity of 80% and a specificity of 71%. Conclusions The PERG can help to predict stability or progression to glaucoma in OHT at least 1 year ahead of conversion. |
| Databáze: | OpenAIRE |
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