scholarly journals Relationship between structural and functional changes in glaucomatous eyes: A multifocal electroretinogram study

2020 ◽  
Author(s):  
Hiroki Tanaka ◽  
Kyoko Ishida ◽  
Kenji Ozawa ◽  
Takuma Ishihara ◽  
Akira Sawada ◽  
...  
Keyword(s):  
Multifocal Electroretinogram ◽  
Visual Fields ◽  
Negative Response ◽  
Photopic Negative Response ◽  
Mean Deviation ◽  
Ganglion Cell Complex ◽  
P Values ◽  
Functional Changes ◽  
The Mean ◽  
Optimal Measure

Abstract Background: The nasal to temporal amplitudes ratio (N/T) of multifocal electroretinography (mfERG) scans measured within 5° of the macula can be used to detect glaucomatous change. The photopic negative response (PhNR) of mfERG elicited by a circular stimulus centered on the fovea was significantly reduced in eyes with glaucoma. The PhNR to B-wave ratio (PhNR/B) is the optimal measure of the PhNR. However, clinical superiority for evaluating glaucoma patients has not been determined between N/T and PhNR/B yet. Methods: For morphological assessments, ganglion cell complex (GCC) in six regions and the average were measured by optical coherence tomography (OCT). For functional assessment, Humphrey visual fields (VF) with mean sensitivities (MT) and mfERG scans with parameters of N/T and the multifocal photopic negative response to B-wave ratio (mfPhNR/B) were measured. Sixty-nine eyes of forty-four glaucoma patients were included and correlations between mfERG parameters and OCT or VF parameters were evaluated. Results: The mean age of patients was 59.4 years. The mean deviation for all eyes obtained with the VF 30-2 and VF 10-2 was -7.00 and -6.31 dB, respectively. Significant correlations between GCC thickness or VF parameter and the N/T were found, especially in the inferior and inforotemporal retinal areas corresponding to superior and superonasal VF sectors (GCC vs N/T; coefficient = -7.916 and -7.857, and MT vs N/T ; coefficient = -4.302 and -4.437, in the inferior and inforotemporal retinal areas, respectively, all p values < 0.05). However, similar associations were not obtained between mfPhNR/B and OCT or VF parameters. The mfPhNR/B only in the inferotemporal sector was significantly correlated with the average thickness of GCC (coefficient = 4.823, P = 0.012). Conclusions: The N/T is better parameter than PhNR/B for the assessment of glaucomatous eyes in the current study’s measurement conditions. A future study modifying the stimuli and amplitudes to obtain the spatial correspondence to OCT and VF measurement will be required to evaluate the value of mfERG.

scholarly journals Relationship between structural and functional changes in glaucomatous eyes: a multifocal electroretinogram study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hiroki Tanaka ◽  
Kyoko Ishida ◽  
Kenji Ozawa ◽  
Takuma Ishihara ◽  
Akira Sawada ◽  
...  
Keyword(s):  
Functional Assessment ◽  
Multifocal Electroretinogram ◽  
Visual Fields ◽  
Negative Response ◽  
Photopic Negative Response ◽  
Mean Deviation ◽  
Ganglion Cell Complex ◽  
Functional Changes ◽  
The Mean ◽  
Optimal Measure

Abstract Background The nasal to temporal amplitudes ratio (N/T) of multifocal electroretinography (mfERG) scans measured within 5° of the macula can be used to detect glaucomatous change. The photopic negative response (PhNR) of mfERG elicited by a circular stimulus centered on the fovea was significantly reduced in eyes with glaucoma. The PhNR to B-wave ratio (PhNR/B) is the optimal measure of the PhNR. However, clinical superiority for evaluating glaucoma patients has not been determined between N/T and PhNR/B yet. Methods For morphological assessments, ganglion cell complex (GCC) in six regions and the average were measured by optical coherence tomography (OCT). For functional assessment, Humphrey visual fields (VF) with mean sensitivities (MT) and mfERG scans with parameters of N/T and the multifocal photopic negative response to B-wave ratio (mfPhNR/B) were measured. Sixty-nine eyes of 44 glaucoma patients were included and correlations between mfERG parameters and OCT or VF parameters were evaluated. Results The mean age of patients was 59.4 years. The mean deviation for all eyes obtained with the VF 30–2 and VF 10–2 was − 7.00 and − 6.31 dB, respectively. Significant correlations between GCC thickness or VF parameter and the N/T were found, especially in the inferior and inforotemporal retinal areas corresponding to superior and superonasal VF sectors (GCC vs N/T; coefficient = − 7.916 and − 7.857, and MT vs N/T; coefficient = − 4.302 and − 4.437, in the inferior and inforotemporal retinal areas, respectively, all p values < 0.05). However, similar associations were not obtained between mfPhNR/B and OCT or VF parameters. The mfPhNR/B only in the inferotemporal sector was significantly correlated with the average thickness of GCC (coefficient = 4.823, P = 0.012). Conclusions The N/T was correlated with GCC and VF in more numbers of measurement areas than the mfPhNR/B in the current study, however, a future study modifying the stimuli and amplitudes to obtain the spatial correspondence to OCT and VF measurement will be required to evaluate the value of mfERG.

scholarly journals Relationship between structural and functional changes in glaucomatous eyes: A multifocal electroretinogram study

2020 ◽  
Author(s):  
Hiroki Tanaka ◽  
Kyoko Ishida ◽  
Kenji Ozawa ◽  
Akira Sawada ◽  
Kiyofumi Mochizuki ◽  
...  
Keyword(s):  
Multifocal Electroretinogram ◽  
Central Area ◽  
Plexiform Layer ◽  
Normal Subjects ◽  
Photopic Negative Response ◽  
Inner Plexiform Layer ◽  
Fiber Layer ◽  
P Values ◽  
Functional Changes ◽  
Order Kernel

Abstract Background: The association between the structure of the macular region and its function as measured by multifocal electroretinography (mfERG) and the mean thresholds (MT) of the visual field (VF) is not well-understood. Methods: The macular retinal nerve fiber layer (mRNFL) and the ganglion cell and inner plexiform layer (GCIPL) in six regions were measured by optical coherence tomography (OCT). For functional assessment, MT and mfERG scans with parameters of the second-order kernel responses within the central 5°, nasal to temporal amplitudes ratio (N/T), and the multifocal photopic negative response to B-wave ratio (mfPhNR/B) were measured. Forty-one glaucoma patients underwent OCT, mfERG, and MT measurement and 55 healthy subjects underwent mfERG. Results: The mfPhNR/B was significantly smaller ( P < 0.01) and the N/T was significantly larger ( P < 0.01) in glaucoma patients than in normal subjects. In glaucoma patients, the N/T is significantly correlated with the thickness of inferior and inferotemporal GCIPL ( r = -0.317 and -0.360, respectively) and MT of corresponding VF areas ( r = -0.330 and -0.334, respectively) (all P values < 0.05). The mfPhNR/B was significantly correlated with the thickness of mRNFL in the central area ( r = 0.365, P = 0.02) and with the MT of all corresponding VF areas ( r rages between 0.330 and 0.460, all P values < 0.04), except for the inferotemporal area. However, correlation was not observed between the N/T and the mfPhNR/B in any location. Conclusions: Significant differences exist between glaucoma and healthy participants in the N/T and mfPhNR/B. Correlations were observed between two mfERG parameters and OCT parameters or MT in glaucoma patients. Further research should seek to demonstrate whether the N/T and the mfPhNR/B should be applied in a complementary fashion.

scholarly journals Monitoring for glaucoma progression with SAP, electroretinography (PERG and PhNR) and OCT

2021 ◽  
Author(s):  
Barbara Cvenkel ◽  
Maja Sustar ◽  
Darko Perovšek
Keyword(s):  
Optic Disc ◽  
Repeated Measurements ◽  
Photopic Negative Response ◽  
Ganglion Cell Complex ◽  
Automated Perimetry ◽  
Stable Group ◽  
Standard Automated Perimetry ◽  
Glaucoma Progression ◽  
The Mean ◽  
Over Time

Abstract Purpose To investigate the value of pattern electroretinography (PERG) and photopic negative response (PhNR) in monitoring glaucoma compared to standard clinical tests (standard automated perimetry (SAP) and clinical optic disc assessment) and structural measurements using spectral-domain OCT. Methods A prospective study included 32 subjects (32 eyes) with ocular hypertension, suspect or early glaucoma monitored for progression with clinical examination, SAP, PERG, PhNR and OCT for at least 4 years. Progression was defined clinically by the documented change of the optic disc and/or significant visual field progression (EyeSuite™ trend analysis). One eye per patient was included in the analysis. Results During the follow-up, 13 eyes (40.6%) showed progression, whereas 19 remained stable. In the progressing group, all parameters showed significant worsening over time, except for the PhNR, whereas in the stable group only the OCT parameters showed a significant decrease at the last visit. The trend of change over time using linear regression was steepest for the OCT parameters. At baseline, only the ganglion cell complex (GCC) and peripapillary retinal nerve fibre (pRNFL) thicknesses significantly discriminated between the stable and progressing eyes with the area under the ROC curve of 0.72 and 0.71, respectively. The inter-session variability for the first two visits in the stable group was lower for OCT (% limits of agreement within ± 17.4% of the mean for pRNFL and ± 3.6% for the GCC thicknesses) than for ERG measures (within ± 35.9% of the mean for PERG N95 and ± 59.9% for PhNR). The coefficient of variation for repeated measurements in the stable group was 11.9% for PERG N95 and 23.6% for the PhNR, while it was considerably lower for all OCT measures (5.6% for pRNFL and 1.7% for GCC thicknesses). Conclusions Although PERG and PhNR are sensitive for early detection of glaucomatous damage, they have limited usefulness in monitoring glaucoma progression in clinical practice, mainly due to high inter-session variability. On the contrary, OCT measures show low inter-session variability and might have a predicting value for early discrimination of progressing cases.

scholarly journals Comparison of Perimetric Outcomes from Melbourne Rapid Fields Tablet Perimeter Software and Humphrey Field Analyzer in Glaucoma Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Harsh Kumar ◽  
Mithun Thulasidas
Keyword(s):  
Standard Deviation ◽  
Visual Field ◽  
Rural Areas ◽  
Visual Fields ◽  
Test Time ◽  
Mean Deviation ◽  
Time Saving ◽  
Humphrey Field Analyzer ◽  
Probability Plot ◽  
The Mean

Purpose. To compare visual field results obtained using Melbourne Rapid Fields (MRF) iPad-based perimeter software and Humphrey Field Analyzer (HFA) 24-2 Swedish Interactive Threshold Algorithm (SITA) standard program in glaucoma patients. Design. A cross-sectional observational study. Methods. In this single-centre study involving patients diagnosed with glaucoma, the perimetric outcomes of MRF were compared against those returned from the HFA 24-2 SITA standard. Outcomes included mean deviation (MD), pattern standard deviation (PSD), visual field index (VFI)/visual capacity (VC), foveal threshold, test time, number of points depressed at P<5% on PSD probability plot, and glaucoma hemifield test/color coded indicator. Results. The study included 28 eyes of 28 glaucoma patients. Mean (standard deviation) test times were 342.07 (56.70) seconds for MRF and 375.11 (88.95) for HFA 24-2 SITA standard P=0.046. Mean MD was significantly lower for MRF (Δ = 3.09, P<0.001), and mean PSD was significantly higher for MRF (Δ = 1.40, P=0.005) compared with HFA. The mean foveal threshold for the MRF was significantly lower than the mean HFA foveal threshold ((Δ = 9.25, P<0.001). The number of points depressed at P<5% on the PSD probability plot was significantly less for MRF P<0.001. Other perimetric outcomes showed no significant differences between both. Bland–Altman plots showed that considerable variability existed between the programs. Conclusion. MRF is a good cost-effective, time-saving, user-friendly tool for monitoring visual fields in settings where access to traditional perimetry is limited. The lack of Internet strength in rural areas and questionable detection of early cases may be two points in MRF fields requiring an upgrade.

scholarly journals The Association Between the Number of Visual Fields and the Accuracy of Future Prediction in Eyes With Retinitis Pigmentosa

2021 ◽  
Author(s):  
Ryo Asaoka ◽  
Akio Oishi ◽  
Yuri Fujino ◽  
Hiroshi Murata ◽  
Keiko Azuma ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Retinitis Pigmentosa ◽  
Prediction Error ◽  
Visual Fields ◽  
Absolute Error ◽  
Mean Deviation ◽  
Humphrey Field Analyzer ◽  
Minimum Number ◽  
Future Prediction ◽  
The Mean

Abstract The purpose of the study was to evaluate the minimum number of visual fields (VFs) required to precisely predict future VFs in eyes with retinitis pigmentosa (RP). A series of 12 VFs (Humphrey Field Analyzer 10-2 test, (8.9 years in average) were analyzed from 102 eyes of 52 RP patients. The absolute error to predict the 12th VF using the prior 11 VFs was calculated in a pointwise manner, using the linear regression, and the 95% confidence interval (CI) range was determined. Then, using 3 to 10 initial VFs, next VFs (4th to 11th VFs, respectively) were also predicted. The minimum number of VFs required for the mean absolute prediction error to reach the 95% CI was identified. Similar analyses were iterated for the second and third next VF predictions. Similar analyses were conducted using mean deviation (MD). In the pointwise analysis, the minimum number of VFs required to reach the 95% CI for the 12th VF was 5 (first and second next VF predictions) and 6 (third next VF prediction). For the MD analysis, 3 (first and second next VF predictions) and 4 (third next VF prediction) VFs were required to reach 95% CI for the 12th VF.

scholarly journals Association between the number of visual fields and the accuracy of future prediction in eyes with retinitis pigmentosa

2021 ◽  
Vol 6 (1) ◽  
pp. e000900
Author(s):  
Ryo Asaoka ◽  
Akio Oishi ◽  
Yuri Fujino ◽  
Hiroshi Murata ◽  
Keiko Azuma ◽  
...  
Keyword(s):  
Linear Regression ◽  
Retinitis Pigmentosa ◽  
Prediction Error ◽  
Visual Fields ◽  
Absolute Error ◽  
Mean Deviation ◽  
Humphrey Field Analyzer ◽  
Minimum Number ◽  
Future Prediction ◽  
The Mean

PurposeTo evaluate the minimum number of visual fields (VFs) required to precisely predict future VFs in eyes with retinitis pigmentosa (RP).MethodsA series of 12 VFs (Humphrey Field Analyzer 10–2 test (8.9 years in average) were analysed from 102 eyes of 52 patients with RP. The absolute error to predict the 12th VF using the prior 11 VFs was calculated in a pointwise manner, using the linear regression, and the 95% CI range was determined. Then, using 3–10 initial VFs, next VFs (4th to 11th VFs, respectively) were also predicted. The minimum number of VFs required for the mean absolute prediction error to reach the 95% CI was identified. Similar analyses were iterated for the second and third next VF predictions. Similar analyses were conducted using mean deviation (MD).ResultsIn the pointwise analysis, the minimum number of VFs required to reach the 95% CI for the 12th VF was five (first and second next VF predictions) and six (third next VF prediction). For the MD analysis, three (first and second next VF predictions) and four (third next VF prediction) VFs were required to reach 95% CI for the 12th VF.ConclusionsThe minimum number of VFs required to obtain accurate predictions of the future VF was five or six in the pointwise analysis and three or four in the analysis with MD.

scholarly journals Impaired Ganglion Cell Function Objectively Assessed by the Photopic Negative Response in Affected and Asymptomatic Members From Brazilian Families With Leber's Hereditary Optic Neuropathy

2021 ◽  
Vol 11 ◽  
Author(s):  
Gabriel Izan Santos Botelho ◽  
Solange Rios Salomão ◽  
Célia Harumi Tengan ◽  
Rustum Karanjia ◽  
Felipo Victor Moura ◽  
...  
Keyword(s):  
Ganglion Cell ◽  
Cell Function ◽  
Visual Fields ◽  
Color Discrimination ◽  
Negative Response ◽  
Photopic Negative Response ◽  
Control Group ◽  
Full Field ◽  
Asymptomatic Carriers ◽  
Mtdna Mutations

Purpose: The photopic negative response (PhNR) is an electrophysiological method that provides retinal ganglion cell function assessment using full-field stimulation that does not require clear optics or refractive correction. The purpose of this study was to assess ganglion cell function by PhNR in affected and asymptomatic carriers from Brazilian families with LHON.Methods: Individuals either under suspicion or previously diagnosed with LHON and their family members were invited to participate in this cross-sectional study. Screening for the most frequent LHON mtDNA mutations was performed. Visual acuity, color discrimination, visual fields, pattern-reversal visual evoked potentials (PRVEP), full-field electroretinography and PhNR were tested. A control group of healthy subjects was included. Full-field ERG PhNR were recorded using red (640 nm) flashes at 1 cd.s/m2, on blue (470 nm) rod saturating background. PhNR amplitude (μV) was measured using baseline-to-trough (BT). Optical coherence tomography scans of both the retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) were measured. PhNR amplitudes among affected, carriers and controls were compared by Kruskal-Wallis test followed by post-hoc Dunn test. The associations between PhNR amplitude and OCT parameters were analyzed by Spearman rank correlation.Results: Participants were 24 LHON affected patients (23 males, mean age=30.5 ± 11.4 yrs) from 19 families with the following genotype: m.11778G&gt;A [N = 15 (62%), 14 males]; m.14484T&gt;C [N = 5 (21%), all males] and m.3460G&gt;A [N = 4 (17%), all males] and 14 carriers [13 females, mean age: 43.2 ± 13.3 yrs; m.11778G&gt;A (N = 11); m.3460G&gt;A (N = 2) and m.14484T&gt;C (N = 1)]. Controls were eight females and seven males (mean age: 32.6 ± 11.5 yrs). PhNR amplitudes were significantly reduced (p = 0.0001) in LHON affected (−5.96 ± 3.37 μV) compared to carriers (−16.53 ± 3.40 μV) and controls (−23.91 ± 4.83; p &lt; 0.0001) and in carriers compared to controls (p = 0.01). A significant negative correlation was found between PhNR amplitude and total macular ganglion cell thickness (r = −0.62, p &lt; 0.05). Severe abnormalities in color discrimination, visual fields and PRVEPs were found in affected and subclinical abnormalities in carriers.Conclusions: In this cohort of Brazilian families with LHON the photopic negative response was severely reduced in affected patients and mildly reduced in asymptomatic carriers suggesting possible subclinical abnormalities in the latter. These findings were similar among pathogenic mutations.

Alterations of Photopic Negative Response of Multifocal Electroretinogram in Patients with Glaucoma

2014 ◽  
Vol 40 (1) ◽  
pp. 77-86 ◽  
Author(s):  
Muneyoshi Kaneko ◽  
Shigeki Machida ◽  
Yuya Hoshi ◽  
Daijiro Kurosaka
Keyword(s):  
Multifocal Electroretinogram ◽  
Negative Response ◽  
Photopic Negative Response
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