Long-term PERG monitoring of untreated and treated glaucoma suspects
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ORIGINAL RESEARCH ARTICLE
Long-term PERG monitoring of untreated and treated glaucoma suspects Phillip S. Gordon . Maja Kostic . Pedro F. Monsalve . Giacinto Triolo . Luri Golubev . Gabriel Luna . Lori M. Ventura . William J. Feuer . Vittorio Porciatti
Received: 6 November 2019 / Accepted: 2 March 2020 Ó Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To investigate long-term structural and functional progression of untreated and treated glaucoma suspects (UGS and TGS). Methods Retrospective analysis of serial steadystate pattern electroretinogram (PERG), mean retinal nerve fiber layer thickness (RNFLT), and standard automated perimetry mean deviation (SAP-MD) in UGS (N = 20) and TGS (N = 18). Outcome measures were the rates of change (linear regression slopes) of PERG amplitude, PERG phase, mean RNFLT, and SAP-MD over 9.8 ± 1.3 years (15.6 ± 4.2 visits). Results The number of patients with significant (P \ 0.05) progression slopes for PERG amplitude, PERG phase, RNFLT, and SAP-MD was, respectively, UGS: 5, 0, 4, 2; TGS: 8, 2, 6, 5. In UGS, outcome measures were not correlated with each other. In TGS, both PERG amplitude and RNFLT were significantly (P \ 0.05) correlated with SAPMD (R C 0.58), while PERG amplitude and RNFLT were not correlated with each other (R = 0.43, P = 0.064). The rate of change of SAP-MD was
P. S. Gordon M. Kostic P. F. Monsalve G. Triolo L. Golubev G. Luna L. M. Ventura W. J. Feuer V. Porciatti (&) Mc Knight Vision Research Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 1638 NW 10th Ave., Room 101, Miami, FL 33136, USA e-mail: [email protected]
predicted (P \ 0.05) by a linear combination of RNFLT slope and PERG amplitude slope. Conclusions Results substantiate and extend previous results showing that steady-state PERG amplitude progressively decreased over time in a proportion of glaucoma suspects, with relatively steeper slope in TGS compared to UGS. RNFLT progression also had a steeper slope in TGS compared to UGS; however, progressions of PERG amplitude and RNFLT were not significantly correlated. Both PERG progression and RNFLT progression independently contribute to prediction of visual field progression. Keywords Retinal ganglion cell function Pattern electroretinogram Retinal nerve fiber layer thickness Glaucoma suspects
Introduction The pattern electroretinogram (PERG) is a wellestablished, sensitive measure of retinal ganglion cell (RGC) function that is extensively used to detect early RGC dysfunction in optic nerve disorders [1]. A number of cross-sectional studies have shown that the PERG is early altered in glaucoma [2–6]. Longitudinal PERG assessment may provide indication of the magnitude of progression of disease and whether progression is altered with treatment. Longitudinal
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Doc Ophthalmol
PERG studies in early glaucoma are scarce and limited to 5 years [7–9]. Bode et al. 2011 [10] monitored glaucoma suspects for about 10
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