Long-term PERG monitoring of untreated and treated glaucoma suspects

• Published in: Documenta ophthalmologica Vol. 141; no. 2; pp. 149 - 156
• Main Authors: Gordon, Phillip S., Kostic, Maja, Monsalve, Pedro F., Triolo, Giacinto, Golubev, Luri, Luna, Gabriel, Ventura, Lori M., Feuer, William J., Porciatti, Vittorio
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2020
• Subjects: Adult; Antihypertensive Agents - therapeutic use; Disease Progression; Electroretinography - methods; Female; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Nerve Fibers - physiology; Ocular Hypertension - diagnosis; Ocular Hypertension - drug therapy; Ocular Hypertension - physiopathology; Ophthalmology; Original Research Article; Pattern Recognition, Visual - physiology; Retinal Ganglion Cells - physiology; Retrospective Studies; Visual Field Tests - methods; Visual Fields - physiology; Retinal ganglion cell function; Glaucoma suspects; Retinal nerve fiber layer thickness; Pattern electroretinogram
• ISSN: 0012-4486; 1573-2622
• DOI: 10.1007/s10633-020-09760-5

Purpose To investigate long-term structural and functional progression of untreated and treated glaucoma suspects (UGS and TGS). Methods Retrospective analysis of serial steady-state 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 SAP-MD ( R  ≥ 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 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.