Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2014 Feb;128(1):53-8.
doi: 10.1007/s10633-013-9414-x. Epub 2013 Oct 19.

Pattern electroretinogram (PERG) in the early diagnosis of normal-tension preperimetric glaucoma: a case report

Joanna Karaśkiewicz  1 , Monika Drobek-Słowik, Wojciech Lubiński
Affiliations
Case Reports

Pattern electroretinogram (PERG) in the early diagnosis of normal-tension preperimetric glaucoma: a case report

Joanna Karaśkiewicz et al. Doc Ophthalmol. 2014 Feb.

Abstract

Introduction: The purpose of this case is to present the use of pattern electroretinogram (PERG) in the early diagnosis of normal-tension preperimetric glaucoma in 56 years old woman.

Methods and results: At baseline the results were as follows: distance-corrected visual acuity in the right eye (RE) and left eye (LE) 1.0 and 0.7, respectively (Snellen table), normal anterior segments in both eyes, normal fundus in the RE and abnormal cup to disc ratio (0.6) in the LE. Intraocular pressure (IOP) was within normal limits in both eyes: RE-14 mmHg, LE-18 mmHg (Goldmann tonometer). Results of standard automated perimetry (SAP), short wavelength automated perimetry (SWAP) and nerve fiber analyzer (GDx) were normal in both eyes. PERG result was normal in the RE but in the LE reduced amplitudes of P50 and N95 waves were observed. After topical treatment (Xalacom to the LE), a reduction of IOP to 13 mmHg was achieved and was accompanied by amplitudes increase of PERG waves. After discontinuation of the therapy, IOP increased to 18 mmHg and P50 and N95 amplitudes decreased to the values before treatment, suggesting the influence of IOP lowering therapy on electrical function of retinal ganglion cells. After 4 years from the baseline, static perimetry results were still normal, but abnormalities in retinal nerve fiber layer thickness were detected in GDx.

Conclusions: PERG was a useful test not only for the early diagnosis of normal-tension preperimetric glaucoma, but also in evaluating the effectiveness of antiglaucomatous treatment.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Fundus photographs of the right (a) and left (b) eyes. Increased cup-to-disc ratio (0, 6) in the left eye was detected
Fig. 2
Fig. 2
Gdx results in both eyes within normal limits
Fig. 3
Fig. 3
Right eye (left side): PERG amplitudes of P50 and N95 waves within normal limits. Left eye (right side): lower PERG amplitudes of P50 and N95 waves
Fig. 4
Fig. 4
Left eye: increase in PERG amplitudes after instillation of Xalacom (right side), in comparison with the score before treatment (left side)
Fig. 5
Fig. 5
Left eye: decrease in PERG amplitudes after 1-month discontinuation of Xalacom therapy (left side treated eye, right side without treatment)
Fig. 6
Fig. 6
Left eye: gdx result after 4 years of follow-up: abnormal thickness of RNFL in the lower quadrant and a pathological nerve fiber index (NFI) = 43
See this image and copyright information in PMC

References

    1. European Glaucoma Society . Terminology and guidelines for glaucoma. 3. Italy: European Glaucoma Society; 2008. - PubMed
    1. American Academy of Ophthalmology (2009–2010) Glaucoma basic and clinical science course. American Academy of Ophthalmology, Singapore
    1. Mroczkowska S, Ekart A, Sung V, Negi A, Qin L, Patel SR, Jacob S, Atkins C, Benavente-Perez A, Gherghel D. Coexistence of macro- and micro-vascular abnormalities in newly diagnosed normal tension glaucoma patients. Acta Ophthalmol. 2012;90(7):553–559. doi: 10.1111/j.1755-3768.2012.02494.x. - DOI - PubMed
    1. Holder GE, Brigell MG, Hawlina M, Meigen T, Vaegan, Bach M, International Society for Clinical Electrophysiology of Vision ISCEV standard for clinical pattern electroretinography. Doc Ophthalmol. 2007;114(3):111–116. doi: 10.1007/s10633-007-9053-1. - DOI - PMC - PubMed
    1. Kim HG, Heo H, Park SW. Comparison of scanning laser polarimetry and optical coherence tomography in preperimetric glaucoma. Optom Vis Sci. 2011;88(1):124–129. doi: 10.1097/OPX.0b013e3181fdef9c. - DOI - PubMed

Publication types

LinkOut - more resources