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. 2020 Dec;9(4):981-992.
doi: 10.1007/s40123-020-00302-5. Epub 2020 Sep 16.

Short-Term Steady-State Pattern Electroretinography Changes Using a Multi-Pressure Dial in Ocular Hypertensive, Glaucoma Suspect, and Mild Open-Angle Glaucoma Patients: A Randomized, Controlled, Prospective, Pilot Study

Jeremy J Kudrna  1 , Tanner J Ferguson  2 , Russell J Swan  3 , Steven J Ferguson  4 , Brandon J Baartman  5 , Adam R Bleeker  6 , Ramu G Sudhagoni  7 , John P Berdahl  8 , Michael D Greenwood  9
Affiliations

Short-Term Steady-State Pattern Electroretinography Changes Using a Multi-Pressure Dial in Ocular Hypertensive, Glaucoma Suspect, and Mild Open-Angle Glaucoma Patients: A Randomized, Controlled, Prospective, Pilot Study

Jeremy J Kudrna et al. Ophthalmol Ther. 2020 Dec.

Abstract

Introduction: This study evaluates the effects of the multi-pressure dial (MPD) on steady-state pattern electroretinography (ss-pERG) parameters. The study is a randomized, controlled, prospective, pilot trial in a private practice setting with ocular hypertensive (OHT), glaucoma suspect, and open-angle glaucoma (OAG) subjects.

Methods: This study included nine patients (64 ± 9.0 years, nine female) with OHT, glaucoma suspect, or mild OAG. One eye of each subject was randomized to receive negative periocular pressure, while the contralateral eye served as the intrasubject control through the goggle without negative pressure. The Diopsys High Contrast Sensitivity ss-pERG protocol was conducted on both eyes of each subject while wearing the MPD device. Application of negative periocular pressure was set at 50% of baseline intraocular pressure for each study eye.

Results: Following 2 h of negative periocular pressure application, the difference in MagnitudeD (MagD) from baseline for eyes randomized to receive negative periocular pressure (+ 0.17 versus - 0.26) was statistically significant (p = 0.023). Over the same period, the change in MagD/Magnitude (MagD/Mag ratio) from baseline for eyes randomized to receive negative periocular pressure was also higher (+ 0.14 versus - 0.16), compared to the control eyes, approached significance (p = 0.059).

Conclusions: Following 2 h of MPD wear, the measured MagD and MagD/Mag ratio improved compared to control, suggesting that negative periocular pressure application to the anterior globe can lead to short-term improvement in one measure of retinal ganglion cell function.

Keywords: Glaucoma management; Multi-pressure dial; Steady-state pattern electroretinogram.

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Figures

Fig. 1
Fig. 1
Standard iteration of the multi-pressure dial (MPD), which consists of a pair of pressure-sensing goggles connected to a pressure-modulating pump
Fig. 2
Fig. 2
Mean change in MagD during MPD wear (stages 1–5). The mean zero values indicate the starting MagD for the control eyes (0.60) and for the study eyes (0.51), the differences in these stage 1 values were not statistically significant (p = 0.13). Negative periocular pressure applied to the study eye during stages 2, 3, and 4, while the fellow eye served as the intrasubject control through the goggle without negative pressure. Standard error bars shown. There was a statistically significant (p = 0.023**) difference observed between study and control eye groups at stage 4
Fig. 3
Fig. 3
Mean Change in MagD/Mag ratios during MPD wear (stages 1–5). The mean zero values indicate the starting MagD/Mag ratio for the control eyes (0.57) and for the study eyes (0.44), and the differences in these stage 1 values were not statistically significant (p = 0.078). Negative periocular pressure applied to the study eye during stages 2, 3, and 4, while the fellow eye served as the intrasubject control through the goggle without negative pressure. Standard error bars shown. The difference observed between study and control eye groups at stage 4 approached significance (p = 0.059)*
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