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
. 2021 Nov 17:15:4455-4465.
doi: 10.2147/OPTH.S336903. eCollection 2021.

Steady-State Pattern Electroretinography in Eyes with Glaucoma and High Myopia

Xian Hui Lim  1 , Monisha Esther Nongpiur  1   2   3 , Raymond P Najjar  2   3 , Quan V Hoang  1   2   3   4 , Dan Milea  1   2   3 , Chee Wai Wong  1   2   3 , Rahat Husain  1   3 , Hla Myint Htoon  2   3 , Tin Aung  1   2   3   5 , Shamira Perera  1   2   3 , Tina Tzee Ling Wong  1   2   3   5
Affiliations

Steady-State Pattern Electroretinography in Eyes with Glaucoma and High Myopia

Xian Hui Lim et al. Clin Ophthalmol. .

Abstract

Purpose: To investigate features of the steady-state pattern electroretinogram (ssPERG) in subjects with glaucoma (G), high myopia (HM; spherical equivalent ≤-6D) and glaucoma with high myopia (GHM).

Patients and methods: Our study included 48 participants divided into 3 groups (G, HM, and GHM) who each underwent monocular ssPERG testing with Diopsys NOVA PERG protocols. The ConStim protocol detects distinct topographic patterns of dysfunction 16° and 24° around the central macula. MagD is the amplitude of the average signal and MagD/Mag ratio indicates the consistency of the response. ssPERG indices were compared between groups and correlated with functional (ie, visual field mean deviation (VFMD)) and structural (ie, average retinal nerve fibre layer (RNFL) thickness; Cirrus optical coherence tomography) features.

Results: Participants had an average age of 59.4±7.6 years. Mean Humphrey VFMD was -14.22 ± 2.88dB, -2.62 ± 1.18dB and -12.80 ± 2.60dB for G, HM and GHM groups, respectively. Mean RNFL thickness was 63.0 ± 8.20μm, 69.5 ± 15.7μm and 60.6 ± 5.0μm for G, HM and GHM groups, respectively. For the 24° setting, no significant differences were noted for any of the parameters. For the 16° setting, MagD was lower in the GHM group compared to the HM group (0.29µV vs 0.52µV; p = 0.02). Significant differences were noted for the MagD/Mag ratio between HM and G groups (0.58 vs 0.40; p = 0.02) and between HM and GHM groups (0.58 vs 0.35; p = 0.002). There were positive correlations between both MagD 16° and MagD/Mag ratio 16° with VFMD (correlation coefficient [r]=0.37, p = 0.009; and r = 0.44, p = 0.002, respectively) and RNFL (r = 0.43, p = 0.002; and r = 0.48, p = 0.001, respectively).

Conclusion: MagD/Mag ratio at 16° was significantly lower in glaucomatous eyes (with or without high myopia) compared to those with high myopia without glaucoma, suggesting that glaucoma has a distinct impact on MagD/Mag ratio at 16° irrespective of the presence of myopia.

Keywords: optical coherence tomography; pattern electroretinogram; retinal nerve fibre layer; visual field mean deviation.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Diopsys PERG trace of a patient from group GHM. The right eye of this participant was included in the study and had spherical equivalent of −9.75D, visual field mean deviation −11.34dB and average retinal nerve fibre layer thickness of 61µm. Left: Concentric stimulus (ConStim) protocol with 24° (top) and 16° (bottom) settings. Signal quality was good (120dBµV). (A) demonstrates the waveform obtained. The vertical axis indicates the amplitude (µV) and the horizontal axis, the time between 0 and 200 milliseconds. (B) is the strip chart, reflecting the PERG recording with artifacts represented by pronounced vertical peaks. In this case, there were 0 artifacts recorded. (C) is the frequency distribution chart, indicating the PERG response at various frequencies. The Magnitude value is obtained at 15Hz. Right: Contrast Sensitivity (ConSen) protocol with high contrast (Hc) (top) and low contrast (Lc) (bottom) settings. Signal quality was similarly good (125dBµV).
Figure 2
Figure 2
Diopsys PERG trace of a patient from group G. The right eye of this participant was included in the study and had spherical equivalent of +0.50D, visual field mean deviation −12.51dB and average retinal nerve fibre layer thickness of 60µm. Left: Concentric stimulus (ConStim) protocol with 24° (top) and 16° (bottom) settings. Signal quality was good (87dBµV). Right: Contrast Sensitivity (ConSen) protocol with high contrast (Hc) (top) and low contrast (Lc) (bottom) settings. Signal quality was similarly good (82dBµV).
Figure 3
Figure 3
Diopsys PERG trace of a patient from group HM. The right eye of this participant was included in the study and had spherical equivalent of −10.87D, visual field mean deviation −17.69dB and average retinal nerve fibre layer thickness of 56µm. Left: Concentric stimulus (ConStim) protocol with 24° (top) and 16° (bottom) settings. Signal quality was good (96dBµV). Right: Contrast Sensitivity (ConSen) protocol with high contrast (Hc) (top) and low contrast (Lc) (bottom) settings. Signal quality was similarly good (86dBµV).
Figure 4
Figure 4
Correlation plots of (A) MagD 16° and visual field mean deviation, (B) MagD/Mag ratio 16° and visual field mean deviation, (C) MagD 16° and optical coherence tomography retinal nerve fibre layer mean thickness and (D) MagD/Mag ratio 16° and optical coherence tomography retinal nerve fibre layer mean thickness.
See this image and copyright information in PMC

References

    1. Weinreb RN, Aung T, Medeiros FA. The pathophysiology and treatment of glaucoma: a review. JAMA. 2014;311(18):1901–1911. doi:10.1001/jama.2014.3192 - DOI - PMC - PubMed
    1. Quigley HA. Glaucoma. Lancet. 2011;377(9774):1367–1377. doi:10.1016/S0140-6736(10)61423-7 - DOI - PubMed
    1. Holden BA, Fricke TR, Wilson DA, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology. 2016;123(5):1036–1042. doi:10.1016/j.ophtha.2016.01.006 - DOI - PubMed
    1. Leung CK, Yu M, Weinreb RN, et al. Retinal nerve fiber layer imaging with spectral-domain optical coherence tomography: interpreting the RNFL maps in healthy myopic eyes. Invest Ophthalmol Vis Sci. 2012;53(11):7194–7200. doi:10.1167/iovs.12-9726 - DOI - PubMed
    1. Tan NYQ, Sng CCA, Ang M. Myopic optic disc changes and its role in glaucoma. Curr Opin Ophthalmol. 2019;30(2):89–96. doi:10.1097/ICU.0000000000000548 - DOI - PubMed