Sensitivity and specificity of the uniform field electroretinogram in glaucoma detection in comparison to the pattern electroretinogram

Purpose To determine the ability of the photopic negative response (PhNR) of the uniform field electroretinogram (UF-ERG) to identify early glaucomatous changes in comparison to the checkerboard and bar stimuli of the pattern electroretinogram (PERG). Methods Forty-nine glaucoma patients were classi...

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Bibliographic Details
Published in:Documenta ophthalmologica 2024-04, Vol.148 (2), p.97-106
Main Authors: Hermas, Asma, Tsilfidis, Catherine, Karanjia, Rustum, Miller, Garfield, Kantungane, Ange-Lynca, El-Salibi, Amanda, Kherani, Irfan N., Bali, Shveta, Coupland, Stuart
Format: Article
Language:English
Subjects:
Electroretinograms
Electroretinography - methods
Eye
Glaucoma
Glaucoma - diagnosis
Humans
Medicine
Medicine & Public Health
Ocular Hypertension - diagnosis
Ophthalmology
Original Research Article
Retinal Ganglion Cells - physiology
Sensitivity and Specificity
Visual field
Visual Field Tests
Visual Fields
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Summary:Purpose To determine the ability of the photopic negative response (PhNR) of the uniform field electroretinogram (UF-ERG) to identify early glaucomatous changes in comparison to the checkerboard and bar stimuli of the pattern electroretinogram (PERG). Methods Forty-nine glaucoma patients were classified into two groups: glaucoma-suspect (23 eyes) and early to moderate glaucoma (30 eyes), based on their clinical examination and the results of standard automated perimetry. Thirty patients (30 eyes) with intraocular pressures (IOP) of 21 mmHg or less, with no history of reported high IOP, were included as controls. PERG and UF-ERG recordings were obtained on a Diagnosys D-341 Attaché-Envoy System. Visual field testing was done only for glaucoma-suspect and glaucoma patients. Results All three tests (PERG bar stimulus, PERG checkerboard stimulus and PhNR) displayed significantly prolonged peak times for glaucoma and glaucoma-suspect patients, with delays ranging from 7.8 to 14.8%, depending on the test. The PERG bar stimulus also showed a significantly lower N95 amplitude for both glaucoma groups (with reductions of 26.0% and 33.0% for glaucoma–suspect and glaucoma groups, respectively). The PERG checkerboard N95 amplitude component had high sensitivity for detecting glaucoma patients but a low specificity (97% and 37%, respectively; AUC = 0.61). Overall, the PhNR peak time showed the highest sensitivity and specificity (77% and 90%, respectively; AUC = 0.87). Conclusions PERG bar stimuli and the PhNR of the UF-ERG can be used in the clinical setting to detect glaucoma-related changes in glaucoma-suspect and glaucoma patients. However, our data confirm that the PhNR peak time has the best combined sensitivity and specificity.
ISSN:0012-4486
1573-2622
DOI:10.1007/s10633-023-09960-9