title: Pattern electroretinogram progression in glaucoma suspects.
abstract: OBJECTIVE
  To prospectively monitor progressive changes of retinal ganglion cell function in early glaucoma using the pattern electroretinogram (PERG).
  
  
  METHODS
  Fifty-nine patients enrolled as glaucoma suspects were observed untreated over an average of 5.7±1.4 years, during which they were tested with PERG (PERGLA paradigm) and standard automated perimetry (SAP) 2 times per year. PERG amplitude and phase were normalized for physiological age-related changes, and linear regressions fitted to the data to calculate progression slopes (signal), slope SE (noise), and corresponding signal-to-noise ratios (SNR=slope÷SE). Linear regressions were also used to fit SAP global indices mean deviation (MD) and pattern standard deviation (PSD).
  
  
  RESULTS
  On average, progression slopes of PERG amplitude/phase were skewed toward negative values, their mean being significantly (P<0.01) different from zero. In contrast, mean slopes of SAP-MD and PSD were not significantly different from zero. SNRs were higher for PERG than SAP (P<0.01). A substantial number of eyes displayed significant (P<0.05) progression of PERG amplitude (15% to 20%) or PERG phase (16% to 25%). Fewer eyes displayed significant progression of SAP-MD (0% to 2%) or SAP-PSD (4% to 8%).
  
  
  CONCLUSIONS
  The PERG displayed clear longitudinal loss of signal (diminished amplitude, phase delay, or both) in a substantial number of eyes of patients, indicating progressive deterioration of retinal ganglion cell function. Progression of SAP global indices MD and PSD was found in a relatively smaller number of eyes. It remains to be established whether PERG progression has predictive value for developing visual dysfunction.
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
authors.forename: Lori M
authors.initials: LM
authors.lastname: Ventura
authors.forename: Iuri
authors.initials: I
authors.lastname: Golubev
authors.forename: William J
authors.initials: WJ
authors.lastname: Feuer
authors.forename: Vittorio
authors.initials: V
authors.lastname: Porciatti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D004596:Electroretinography; D006801:Humans; D007429:Intraocular Pressure; D008875:Middle Aged; D009798:Ocular Hypertension / Q000175:diagnosis / Q000503:physiopathology*; D010364:Pattern Recognition, Visual / Q000502:physiology*; D011446:Prospective Studies; D012165:Retinal Ganglion Cells / Q000502:physiology*; D059629:Signal-To-Noise Ratio; D014786:Vision Disorders / Q000175:diagnosis / Q000503:physiopathology*; D014792:Visual Acuity; D058609:Visual Field Tests; D014794:Visual Fields; D055815:Young Adult
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