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Electroretinography in idiopathic intracranial hypertension: comparison of the pattern ERG and the photopic negative response

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Abstract

Purpose

To evaluate the relationship between electrophysiological measures of retinal ganglion cell (RGC) function in patients who have idiopathic intracranial hypertension (IIH).

Methods

The pattern electroretinogram (pERG) and photopic negative response (PhNR) were recorded from 11 IIH patients and 11 age-similar controls. The pERG was elicited by a contrast-reversing checkerboard. The PhNR, a slow negative component following the flash ERG b-wave, was recorded in response to a long-wavelength flash presented against a short-wavelength adapting field. The PhNR was elicited using full-field (ffPhNR) and focal macular (fPhNR) stimuli. Additionally, Humphrey visual field mean deviation (HVF MD) was measured and ganglion cell complex volume (GCCV) was obtained by optical coherence tomography.

Results

The ffPhNR, fPhNR, and pERG amplitudes were outside of the normal range in 45, 9, and 45% of IIH patients, respectively. However, only mean ffPhNR amplitude was reduced significantly in the patients compared to controls (p < 0.01). The pERG amplitude correlated significantly with HVF MD and GCCV (both r > 0.65, p < 0.05). There were associations between ffPhNR amplitude and HVF MD (r = 0.58, p = 0.06) and with GCCV (r = 0.52, p = 0.10), but these did not reach statistical significance. fPhNR amplitude was not correlated significantly with HVF MD or GCCV (both r < 0.40, p > 0.20).

Conclusions

Although the fPhNR is generally normal in IIH, other electrophysiological measures of RGC function, the ffPhNR and pERG, are abnormal in some patients. These measures provide complementary information regarding RGC dysfunction in these individuals.

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Acknowledgements

This project was supported by the National Institutes of Health Grants K12EY021475 (HM), K23EY024345 (HM), and P30EY01792 (UIC Core); an Illinois Society for the Prevention of Blindness Research Grant (HM); an unrestricted departmental grant, Sybil B. Harrington (HM) and Dolly Green (JM) Special Scholar Awards from Research to Prevent Blindness.

Funding

The National Institutes of Health, Research to Prevent Blindness, and the Illinois Society for the Prevention of Blindness provided financial support in the form of funding. The sponsors had no role in the design or conduct of this research.

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Correspondence to J. Jason McAnany.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Animals were not involved in this project.

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Informed consent was obtained from all individual participants included in the study.

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Park, J.C., Moss, H.E. & McAnany, J.J. Electroretinography in idiopathic intracranial hypertension: comparison of the pattern ERG and the photopic negative response. Doc Ophthalmol 136, 45–55 (2018). https://doi.org/10.1007/s10633-017-9620-z

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  • DOI: https://doi.org/10.1007/s10633-017-9620-z

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