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Comparison between broadband and monochromatic photopic negative response in full-field electroretinogram in controls and subjects with primary open-angle glaucoma

  • Aniruddha Banerjee
  • Mona Khurana
  • Ramya Sachidanandam
  • Parveen SenEmail author
Original Research Article
  • 11 Downloads

Abstract

Purpose

A prospective, cross-sectional, case–control study was conducted to investigate the role of broadband and monochromatic photopic negative response (PhNR) of the full-field flash electroretinogram (ERG) in the evaluation of ganglion cell damage in primary open-angle glaucoma (POAG) subjects.

Methods

Subjects with POAG and age-matched normal subjects were recruited from the outpatient department of a tertiary eye care center in South India. A total of 25 patients with POAG and 50 age-matched normal subjects were recruited. ERG was recorded using broadband (3.5 cd.s/m2 white stimulus on 10 cd/m2 white background) and monochromatic (3.5 cd.s/m2 red stimulus on 10 cd/m2 blue background and 1 cd.s/m2 blue stimulus on 10 cd/m2 yellow background) stimuli.

Results

The reduction in PhNR amplitude in POAG compared to normal individuals was higher in red-on-blue PhNR [26.37 µV; p < 0.001, confidence interval (CI) 19.34 to 33.4] as compared to broadband stimuli (16.41 µV; p < 0.001, CI 8.68 to 24.13), and blue on yellow (21.96 µV; p < 0.001, CI 10.12 to 33.8). Red-on-blue PhNR amplitudes correlated better with mean deviation (MD; r = − 0.66, p < 0.05), pattern standard deviation (PSD; r = − 0.4, p = 0.04), visual field index (VFI; r = − 0.58, p < 0.05), and retinal nerve fiber layer thickness (r = − 0.67, p < 0.05) in comparison with broadband and monochromatic blue-on-yellow PhNR. Receiver operating characteristic curve revealed largest area under the curve (0.89) in red-on-blue PhNR compared to broadband (0.76) and blue on yellow (0.74). The sensitivity and specificity was also higher in red-on-blue PhNR (72% and 80%, respectively) as compared to the other stimuli (sensitivity and specificity of broadband 0.68 and 0.7, blue on yellow 0.64 and 0.7, respectively).

Conclusion

Correlation of PhNR with Humphrey visual field parameters and retinal nerve fiber layer thickness showed that red-on-blue PhNR can be a useful additional tool for clinical assessment of retinal ganglion cell dysfunction in glaucoma patients. Red-on-blue PhNR was more sensitive as compared to white-on-white and blue-on-yellow PhNR in identifying ganglion cell dysfunction and correlates well with other structural and functional tests for glaucoma such as MD, PSD, VFI, and RNFL thickness.

Keywords

Full-field electroretinogram Photopic negative response Broadband ERG Monochromatic ERG Primary open-angle glaucoma 

Notes

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interests.

Statement of human rights

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 Declaration of Helsinki and its later amendments or comparable ethical standards.

Statement on the welfare of animals

This article does not contain any studies with animals performed by any of the authors.

Informed consent

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

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Elite School of Optometry, Unit of Medical Research FoundationChennaiIndia
  2. 2.Srimathi Sundari Subramanian Department of Visual PsychophysicsSankara NethralayaChennaiIndia
  3. 3.Department of Retina, Shri Bhagwan Mahavir Vitreoretinal ServicesSankara Nethralaya, Medical Research FoundationChennaiIndia
  4. 4.Smt. Jadhavbai Nathamal Singhvee Glaucoma ServicesSankara NethralayaChennaiIndia

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