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Functional involvement of cone photoreceptors in advanced glaucoma: a multifocal electroretinogram study

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Abstract

The purpose of the study is (1) to demonstrate the anatomical variation of cone photoreceptor density across normal retina as a sectoral amplitude asymmetry of photopic multifocal electroretinogram (mfERG) and (2) to study the potential presence of sequential or differential, functional cone photoreceptor damage in glaucoma using this amplitude asymmetry. A 37-Block scaled mfERG was recorded from 22 controls and 27 glaucoma subjects. The N1 and P1 amplitudes of averaged responses from corresponding zones nasal and temporal to fovea were analyzed for asymmetry in controls and glaucoma subjects. Amplitude asymmetry was demonstrable for both N1 (p < 0.001) and P1 (p < 0.001) parameters in control subjects. Although this amplitude asymmetry was preserved in glaucoma subjects with moderate field defects, it was not demonstrable in patients with advanced field defects. The anatomical variation in cone photoreceptor distribution across normal retina is demonstrated as an amplitude asymmetry in first order kernel responses of mfERG. The cone photoreceptors in the region nasal to fovea appear to be affected only in advanced glaucoma possibly suggesting that photoreceptors could follow a sequential damage like the overlying neuroretinal rim in glaucoma.

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Acknowledgments

The authors are thankful to Dr. Rashmi Rodriguez and Dr. Pretesh R Kiran (St. John’s medical college, Bangalore) for assistance in statistics. The authors are thankful to Dr. Charlier, J (Metrovision, France) for customizing mfERG stimulus. The authors are thankful to Dr. Somashekhar N and Dr. Prasanth CN (Narayana Nethralaya, Bangalore) for assistance in recruiting control subjects. The authors are thankful to Mrs. Vijayalakshmi Pires (PhD Eng Litt) and Mrs. Thaliath, NMAF for assistance in English language editing. The authors are thankful to Mrs Revathi MP for assistance in mfERG recording and Mr. Muhammed Naizal T (Narayana Ophthalmic Multimedia Art Department) for assistance in figures.

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Authors and Affiliations

  1. Department of Electrophysiology, Narayana Nethralaya, Super Specialty Eye Hospital and Post Graduate Institute of Ophthalmology, 121/C, Chord Road, Rajaji Nagar 1st ‘R’ Block, Bangalore, 560010, India

    Ajoy Vincent, Rohit Shetty & Bhujang Shetty

  2. Department of Glaucoma, Narayana Nethralaya, Super Specialty Eye Hospital and Post Graduate Institute of Ophthalmology, 121/C, Chord Road, Rajaji Nagar 1st ‘R’ Block, Bangalore, 560010, India

    Sathi A. V. Devi & Ramgopal Balu

  3. Department of Epidemiology and Medical Statistics, Narayana Nethralaya, Super Specialty Eye Hospital and Post Graduate Institute of Ophthalmology, 121/C, Chord Road, Rajaji Nagar 1st ‘R’ Block, Bangalore, 560010, India

    Mathew K. Kurian

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  1. Ajoy Vincent
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  2. Rohit Shetty
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Correspondence to Ajoy Vincent.

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Vincent, A., Shetty, R., Devi, S.A.V. et al. Functional involvement of cone photoreceptors in advanced glaucoma: a multifocal electroretinogram study. Doc Ophthalmol 121, 21–27 (2010). https://doi.org/10.1007/s10633-010-9227-0

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  • DOI: https://doi.org/10.1007/s10633-010-9227-0

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