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Luminance-modulated adaptation in the global flash mfERG: a preliminary study of early retinal functional changes in high-risk glaucoma patients

  • Glaucoma
  • Published:
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Abstract

Purpose

To investigate the association of the luminance-modulation global flash multifocal electroretinogram (mfERG) and other clinical assessments of vision in subsets of subjects at high risk of developing glaucomatous damage.

Methods

Eighteen subjects (28 eyes) with asymmetric glaucoma and ocular hypertension were measured in this longitudinal study of visual field, OCT, and multifocal electroretinogram (mfERG). Five ophthalmic examinations were scheduled, once every 12 months over a 4-year period. The mfERG was assessed using a luminance-modulated global flash stimulation paradigm. The adaptive index which we have reported previously was calculated.

Results

There was a significant thinning of the peripapillary retinal nerve fiber layer over the course of the study for eyes with ocular hypertension, or for fellow eyes with asymmetric glaucoma which initially had an abnormal adaptive index; such eyes showed a thinning rate of −3.59 and −3.69 μm/year, respectively. However, no significant thinning was found for eyes which initially had a normal adaptive index. Two subjects were shown to have glaucomatous damage, confirmed by abnormal thinning of the retinal nerve fiber layer and visual field loss respectively at the last visit. However, these patients had shown an abnormal adaptive index in the mfERG measurement at the first visit.

Conclusions

The adaptive index calculated from the measurement of luminance-modulated global flash mfERG is useful for predicting progression of signs related to glaucoma, especially in high-risk groups. The abnormal adaptive index reflects the change in fast-adaptive mechanisms in the retina and indicates the risk of developing glaucoma.

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Acknowledgements

This study was supported by the Competitive Earmark Research Grant (PolyU 5384/04 M) from The Research Grants Committee of the Hong Kong SAR, the Grants for Post-Doctoral Fellowship (G-YX3C) and the Niche Areas – Glaucoma Research (J-BB76) from The Hong Kong Polytechnic University.

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Authors and Affiliations

  1. Laboratory of Experimental Optometry (Neuroscience), School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China

    Patrick HW Chu, Yiu-fai Ng, Chi-ho To & Henry HL Chan

  2. Department of Anatomy, Research Centre of Heart, Brain, Hormone and Healthy Aging, The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China

    Kwok-fai So

  3. Institute of Health and Biological Innovation and School of Optometry, Queensland University of Technology, Brisbane, Australia

    Brian Brown

  4. School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China

    Henry HL Chan

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  1. Patrick HW Chu
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Correspondence to Henry HL Chan.

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HW Chu, P., Ng, Yf., To, Ch. et al. Luminance-modulated adaptation in the global flash mfERG: a preliminary study of early retinal functional changes in high-risk glaucoma patients. Graefes Arch Clin Exp Ophthalmol 250, 261–270 (2012). https://doi.org/10.1007/s00417-011-1790-x

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  • DOI: https://doi.org/10.1007/s00417-011-1790-x

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