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Pattern electroretinography improves early glaucoma detection

Issue: June 2016

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NEW ORLEANS — Pattern electroretinography is a reliable and objective tool for diagnosing and managing glaucoma, particularly in low-risk glaucoma suspects, a speaker told colleagues here.

“Pattern ERG is probably one of the most useful clinical tools for glaucoma patients and early glaucoma suspects. It has really changed who we are treating and I think, based on that, we’re doing a better job of identifying the average risk and the lower risk people who we can defer treatment on as well,” Robert J. Noecker, MD, said at Glaucoma Day preceding the American Society of Cataract and Refractive Surgery meeting.

Robert J. Noecker

Visual fields and optical coherence tomography (OCT) detect changes resulting from retinal ganglion cell death, Noecker said.

“If you have an OCT change, you’re measuring dead stuff. If you have a visual field defect, you’re measuring dead stuff. We want to measure [live cells] and we want to decide earlier which [cells are] dysfunctional or at risk,” he said. “With pattern ERG, we can measure recovery. We’re measuring live cells. In glaucoma, the live cells will function less well at higher pressures. If we can manipulate that, we can improve function.”

PERG measures retinal electrophysiology and, most importantly, function of retinal ganglion cells, Noecker said.

“You want to generate the stimulus and want to see that this stimulus is reflected in the brain,” he said.

Noecker pointed out that various studies have shown the effectiveness of PERG in detecting early glaucoma in suspects and low-risk patients with ocular hypertension, family history of glaucoma and thin corneas. – by Matt Hasson and Patricia Nale, ELS

Reference:

Noecker RJ. Pattern electroretinogram (PERG) and glaucoma. Presented at: American Society of Cataract and Refractive Surgery meeting; May 6-10, 2016; New Orleans.

Disclosure: Noecker reports he is a consultant for Diopsys.