Significant correlations between photopic negative response, afferent pupillary defect, and mean defects of visual fields in asymmetric optic nerve disorders

Abstract Background The nasal to temporal amplitudes ratio (N/T) of multifocal electroretinography (mfERG) scans measured within 5° of the macula can be used to detect glaucomatous change. The photopic negative response (PhNR) of mfERG elicited by a circular stimulus centered on the fovea was significantly reduced in eyes with glaucoma. The PhNR to B-wave ratio (PhNR/B) is the optimal measure of the PhNR. However, clinical superiority for evaluating glaucoma patients has not been determined between N/T and PhNR/B yet. Methods For morphological assessments, ganglion cell complex (GCC) in six regions and the average were measured by optical coherence tomography (OCT). For functional assessment, Humphrey visual fields (VF) with mean sensitivities (MT) and mfERG scans with parameters of N/T and the multifocal photopic negative response to B-wave ratio (mfPhNR/B) were measured. Sixty-nine eyes of 44 glaucoma patients were included and correlations between mfERG parameters and OCT or VF parameters were evaluated. Results The mean age of patients was 59.4 years. The mean deviation for all eyes obtained with the VF 30–2 and VF 10–2 was − 7.00 and − 6.31 dB, respectively. Significant correlations between GCC thickness or VF parameter and the N/T were found, especially in the inferior and inforotemporal retinal areas corresponding to superior and superonasal VF sectors (GCC vs N/T; coefficient = − 7.916 and − 7.857, and MT vs N/T; coefficient = − 4.302 and − 4.437, in the inferior and inforotemporal retinal areas, respectively, all p values < 0.05). However, similar associations were not obtained between mfPhNR/B and OCT or VF parameters. The mfPhNR/B only in the inferotemporal sector was significantly correlated with the average thickness of GCC (coefficient = 4.823, P = 0.012). Conclusions The N/T was correlated with GCC and VF in more numbers of measurement areas than the mfPhNR/B in the current study, however, a future study modifying the stimuli and amplitudes to obtain the spatial correspondence to OCT and VF measurement will be required to evaluate the value of mfERG.

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Clinical Applications of the Photopic Negative Response to Optic Nerve and Retinal Diseases

Journal of Ophthalmology ◽

10.1155/2012/397178 ◽

2012 ◽

Vol 2012 ◽

pp. 1-11 ◽

Cited By ~ 20

Author(s):

Shigeki Machida

Keyword(s):

Optic Nerve ◽

Ganglion Cells ◽

Objective Assessment ◽

Visual Sensitivity ◽

Negative Response ◽

Photopic Negative Response ◽

Retinal Diseases ◽

Automated Perimetry ◽

Retinal Ganglion ◽

Standard Automated Perimetry

The photopic negative response (PhNR) in response to a brief flash is a negative-going wave following the b-wave of the cone electroretinogram (ERG) that is driven by retinal ganglion cells (RGCs). The function of RGCs is objectively evaluated by analysing the PhNR. We reviewed articles regarding clinical use of the PhNR. The PhNR was well correlated with the visual sensitivity obtained by standard automated perimetry and morphometric parameters of the inner retina and optic nerve head in optic nerve and retinal diseases. Moreover, combining the PhNR with focal or multifocal ERG techniques enables the objective assessment of local function of RGCs. The PhNR is therefore likely to become established as an objective functional test for optic nerve and retinal diseases involving RGC injury.

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Impaired Ganglion Cell Function Objectively Assessed by the Photopic Negative Response in Affected and Asymptomatic Members From Brazilian Families With Leber's Hereditary Optic Neuropathy

Frontiers in Neurology ◽

10.3389/fneur.2020.628014 ◽

2021 ◽

Vol 11 ◽

Author(s):

Gabriel Izan Santos Botelho ◽

Solange Rios Salomão ◽

Célia Harumi Tengan ◽

Rustum Karanjia ◽

Felipo Victor Moura ◽

...

Keyword(s):

Ganglion Cell ◽

Cell Function ◽

Visual Fields ◽

Color Discrimination ◽

Negative Response ◽

Photopic Negative Response ◽

Control Group ◽

Full Field ◽

Asymptomatic Carriers ◽

Mtdna Mutations

Purpose: The photopic negative response (PhNR) is an electrophysiological method that provides retinal ganglion cell function assessment using full-field stimulation that does not require clear optics or refractive correction. The purpose of this study was to assess ganglion cell function by PhNR in affected and asymptomatic carriers from Brazilian families with LHON.Methods: Individuals either under suspicion or previously diagnosed with LHON and their family members were invited to participate in this cross-sectional study. Screening for the most frequent LHON mtDNA mutations was performed. Visual acuity, color discrimination, visual fields, pattern-reversal visual evoked potentials (PRVEP), full-field electroretinography and PhNR were tested. A control group of healthy subjects was included. Full-field ERG PhNR were recorded using red (640 nm) flashes at 1 cd.s/m2, on blue (470 nm) rod saturating background. PhNR amplitude (μV) was measured using baseline-to-trough (BT). Optical coherence tomography scans of both the retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) were measured. PhNR amplitudes among affected, carriers and controls were compared by Kruskal-Wallis test followed by post-hoc Dunn test. The associations between PhNR amplitude and OCT parameters were analyzed by Spearman rank correlation.Results: Participants were 24 LHON affected patients (23 males, mean age=30.5 ± 11.4 yrs) from 19 families with the following genotype: m.11778G>A [N = 15 (62%), 14 males]; m.14484T>C [N = 5 (21%), all males] and m.3460G>A [N = 4 (17%), all males] and 14 carriers [13 females, mean age: 43.2 ± 13.3 yrs; m.11778G>A (N = 11); m.3460G>A (N = 2) and m.14484T>C (N = 1)]. Controls were eight females and seven males (mean age: 32.6 ± 11.5 yrs). PhNR amplitudes were significantly reduced (p = 0.0001) in LHON affected (−5.96 ± 3.37 μV) compared to carriers (−16.53 ± 3.40 μV) and controls (−23.91 ± 4.83; p < 0.0001) and in carriers compared to controls (p = 0.01). A significant negative correlation was found between PhNR amplitude and total macular ganglion cell thickness (r = −0.62, p < 0.05). Severe abnormalities in color discrimination, visual fields and PRVEPs were found in affected and subclinical abnormalities in carriers.Conclusions: In this cohort of Brazilian families with LHON the photopic negative response was severely reduced in affected patients and mildly reduced in asymptomatic carriers suggesting possible subclinical abnormalities in the latter. These findings were similar among pathogenic mutations.

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Photopic negative response of full-field and focal macular electroretinograms in patients with optic nerve atrophy

Japanese Journal of Ophthalmology ◽

10.1007/s10384-009-0731-2 ◽

2009 ◽

Vol 53 (6) ◽

pp. 608-614 ◽

Cited By ~ 10

Author(s):

Kunifusa Tamada ◽

Shigeki Machida ◽

Daisuke Yokoyama ◽

Daijiro Kurosaka

Keyword(s):

Optic Nerve ◽

Negative Response ◽

Photopic Negative Response ◽

Optic Nerve Atrophy ◽

Full Field

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The Decline of the Photopic Negative Response (PhNR) in the Rat after Optic Nerve Transection

Documenta Ophthalmologica ◽

10.1007/s10633-005-2629-8 ◽

2005 ◽

Vol 111 (1) ◽

pp. 23-31 ◽

Cited By ~ 35

Author(s):

B. Li ◽

G. E. Barnes ◽

W. F. Holt

Keyword(s):

Optic Nerve ◽

Negative Response ◽

Photopic Negative Response ◽

Nerve Transection ◽

Optic Nerve Transection

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Visual Fields Versus Visual Evoked Potentials in Optic Nerve Disorders

Documenta Ophthalmologica Proceedings Series - Fifth International Visual Field Symposium ◽

10.1007/978-94-009-7272-8_31 ◽

1983 ◽

pp. 239-244 ◽

Cited By ~ 2

Author(s):

Takahiro Ohnuma ◽

Yusaku Tagami ◽

Yoshimasa Isayama

Keyword(s):

Optic Nerve ◽

Evoked Potentials ◽

Visual Evoked Potentials ◽

Visual Fields ◽

Optic Nerve Disorders ◽

Visual Evoked

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Relationship between structural and functional changes in glaucomatous eyes: A multifocal electroretinogram study

10.21203/rs.2.20694/v2 ◽

2020 ◽

Author(s):

Hiroki Tanaka ◽

Kyoko Ishida ◽

Kenji Ozawa ◽

Takuma Ishihara ◽

Akira Sawada ◽

...

Keyword(s):

Multifocal Electroretinogram ◽

Visual Fields ◽

Negative Response ◽

Photopic Negative Response ◽

Mean Deviation ◽

Ganglion Cell Complex ◽

P Values ◽

Functional Changes ◽

The Mean ◽

Optimal Measure

Abstract Background: The nasal to temporal amplitudes ratio (N/T) of multifocal electroretinography (mfERG) scans measured within 5° of the macula can be used to detect glaucomatous change. The photopic negative response (PhNR) of mfERG elicited by a circular stimulus centered on the fovea was significantly reduced in eyes with glaucoma. The PhNR to B-wave ratio (PhNR/B) is the optimal measure of the PhNR. However, clinical superiority for evaluating glaucoma patients has not been determined between N/T and PhNR/B yet. Methods: For morphological assessments, ganglion cell complex (GCC) in six regions and the average were measured by optical coherence tomography (OCT). For functional assessment, Humphrey visual fields (VF) with mean sensitivities (MT) and mfERG scans with parameters of N/T and the multifocal photopic negative response to B-wave ratio (mfPhNR/B) were measured. Sixty-nine eyes of forty-four glaucoma patients were included and correlations between mfERG parameters and OCT or VF parameters were evaluated. Results: The mean age of patients was 59.4 years. The mean deviation for all eyes obtained with the VF 30-2 and VF 10-2 was -7.00 and -6.31 dB, respectively. Significant correlations between GCC thickness or VF parameter and the N/T were found, especially in the inferior and inforotemporal retinal areas corresponding to superior and superonasal VF sectors (GCC vs N/T; coefficient = -7.916 and -7.857, and MT vs N/T ; coefficient = -4.302 and -4.437, in the inferior and inforotemporal retinal areas, respectively, all p values < 0.05). However, similar associations were not obtained between mfPhNR/B and OCT or VF parameters. The mfPhNR/B only in the inferotemporal sector was significantly correlated with the average thickness of GCC (coefficient = 4.823, P = 0.012). Conclusions: The N/T is better parameter than PhNR/B for the assessment of glaucomatous eyes in the current study’s measurement conditions. A future study modifying the stimuli and amplitudes to obtain the spatial correspondence to OCT and VF measurement will be required to evaluate the value of mfERG.

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