scholarly journals Photopic negative response of full-field electroretinography in patients with different stages of glaucomatous optic neuropathy

2016 ◽  
Vol 132 (1) ◽  
pp. 57-65 ◽  
Author(s):  
Marta Kirkiewicz ◽  
Wojciech Lubiński ◽  
Krzysztof Penkala
Keyword(s):  
Optic Neuropathy ◽  
Negative Response ◽  
Photopic Negative Response ◽  
Glaucomatous Optic Neuropathy ◽  
Full Field

scholarly journals Comparison of Machine Learning Approaches to Improve Diagnosis of Optic Neuropathy Using Photopic Negative Response Measured Using a Handheld Device

2021 ◽  
Vol 8 ◽  
Author(s):  
Tina Diao ◽  
Fareshta Kushzad ◽  
Megh D. Patel ◽  
Megha P. Bindiganavale ◽  
Munam Wasi ◽  
...  
Keyword(s):  
Machine Learning ◽  
Time Series ◽  
Optic Neuropathy ◽  
Negative Response ◽  
Photopic Negative Response ◽  
Learning Approaches ◽  
Data Set ◽  
Full Field ◽  
Handheld Device ◽  
Technical Requirements

The photopic negative response of the full-field electroretinogram (ERG) is reduced in optic neuropathies. However, technical requirements for measurement and poor classification performance have limited widespread clinical application. Recent advances in hardware facilitate efficient clinic-based recording of the full-field ERG. Time series classification, a machine learning approach, may improve classification by using the entire ERG waveform as the input. In this study, full-field ERGs were recorded in 217 eyes (109 optic neuropathy and 108 controls) of 155 subjects. User-defined ERG features including photopic negative response were reduced in optic neuropathy eyes (p < 0.0005, generalized estimating equation models accounting for age). However, classification of optic neuropathy based on user-defined features was only fair with receiver operating characteristic area under the curve ranging between 0.62 and 0.68 and F1 score at the optimal cutoff ranging between 0.30 and 0.33. In comparison, machine learning classifiers using a variety of time series analysis approaches had F1 scores of 0.58–0.76 on a test data set. Time series classifications are promising for improving optic neuropathy diagnosis using ERG waveforms. Larger sample sizes will be important to refine the models.

scholarly journals The photopic negative response (PhNR): measurement approaches and utility in glaucoma

2020 ◽  
Vol 40 (12) ◽  
pp. 3565-3576
Author(s):  
Matteo Prencipe ◽  
Tommaso Perossini ◽  
Giampaolo Brancoli ◽  
Mario Perossini
Keyword(s):  
Optic Neuropathy ◽  
Negative Response ◽  
Photopic Negative Response ◽  
Diagnostic Process ◽  
Glaucomatous Optic Neuropathy ◽  
Specific Information ◽  
Automated Perimetry ◽  
Pattern Erg ◽  
Glaucomatous Damage ◽  
Additional Tool

Abstract Purpose Visual electrophysiological testing continues to generate interest among glaucoma experts because of its potential help in clarifying disease pathophysiology and promoting early detection of glaucomatous damage. The photopic negative response (PhNR) is a slow negative component of the full-field electroretinogram that has been shown to provide specific information about retinal ganglion cells (RGCs) activity. The purpose of this article is to review the literature to explore the currently available measurement methods and the utility of PhNR in glaucoma diagnostic process. Methods We gathered publications related to the origins, types of stimuli used, measurements methods and applications of the PhNR of ERG in animal models and humans through a search of the literature cited in PubMed. Search terms were: “PhNR”, “photopic negative response”, “glaucoma”, “glaucomatous optic neuropathy”, “ERG”, “electroretinogram”. Results The most reliable PhNR measurements are obtained using a red stimulus on a blue background, without requiring refractive correction, fixation monitoring, or ocular media transparency. Given its direct correlation with RGCs response, the PhNR measured as baseline-to-trough (BT) represents the most reliable parameter of evaluation. Glaucoma patients with evident perimetric defects show pathologic PhNR values. Even though the PhNR is promising in detecting early RGCs impairment, distinguishing between healthy subjects and suspect patients at risk of developing glaucomatous damage still remains challenging. Conclusion The PhNR is a useful additional tool to explore disorders that affect the innermost retina, including glaucoma and other forms of optic neuropathy. In particular, comparing reports of the standard examinations (optic disc assessment, OCT RNFL measurement, standard automated perimetry) with the results of electrophysiological tests may be helpful in solving clinical diagnostic and management dilemmas. On the one hand, the PhNR of the ERG can examine the parvocellular pathways; on the other hand, the steady-state pattern ERG optimized for glaucoma screening (PERGLA) can explore the magnocellular pathways. This could give ophthalmologists a useful feedback to identify early RGCs alterations suggestive of glaucoma, stratify the risk and potentially monitor disease progression.

scholarly journals Comparison of Photopic Negative Response of Full-Field and Focal Electroretinograms in Detecting Glaucomatous Eyes

2011 ◽  
Vol 2011 ◽  
pp. 1-11 ◽  
Author(s):  
Shigeki Machida ◽  
Kunifusa Tamada ◽  
Taku Oikawa ◽  
Yasutaka Gotoh ◽  
Tomoharu Nishimura ◽  
...  
Keyword(s):  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Negative Response ◽  
Photopic Negative Response ◽  
Diagnostic Ability ◽  
Full Field ◽  
Receiver Operating Characteristic Curves ◽  
Advanced Glaucoma ◽  
Blue Background ◽  
Higher Sensitivity

Purpose. To compare the photopic negative response (PhNR) of the full-field electroretinogram (ERG) to the PhNR of the focal ERGs in detecting glaucoma.Methods. One hundred and three eyes with glaucoma and 42 normal eyes were studied. Full-field ERGs were elicited by red stimuli on a blue background. The focal ERGs were elicited by a15∘white stimulus spot centered on the macula, the superotemporal or the inferotemporal areas of the macula.Results. In early glaucoma, the areas under the receiver operating characteristic curves (AUCs) were significantly larger for the focal PhNR (0.863–0.924) than those for the full-field PhNR (0.666–0.748) (P<.05). The sensitivity was significantly higher for the focal PhNR than for the full-field PhNR in early (P<.01) and intermediate glaucoma (P<.05). In advanced glaucoma, there was no difference in the AUCs and sensitivities between the focal and full-field PhNRs.Conclusions. The focal ERG has the diagnostic ability with higher sensitivity in detecting early and intermediate glaucoma than the full-field ERG.

scholarly journals Electrophysiological markers of preclinical diagnosis of glaucomatous optic neuropathy

2021 ◽  
Vol 14 (1) ◽  
pp. 35-41
Author(s):  
M. O. Kirillova ◽  
M. V. Zueva ◽  
I. V. Tsapenko ◽  
A. N. Zhuravleva
Keyword(s):  
Optic Neuropathy ◽  
Ganglion Cells ◽  
Open Angle Glaucoma ◽  
Statistical Significance ◽  
Photopic Negative Response ◽  
Glaucomatous Optic Neuropathy ◽  
Functional Changes ◽  
Bright Flash ◽  
Pattern Size ◽  
Group 2

Purpose: to evaluate the changes in electrophysiological indicators reflecting various aspects of the function of retinal ganglion cells (RGC) and their axons in the early diagnosis of glaucomatous optic neuropathy (GON).Material and methods. Two clinical groups, (1) 35 patients (60 eyes) aged 49 to 70 with suspected glaucoma and (2) 16 patients (30 eyes) aged 43–68 with initial primary open-angle glaucoma (POAG), and a comparison group of 38 relatively healthy subjects (45 eyes) aged 42–70 were tested for pattern-reversed visual evoked potentials (PVEP), transient and stationary pattern-ERGs (PERG) according to ISCEV, and photopic negative response (PhNR).Results. The P100 amplitudes in both clinical groups differed significantly from the norm in PVEP on small and large patterns. The elongation of peak latency (T) of P100 compared with norm was significant for the stimulus 1° in group 2. In both groups of patients, increased variability of the temporal parameters of PERG and PVEP for small patterns was found. In groups 1 and 2, a decrease in the amplitude of P50 and N95 peaks of transient PERG for all stimuli was revealed, which was the most significant for the 0.3° pattern. In group 1, the N95 peak was significantly delayed in PERG for large patterns. A statistically significant reduction in the steady-state PERG's amplitude was found in the groups of suspected glaucoma and initial POAG. The sharpest changes were found for small (0.8° and 0.3°) patterns. The elongation of T compared to the norm was most pronounced for PERG at 0.3°, but due to the high variability of temporary indicators within the group, it had no statistical significance. The amplitude of PhNR was significantly different from the norm in the ERG for a flash of 3.0 cd·sec/m2.Conclusion. In patients with suspected glaucoma, a decrease in the P100 VEP amplitude with the simultaneous elongation of T may be considered as a criteria for the plastic stage at the level of lateral geniculate nucleus. Markers of functional changes in RGCs are the decrease in the amplitude of PhNR in response to bright flash, and P50 and N95 of PERG for pattern size 0.3°. The results indicate a greater vulnerability of the parvocellular system to early events in the development of GON.

The Photopic Negative Response evaluation in patients with Leber's hereditary optic neuropathy

2021 ◽  
pp. 216-219
Author(s):  
M.S. Shmelkova ◽  
◽  
N.L. Sheremet ◽  
I.A. Ronzina ◽  
N.A. Andreeva ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Ganglion Cells ◽  
Optic Neuropathy ◽  
Ganglion Cells ◽  
Negative Response ◽  
Photopic Negative Response ◽  
Control Group ◽  
Retinal Ganglion ◽  
Leber's Hereditary Optic Neuropathy ◽  
Hereditary Optic Neuropathy

Purpose. To assess the retinal ganglion cells function in patients with Leber's hereditary optic neuropathy (LHON) by registering the photopic negative response (PhNR) while the photopic electroretinography is performed. Material and methods. 14 patients with different LHON mutations and 9 healthy individuals were examined. A standard ophtalmological examination was performed, including visual fields, spectral optical coherence tomography, photopic electroretinography and PhNR tests. Results. Significant differences in the PhNR latency (68.4±4.01/64.28±5.37, p<0,01) and the PhNR amplitude (21.5±9.34/32.72±12.73, p<0,003) were revealed in patients with LHON and the control group. The study revealed significant differences between the PhNR latency (р<0.01) and the PhNR amplitude (р<0.008) in patients with visual acuity (VA) ≤ 0.1 and the control group, and between the PhNR amplitude in patients with VA≥0.13 and the control group (р<0.05). There were found significant correlations between the PhNR parameters and visual acuity, mean sensitivity, RNFL and GCC thickness. A strong positive correlation was found between the PhNR amplitude and the GCC thickness in patients with VA≥0.3. Conclusion. The PhNR parameters reflect the retinal ganglion cells function in patients with LHON and correlate with RNFL and GCC structural changes. Key words: Leber hereditary optic neuropathy, mitochondrial optical neuropathies, retinal ganglion cell, photopic negative response, PhNR.

scholarly journals 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

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&gt;A [N = 15 (62%), 14 males]; m.14484T&gt;C [N = 5 (21%), all males] and m.3460G&gt;A [N = 4 (17%), all males] and 14 carriers [13 females, mean age: 43.2 ± 13.3 yrs; m.11778G&gt;A (N = 11); m.3460G&gt;A (N = 2) and m.14484T&gt;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 &lt; 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 &lt; 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.

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

2009 ◽  
Vol 53 (6) ◽  
pp. 608-614 ◽  
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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