Measurement of macular structure-function relationships using spectral domain-optical coherence tomography (SD-OCT) and pattern electroretinograms (PERG)

by Keunheung Park, Jinmi Kim, Jiwoong Lee

Retinal ganglion cell (RGC) death is a common cause of loss of vision during glaucoma. Pattern electroretinogram (PERG) is an objective measure of the central retinal function that correlates with macular GCL thickness. The aim of this study is to determine possible relationships between the N95 amplitude of pattern electroretinogram (PERG_amp) and macular ganglion cell/inner plexiform layer thickness (GCIPLT).

This was a retrospective and comparative study including 74 glaucoma patients (44 early stage and 30 advanced stage cases) and 66 normal control subjects. Macular GCIPLT was measured using Cirrus spectral domain-optical coherence tomography. Standard automated perimetry and pattern ERGs were used in all patient examinations. Three types of regression analysis (broken stick, linear regression, and quadratic regression) were used to evaluate possible relationships between PERG_amp and GCIPLT. Correlations between visual field parameters and GCIPLT were evaluated according to glaucoma severity. The best fit model for the relationship between PERG_amp and GCIPLT was the linear regression model (r² = 0.22; P < 0.001). The best-fit model for the relationship between visual field parameters and GCIPLT was the broken stick model. During early glaucoma, macular GCIPLT was positively correlated with PERG_amp, but not with visual field loss. In advanced glaucoma, macular GCIPLT was positively correlated with both PERG_amp and visual field loss.

PERG_amp was significantly correlated with macular GCIPT in early glaucoma patients, while visual field performance showed no correlation with GCIPLT. PERG_amp can therefore assist clinicians in making an early decision regarding the most suitable treatment plan, especially when GCIPLT is thinning with no change in visual field performance.