Progressive loss of retinal ganglion cell function precedes structural loss by several years in glaucoma suspects

Michael R. Banitt, Lori M. Ventura, William J Feuer, Eleonore Savatovsky, Gabriel Luna, Olga Shif, Brandon Bosse, Vittorio Porciatti

Research output: Contribution to journalArticle

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Abstract

PURPOSE. We determined the time lag between loss of retinal ganglion cell function and retinal nerve fiber layer (RNFL) thickness. METHODS. Glaucoma suspects were followed for at least four years. Patients underwent pattern electroretinography (PERG), optical coherence tomography (OCT) of the RNFL, and standard automated perimetry testing at 6-month intervals. Comparisons were made between changes in all testing modalities. To compare PERG and OCT measurements on a normalized scale, we calculated the dynamic range of PERG amplitude and RNFL thickness. The time lag between function and structure was defined as the difference in time-to-criterion loss between PERG amplitude and RNFL thickness. RESULTS. For PERG (P < 0.001) and RNFL (P1/40.030), there was a statistically significant difference between the slopes corresponding to the lowest baseline PERG amplitude stratum (≤50%) and the reference stratum (>90%). Post hoc comparisons demonstrated highly significant differences between RNFL thicknesses of eyes in the stratum with most severely affected PERG (≤50%) and the two strata with least affected PERG (>70%). Estimates suggested that the PERG amplitude takes 1.9 to 2.5 years to lose 10% of its initial amplitude, whereas the RNFL thickness takes 9.9 to 10.4 years to lose 10% of its initial thickness. Thus, the time lag between PERG amplitude and RNFL thickness to lose 10% of their initial values is on the order of 8 years. CONCLUSIONS. In patients who are glaucoma suspects, PERG signal anticipates an equivalent loss of OCT signal by several years.

Original languageEnglish
Pages (from-to)2346-2352
Number of pages7
JournalInvestigative Ophthalmology and Visual Science
Volume54
Issue number3
DOIs
StatePublished - Apr 5 2013

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Electroretinography
Ocular Hypertension
Retinal Ganglion Cells
Nerve Fibers
Optical Coherence Tomography
Visual Field Tests

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

Cite this

Progressive loss of retinal ganglion cell function precedes structural loss by several years in glaucoma suspects. / Banitt, Michael R.; Ventura, Lori M.; Feuer, William J; Savatovsky, Eleonore; Luna, Gabriel; Shif, Olga; Bosse, Brandon; Porciatti, Vittorio.

In: Investigative Ophthalmology and Visual Science, Vol. 54, No. 3, 05.04.2013, p. 2346-2352.

Research output: Contribution to journalArticle

Banitt, Michael R. ; Ventura, Lori M. ; Feuer, William J ; Savatovsky, Eleonore ; Luna, Gabriel ; Shif, Olga ; Bosse, Brandon ; Porciatti, Vittorio. / Progressive loss of retinal ganglion cell function precedes structural loss by several years in glaucoma suspects. In: Investigative Ophthalmology and Visual Science. 2013 ; Vol. 54, No. 3. pp. 2346-2352.
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N2 - PURPOSE. We determined the time lag between loss of retinal ganglion cell function and retinal nerve fiber layer (RNFL) thickness. METHODS. Glaucoma suspects were followed for at least four years. Patients underwent pattern electroretinography (PERG), optical coherence tomography (OCT) of the RNFL, and standard automated perimetry testing at 6-month intervals. Comparisons were made between changes in all testing modalities. To compare PERG and OCT measurements on a normalized scale, we calculated the dynamic range of PERG amplitude and RNFL thickness. The time lag between function and structure was defined as the difference in time-to-criterion loss between PERG amplitude and RNFL thickness. RESULTS. For PERG (P < 0.001) and RNFL (P1/40.030), there was a statistically significant difference between the slopes corresponding to the lowest baseline PERG amplitude stratum (≤50%) and the reference stratum (>90%). Post hoc comparisons demonstrated highly significant differences between RNFL thicknesses of eyes in the stratum with most severely affected PERG (≤50%) and the two strata with least affected PERG (>70%). Estimates suggested that the PERG amplitude takes 1.9 to 2.5 years to lose 10% of its initial amplitude, whereas the RNFL thickness takes 9.9 to 10.4 years to lose 10% of its initial thickness. Thus, the time lag between PERG amplitude and RNFL thickness to lose 10% of their initial values is on the order of 8 years. CONCLUSIONS. In patients who are glaucoma suspects, PERG signal anticipates an equivalent loss of OCT signal by several years.

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