Steady-State PERG Adaptation Reveals Temporal Abnormalities of Retinal Ganglion Cells in Treated Ocular Hypertension and Glaucoma

<b>Background/Objectives:</b> This study investigates adaptive changes in long-lasting pattern electroretinogram (PERG) responses in ocular hypertension (OHT) and open-angle glaucoma (OAG) patients, and in healthy subjects. <b>Methods:</b> Sixty consecutive individuals were r...

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Main Authors: Tommaso Salgarello, Andrea Giudiceandrea, Grazia Maria Cozzupoli, Martina Cocuzza, Romolo Fedeli, Donato Errico, Antonello Fadda, Filippo Amore, Marco Sulfaro, Epifanio Giudiceandrea, Matteo Salgarello, Stanislao Rizzo, Benedetto Falsini
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/14/1797
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Summary:<b>Background/Objectives:</b> This study investigates adaptive changes in long-lasting pattern electroretinogram (PERG) responses in ocular hypertension (OHT) and open-angle glaucoma (OAG) patients, and in healthy subjects. <b>Methods:</b> Sixty consecutive individuals were recruited, including 20 OHT, 20 OAG, and 20 normal subjects. All participants underwent comprehensive ophthalmologic examination, 30–2 perimetry, and retinal nerve fiber layer imaging. Steady-state (7.5 Hz) PERGs were recorded over approximately 2 min, in response to 90% contrast alternating gratings within a large field size. The recordings were acquired into a sequence of 10 averages (packets), lasting 10 s each, following a standardized adaptation paradigm (Next Generation PERG, PERGx). Key outcome measures included PERGx parameters reflecting response amplitude and phase changes over time. <b>Results:</b> The PERGx grand average scalar amplitude, a surrogate of ordinary PERG, was significantly reduced in both OHT and OAG groups compared to normal subjects (<i>p</i> < 0.01). In contrast, minimal adaptation changes were noted in PERGx amplitude among all groups. The PERGx phase exhibited a progressive decline over time, with consistent delays of approximately 20 degrees across all groups. Angular dispersion of the PERGx phase increased significantly in OHT patients compared to normal subjects (<i>p</i> < 0.05). An inverse relationship was observed between PERGx angular dispersion and treated intraocular pressure, specifically in OHT patients. <b>Conclusions:</b> The findings suggest that both OHT and OAG eyes may exhibit temporal abnormalities in PERG adaptation, potentially indicating early dysfunction in retinal ganglion cell activity. <b>Translational Relevance:</b> PERGx phase changes may have significant implications for glaucoma early detection and management.
ISSN:2075-4418