On- and off-response ERGs elicited by sawtooth stimuli in normal subjects and glaucoma patients

• Published in: Documenta ophthalmologica 2012-06, Vol.124 (3), p.237-248
• Main Authors: Pangeni, Gobinda, Lämmer, Robert, Tornow, Ralf P., Horn, Folkert K., Kremers, Jan
• Format: Article
• Language: English
• Subjects: Aged; Electroretinography; Female; Glaucoma; Glaucoma, Open-Angle - physiopathology; Humans; Intraocular Pressure - physiology; Male; Medicine; Medicine & Public Health; Middle Aged; Nerve Fibers - pathology; Ophthalmology; Optic Nerve Diseases - physiopathology; Original Research Article; Photic Stimulation; Retina - physiology; Tomography, Optical Coherence; Visual Field Tests; Visual Fields
• ISSN: 0012-4486; 1573-2622
• DOI: 10.1007/s10633-012-9323-4

The aim of this study is to measure the on- and off-responses and their response asymmetries elicited by sawtooth stimuli in normal subjects and glaucoma patients. Furthermore, the correlation between the ERGs and other functional and structural parameters are investigated. Full-field stimuli were produced using a Ganzfeld bowl with Light Emitting Diodes (LEDs) as light sources. On- and off-response ERGs were recorded from 17 healthy subjects, 12 pre-perimetric and 15 perimetric glaucoma patients using 4-Hz luminance rapid-on and rapid-off sawtooth stimuli (white light; mean luminance 55 cd/m 2 ) at 100 % contrast. The on- and off-responses were added to study response asymmetries. In addition, flash ERGs were elicited by red stimuli (200 cd/m 2 ) on a blue background (10 cd/m 2 ). The mean deviations (MD) of the visual field defects were obtained by standard automated perimetry. The retinal nerve fibre layer thickness (RNFLT) was measured with Spectral Domain Optical Coherence Tomography (SOCT). We studied the correlation between ERG response amplitudes, visual field mean deviation (MDs) and RNFLT values. The on-responses showed an initial negative (N-on) followed by a positive (P-on), a late positive (LP-on) and a late negative responses (LN-on). The off-responses showed an initial positive (P-off) a late positive (LP-off) and a late negative response (LN-off). The addition of on- and off-responses revealed an initial positive (P-add) and a late negative response (LN-add). The on-response components (N-on, P-on and LN-on) in the glaucoma patients were relatively similar to those of the control subjects. However, the LP-on was significantly elevated ( p  = 0.03) in perimetric patients. The LP-off was significantly elevated ( p