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Transl Vis Sci Technol. 2017 Nov 8;6(6):6. doi: 10.1167/tvst.6.6.6. eCollection 2017.

Pattern Electroretinography and Visual Evoked Potentials Provide Clinical Evidence of CNS Modulation of High- and Low-Contrast VEP Latency in Glaucoma.

Author information

1
WESMDPA Baptist Medical Center Glaucoma Service, San Antonio, TX, USA.
2
Vision Sciences, University of the Incarnate Word Rosenberg School of Optometry, San Antonio, TX, USA.
3
Department of Biomedical Engineering, University of Texas San Antonio, San Antonio, TX, USA.
4
Diopsys, Pine Brook, NJ, USA.
5
Ophthalmology, Stanford University, Stanford, CA, USA.
6
Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA.

Abstract

Purpose:

Both pattern electroretinography (PERG) and visual evoked potentials (VEP) can be performed using low- (15%; Lc) and high- (85%; Hc) contrast gratings that may preferentially stimulate the magno- and parvocellular pathways. We observed that among glaucomatous patients showing only one VEP latency deficit per eye, there appeared to be a very strong tendency for an Hc delay in one eye and an Lc delay in the other.

Methods:

Diopsys NOVA-LX system was used to measure VEP Hc and Lc latency among a clinical glaucoma population to find all individuals with either a single Hc or Lc latency abnormality in each eye (group 1), or with greater than 0 and less than 4 Hc or Lc VEP latency abnormalities in the two eyes (group 2) to determine whether a significant inverse correlation existed for these values in either group. Hc and Lc PERG data were also evaluated to assess associated retinal ganglion cell responses.

Results:

A strong inverse correlation (P = 0.0000003) was observed between the Hc and Lc VEP latency values among the 64 eyes in group 1. Group 2 provided a comparable result (n = 143; 286 eyes; P = 0.0005). PERG (n = 81; 162 eyes) also showed strong bilateral symmetry for magnitude values (P < 0.0001 for both Lc and Hc in groups 1 and 2).

Conclusions:

Bilateral retention of both low-resolution/high-speed and high-resolution/low-speed function may persist with both eyes open despite symmetrically pathologic retinal ganglion cell PERG waveform asynchrony for Hc and Lc stimuli in the paired eyes.

Translational Relevance:

Clinical electrophysiology strongly suggests binocular compensation for dynamic dysfunction operates under central nervous system (CNS) control in glaucoma.

KEYWORDS:

central visual pathways; magnocellular/parvocellular; pattern electroretinogram; pattern visual evoked potentials; visual field

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