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RE-PERG, a new paradigm for glaucoma diagnosis, in myopic eyes

Authors Mavilio A, Sisto D, Ferreri P, Dammacco R, Alessio G

Received 6 April 2019

Accepted for publication 21 June 2019

Published 24 July 2019 Volume 2019:13 Pages 1315—1322


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

Alberto Mavilio,1 Dario Sisto,2 Paolo Ferreri,2 Rosanna Dammacco,2 Giovanni Alessio2

1Social Health District, Glaucoma Center, Azienda Sanitaria Locale, Brindisi, Italy; 2Department of Neurosciences, Institute of Ophthalmology, University of Bari, Bari, Italy

Purpose: To evaluate reliability of steady-state pattern electroretinogram (ssPERG) phase variability in re-test (procedure called RE-PERG) in the presence of myopia, which is known to affect ssPERG amplitude, in glaucomatous patients (GP), normal controls (NC), and myopic patients (MY).
Methods: The procedure was performed on 50 GP, 35 NC, and 19 MY. All subjects were examined with RE-PERG, spectral-domain coherence tomography (SD-OCT), and standard automated perimetry (SAP). Standard deviation of phase (ssPERG SDph) and mean amplitude value (ssPERG Amp) of second harmonic (2ndH) were correlated, by means of one-way ANOVA and Pearson correlation, with mean deviation (MD) and pattern standard deviation (PSD) assessed by SAP and retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness assessed by SD-OCT. Receiving operating characteristics were calculated in cohort populations with and without myopia.
Results: GP showed significant differences from the control group for MD, PSD, RNFL, GCC, ssPERG Amp, and ssPERG SDph; GP also showed significant differences from the MY group for all the parameters except for ssPERG Amp, which is reduced in both groups. In GP group, ssPERG Amp showed a specificity of 82.1% (95% confidence interval [CI]I: 66.5–92.5). In MY group, ssPERG Amp was reduced in 58% of the patients. As a consequence of this, in GP and MY groups, considered as a whole, total specificity dropped to 70.69% (95% CI: 57.3–81.9). In the GP group, ssPERG SDph showed a specificity of 84.6% (95% CI: 69.5–91.1). In both GP and MY groups, considered as a whole, ssPERG SDph total specificity increased from 84.6% to 93.1% (95% CI: 83.3–98.1).
Conclusion: Intrinsic phase variability of ssPERG is not influenced by myopia, even in the presence of fundus alterations.

Keywords: glaucoma, pattern electroretinogram, steady-state, perg, re-perg, myopia

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