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Impressum
Evaluation of Non-Linearities in 30 Hz Flicker mf-ERG as an Electrophysiological Follow-Up Assessment Technique in the Detection of Early Glaucomatous Lesions in OAG - Results after 22 Months
1Danielczyk M., 1Tesnau R., 2Gaa J., 1Berger D., 1Welt R.
1Augenklinik Ludwigshafen am Rhein, Bremserstraße 79, 67063 LU, 2Univ.-Klinik f.Radiologie, Klinikum Mannheim d.Universität Heidelberg, 68167 MA
Purpose: To demonstrate linearities and non-linearities by performing
a 30 Hz Flicker mf-ERG in order to confirm glaucomatous lesions (Rhein-Main.Augenärzteversammlung
Nov.99 and ARVO 2001). According to the model of Spekreijse as well as
to the mathematical theory from Victor and Knight we want to demonstrate
whether glaucomatous scotomas in the perimetry would be in a good correspondence
to the recorded 30 Hz Flicker mf-ERG results: our former study analyses
the relationship between the 1st harmonic and the basewave, e.g. the DFT-quot
1H/BW (=Discrete Fourier Transformation). In our present study we want
to reveal whether the DFT-quot is a reliable parameter in the follow-up
of progressing glaucomas.
Methods: Regular follow-up exams showed the outcome of glaucoma
patients in the perimetry of at least one eye. In comparison to them we
examined 142 eyes from 71 healthy volunteers.The 30 Hz Flicker mf-ERG
was performed monocular in mydriasis with a Retiscan device(RolandConsult):stimulation
of ±30°, 61 hexagons.
Results: Initially, all glaucoma patients had been presented with
an at least reduced DFT-quot compared to non-scotoma areas of the same
eye even if the HRT result had been classified as normal. The follow-up
of the glaucoma patients revealed: 7 from 99 eyes showed already in a
6-months follow up a worse DFTquot. In our one-year results one eye decreased
(more than 2 SD) in comparison to the fellow eye, and one additional eye
in a moderate way. Checking the third follow-up: two already pathological
DFT-quot decreased and one glaucoma felloweye converted to a pathological
DFT-quot result without scotoma in the perimetry. In 12 out of 99 eyes
the DFT-quotient was supposed to be a reliable parameter in progressing
glaucomas, whereas by the HRT follow-up only 2 of these 12 eyes could
be identified. Mathematical statistics was done by SAS and STATISTICA.
Conclusion: Performing a 30 Hz Flicker mf-ERG will improve the
detection of progressing glaucoma. Focusing on our results the DFT-quot
1H/BW seemed to detect early glaucomatous lesions in a more sensitive
way than other measurement procedures like the HRT will do. Regarding
the non-linear spectrum of the 30 Hz flicker mf-ERG in combination with
the recorded mf-VEP in glaucoma suspects will even provide more information
and may have the potential to detect preperimetric glaucomatous lesions.