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The effect of broadband and monochromatic stimuli on the photopic negative response of the electroretinogram in normal subjects and in open-angle glaucoma patients

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Abstract

The aim was to investigate the effects of monochromatic and broadband stimuli on the amplitude of the photopic negative response (PhNR) and to compare the sensitivities of these stimuli for the detection of ganglion cell damage in glaucoma patients. Forty-one healthy subjects were studied, along with 16 patients with open-angle glaucoma. Photopic electroretinograms (ERGs) were elicited with monochromatic red, amber, green, and broadband white stimuli of progressively brighter intensities in a blue background. Pattern ERGs were also recorded using a 0.8° checkerboard pattern on a 21.6° × 27.8° screen. In the photopic ERGs of the control subjects, the PhNR amplitude was significantly higher (P < 0.01) to red than to monochromatic amber, green, and broadband white stimuli of the same intensity. In glaucoma patients, the percentage of amplitude reduction was greater for the PhNR to red (68%, P < 0.001) than to the broadband stimulus (38%, P = 0.001). The PhNR to red monochromatic stimulus appeared to be a more sensitive parameter, with a larger area enclosed by the receiver-operating characteristic curve (0.97) than for the PhNR to broadband stimulus (0.76). Also, the PhNR to red stimulus showed a more significant correlation with the pattern ERG and the visual field defects (P < 0.05) than the PhNR elicited with broadband stimulus. These findings suggest that ganglion cell activity can be more efficiently evaluated with the PhNR elicited with a red than with a broadband stimulus. The PhNR thus appears to be a promising test for the diagnostics of the ganglion cell dysfunction.

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Acknowledgments

The authors are grateful to Prof Marko Hawlina, MD, PhD, for initial encouragement in the photopic negative response study. Some of the data from this study were previously presented in an abstract form [33], and the presentation received the Eberhard Dodt Memorial award at the ISCEV symposium in Hyderabad, India, 2007. This study was in part supported by the Slovenian Research Agency, Grant No. J3-6167 and P3-0333.

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Authors and Affiliations

  1. Unit for Visual Electrophysiology, Eye Clinic, University Medical Centre Ljubljana, Grabloviceva 46, 1000, Ljubljana, Slovenia

    Maja Sustar & Jelka Brecelj

  2. Glaucoma Unit, Eye Clinic, University Medical Centre Ljubljana, Grabloviceva 46, 1000, Ljubljana, Slovenia

    Barbara Cvenkel

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  1. Maja Sustar
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Correspondence to Maja Sustar.

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Sustar, M., Cvenkel, B. & Brecelj, J. The effect of broadband and monochromatic stimuli on the photopic negative response of the electroretinogram in normal subjects and in open-angle glaucoma patients. Doc Ophthalmol 118, 167–177 (2009). https://doi.org/10.1007/s10633-008-9150-9

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