Slope between positive and negative ERG components in patients with open-angle glaucoma

To evaluate ERG morphology, in particular the slope between P50 and N95 components of the PERG, as well as between the b-wave and the photopic negative response (PhNR) of the light-adapted (LA) ERG in patients with retinal ganglion cell (RGC) dysfunction due to open-angle glaucoma.

The PERG and LA-ERG traces of 16 glaucoma patients and 21 age-similar controls were retrospectively analysed. The ERG signal between the peak of the positive component (P50 and b-wave) towards the negative component (N95 and PhNR) was described by a linear regression y = a + bx, where the parameter b indicated the steepness of the P50-N95 and b-PhNR slope.

The P50-N95 slope was less steep in glaucoma patients (−0.079 ± 0.034 vs. −0.166 ± 0.050 in controls, p < 0.001), while the b-PhNR slope was not affected (−4.2 ± 2.1 vs. −4.4 ± 1.2, p = NS). The P50-N95 slope showed strong correlation with PhNR and N95 amplitude (r = −0.68 and −0.92, respectively; p < 0.001), while the b-PhNR slope correlated only with b-wave amplitude (r = −0.66, p < 0.001).

The P50-N95 slope is a sensitive indicator of RGC dysfunction in patients with open-angle glaucoma. A similar component of LA-ERG, the b-PhNR slope, is less affected by glaucomatous RGC dysfunction and probably originates from similar retinal mechanisms as the b-wave.