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Electroretinography in idiopathic intracranial hypertension: comparison of the pattern ERG and the photopic negative response

journal contribution
posted on 19.06.2018 by Jason C. Park, Heather E. Moss, J. Jason McAnany
Purpose To evaluate the relationship between electrophysiological measures of retinal ganglion cell (RGC) function in patients who have idiopathic intracranial hypertension (IIH). Methods The pattern electroretinogram (pERG) and photopic negative response (PhNR) were recorded from 11 IIH patients and 11 age-similar controls. The pERG was elicited by a contrast-reversing checkerboard. The PhNR, a slow negative component following the flash ERG b-wave, was recorded in response to a long-wavelength flash presented against a short-wavelength adapting field. The PhNR was elicited using full-field (ffPhNR) and focal macular (fPhNR) stimuli. Additionally, Humphrey visual field mean deviation (HVF MD) was measured and ganglion cell complex volume (GCCV) was obtained by optical coherence tomography. Results The ffPhNR, fPhNR, and pERG amplitudes were outside of the normal range in 45, 9, and 45% of IIH patients, respectively. However, only mean ffPhNR amplitude was reduced significantly in the patients compared to controls (p < 0.01). The pERG amplitude correlated significantly with HVF MD and GCCV (both r > 0.65, p < 0.05). There were associations between ffPhNR amplitude and HVF MD (r = 0.58, p = 0.06) and with GCCV (r = 0.52, p = 0.10), but these did not reach statistical significance. fPhNR amplitude was not correlated significantly with HVF MD or GCCV (both r < 0.40, p > 0.20). Conclusions Although the fPhNR is generally normal in IIH, other electrophysiological measures of RGC function, the ffPhNR and pERG, are abnormal in some patients. These measures provide complementary information regarding RGC dysfunction in these individuals.


Supported by the National Institutes of Health Grants K12EY021475 (HM), K23EY024345 (HM), and P30EY01792 (UIC Core); an Illinois Society for the Prevention of Blindness Research Grant (HM); an unrestricted departmental grant, Sybil B. Harrington (HM) and Dolly Green (JM) Special Scholar Awards from Research to Prevent Blindness.


Publisher Statement

Post print version of article may differ from published version. The final publication is available at springerlink.com; DOI:10.1007/s10633-017-9620-z


Park, J. C., Moss, H. E. and McAnany, J. J. Electroretinography in idiopathic intracranial hypertension: comparison of the pattern ERG and the photopic negative response. Documenta Ophthalmologica. 2018. 136(1): 45-55. 10.1007/s10633-017-9620-z.


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