Decoding PERG: a Neuro-Ophthalmic Retinal Ganglion Cell Function Review

  • Pedro MonsalveEmail author
Retina (R Goldhardt, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Retina


Purpose of Review

Currently, the clinical evaluation of neuro-ophthalmologic diseases is mainly focused on identifying stages where structural or functional damage occurs. Recognition of retinal ganglion cell (RGC) functional patterns as well as monitoring RGC dysfunction can be performed using steady-state pattern electroretinogram (PERG). The analysis of the amplitude and latency shift aids on providing information on early damage or monitoring of the RGC, allowing for prompt clinical intervention and management modification, potentially changing the natural history of the disease. The purpose of this article is to review the latest findings in PERG, in early manifest glaucoma, non-arteritic ischemic optic neuropathy, multiple sclerosis with unilateral recovered optic neuritis, and its fellow eyes.

Recent Findings

The steady-state PERG responses provide new and early specific information in neuro-ophthalmic diseases affecting the inner retina.


Steady-state PERG presents specific amplitude and latency outcomes based on the neuro-ophthalmic disease affecting the inner retina, allowing early recognition of changes at the level of RGC and the degree of RGC dysfunction. In addition, PERG alterations may be induced in healthy subjects as well as susceptible eyes using different stress tests such as head-down tilting or water-drinking tests.


Retinal ganglion cell function Non-arteritic ischemic optic neuropathy (NAION) Multiple sclerosis Optic neuritis Glaucoma Steady-state PERG 


Funding Information

Supported by NIH Center Core Grant R43EY023460 and Research to Prevent Blindness Unrestricted Grant.

Compliance With Ethical Standards

Conflict of Interest

Pedro Monsalve declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Bascom Palmer Eye Institute, Department of OphthalmologyUniversity of Miami Miller School of MedicineMiamiUSA

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