Significant correlations between photopic negative response, afferent pupillary defect, and mean defects of visual fields in asymmetric optic nerve disorders

Abstract

Purpose

The photopic negative response (PhNR) is a negative wave following the b-wave of the photopic electroretinogram (ERG). The PhNR originates from the retinal ganglion cells (RGCs), and it can be used to assess the function of RGCs noninvasively and objectively. The purpose of this study was to determine whether the relative amplitudes (affected/normal eye) of the PhNR are significantly correlated with the degree of the relative afferent pupillary defect (RAPD) in eyes with unilateral or asymmetrical damage of the optic nerve.

Methods

The PhNRs of the full-field photopic ERGs were measured. In addition, videopupillography and automated perimetry were performed on 27 cases with asymmetrical optic nerve disorders including glaucoma. The differences of these assessments were expressed by the relative amplitudes of the PhNRs of the two eyes, the neutral density (ND) filter required to equate the amplitudes of the pupillary light reflexes between the two eyes, and differences of the mean defects (ΔMDs) of the sensitivities of the Humphrey visual fields. The correlations between these values were determined by linear regression analyses.

Results

The relative PhNR amplitudes were significantly and negatively correlated with the ΔMDs (R2 = 0.58, P = 0.0001). In addition, the relative PhNR amplitudes were moderately but significantly and positively correlated with the RAPDs (R2 = 0.36, P = 0.002).

Conclusion

The relative amplitudes of the PhNR of the affected eyes to the contralateral eyes indicate an asymmetric alteration of the RGCs, and they can be used to monitor the physiology of the RGCs objectively.

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Change history

  • 15 June 2020

    The original publication of this paper contains mistakes.

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Acknowledgments

The authors thank Duco Hamasaki, PhD, Bascom Palmer Eye Institute, University of Miami School of Medicine, for discussions and for editing this manuscript.

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Correspondence to Hidehiro Oku.

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All procedures performed in this study involving human participants were in accordance with the ethical standards of Osaka Medical College and the 1964 Helsinki Declaration and its later amendments. This article does not contain any studies with animals performed by any of the authors.

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Okuno, T., Kida, T., Ikeda, T. et al. Significant correlations between photopic negative response, afferent pupillary defect, and mean defects of visual fields in asymmetric optic nerve disorders. Graefes Arch Clin Exp Ophthalmol (2020). https://doi.org/10.1007/s00417-020-04632-9

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Keywords

  • Photopic negative response
  • Relative afferent pupillary defect
  • Mean defect
  • Linear regression analysis
  • Asymmetric optic nerve function