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Glaucoma is a common and potentially blinding disease. It is characterized by an optic nerve damage, a visual field defect and elevated intraocular pressure (IOP).
The loss of retinal nerve fibers is accompanied by functional impairment in the territories corresponding to deficits of the visual field. However, this structure-function relationship is not always found initially. These discrepancies are mainly chronological: the structural damage preceding the functional impairment sometimes of several years
The electroretinogram pattern (ERGP) is an electrophysiological exploration technique that reflects the activity of retinal ganglion cells. It presents itself as an objective field of vision that does not require the active collaboration of the patient. It consists in recording the electrical activity of functional retinal ganglion cells following a light stimulation. Simple (30 minutes maximum), it could improve the detection of early forms of glaucoma. A significant ERGP is also thought to be correlated with peripapillary and macular CNP structural involvement of the ganglionic complex in early forms of glaucoma (MD> -6 dB).
Some results even suggest that ganglion dysfunction could be detected by the ERGP eight years on average before the occurrence of detectable alterations on the RNFL OCT. ERGP is already recognized as a routine examination for monitoring glaucomatous patients (review side in nomenclature and reimbursed by Social Security) but it could therefore be used as a diagnostic tool in very early forms of intraocular hypertonia glaucoma so to objectify signs of preperimetric functional impairment in order to establish a suitable hypotonizing treatment and to improve the prognosis of this disease.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| early age of glaucoma or with important risk factors | Experimental | All patients included will benefit from a complete ophtalmic examination including visual acuity, slit lamp biomicroscopic examination of the anterior segment, measurement of intraocular pressure by Goldmann tonometer aplanation, dynamic gonioscopy with Posner glass. They will also have a fundus examination with examination of the retina, macula and optic nerve as well as the ERGP. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Electroretinogram Pattern (Diopsys® NOVA System) | Device | it's an additional examination that extends the duration of the ophthalmological consultation by 30 minutes |
|
| Measure | Description | Time Frame |
|---|---|---|
| Correlations between Electroretinogram Pattern, vision field and optical coherence tomography | Electroretinogram Patterny : Magnitude, magnitude D, Magnitude D/Magnitude ratio. | Time of inclusion |
| Correlations between Electroretinogram Pattern, vision field and optical coherence | Vision field: mean deviation, corrected pattern standard deviation. | Time of inclusion |
| Correlations between Electroretinogram Pattern, vision field and optical coherence | Optical coherence tomography: retinal nerve fiber layer thickness and macular analysis of the ganglionic complex. | Time of inclusion |
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Inclusion Criteria:
Man and woman age ≥ 18 years
Francophone
Patient with medical insurance
Refraction: sphere ± 5.0 D and cylinder ± 3.0 D
Pupillary diameter ≥ 3mm
Early glaucoma patients :
Patient at risk for glaucoma with:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Groupe Hospitalier Paris Saint-Joseph | Paris | 75014 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 12049575 | Result | Gordon MO, Beiser JA, Brandt JD, Heuer DK, Higginbotham EJ, Johnson CA, Keltner JL, Miller JP, Parrish RK 2nd, Wilson MR, Kass MA. The Ocular Hypertension Treatment Study: baseline factors that predict the onset of primary open-angle glaucoma. Arch Ophthalmol. 2002 Jun;120(6):714-20; discussion 829-30. doi: 10.1001/archopht.120.6.714. | |
| 2712129 |
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| ID | Term |
|---|---|
| D005901 | Glaucoma |
| ID | Term |
|---|---|
| D009798 | Ocular Hypertension |
| D005128 | Eye Diseases |
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