Documenta Ophthalmologica最新文献

{"title":"Sequential central retinal artery occlusion in two brothers: a fight to prevent blindness.","authors":"David Oliver-Gutierrez, Olaia Subirà, Ana Zabalza, Bernat Boy, Joana Marques-Soares, Miguel Ángel Zapata","doi":"10.1007/s10633-025-10006-5","DOIUrl":"10.1007/s10633-025-10006-5","url":null,"abstract":"<p><strong>Importance: </strong>Central retinal artery occlusion (CRAO) is typically associated with older patients with cardiovascular risk factors. However, its occurrence in younger patients without these risk factors suggests the need to explore rare genetic conditions. Identifying genetic disorders like adenosine deaminase 2 deficiency (DADA2), a vasculitic disease, can be critical in such cases to prevent further complications.</p><p><strong>Objective: </strong>To report the challenging diagnosis of two cases of CRAO in brothers under the age of 40, leading to the diagnosis of DADA2, a rare genetic vasculitic disorder.</p><p><strong>Results: </strong>A 34-year-old man and his 32-year-old brother, both without significant medical histories, presented with CRAO eight years apart. Extensive diagnostic evaluations, including blood tests, imaging, and autoimmunity panels, failed to identify common causes. Progressive neurological symptoms in the older brother and the similar presentation in his sibling led to further investigation, including genetic testing. A homozygous mutation c.752C > T p.(Pro251Leu) in the CECR1 gene confirmed the diagnosis of DADA2 in both brothers.</p><p><strong>Conclusion: </strong>These cases underscore the importance of considering genetic disorders like DADA2 in young patients presenting with unexplained vascular occlusions. DADA2, characterized by vasculitis, immune dysregulation, and hematologic disorders, can manifest variably, complicating early diagnosis. Effective treatment with TNF inhibitors can prevent further vision loss and mitigate systemic complications. To our knowledge, these are the first reported cases of DADA2 with CRAO as the initial manifestation without prior clinical findings.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":"105-110"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unilateral best vitelliform macular dystrophy- a case series.","authors":"Dhanashree Ratra, Abhishek Karra","doi":"10.1007/s10633-025-10008-3","DOIUrl":"10.1007/s10633-025-10008-3","url":null,"abstract":"<p><strong>Purpose: </strong>To report 2 cases with unilateral Best vitelliform macular dystrophy (VMD) and describe their multimodal investigations findings.</p><p><strong>Methods: </strong>Two patients in their fifties who were misdiagnosed as central serous chorioretinopathy were carefully evaluated using multimodal imaging and electrooculography (EOG) investigations.</p><p><strong>Results: </strong>Both patients showed neurosensory elevation at the macula in one eye only leading to reduced vision. The optical coherence tomography showed subretinal hyperreflective material lining the undersurface of the elevated retina with thinning of the overlying photoreceptor layer. There was no choroidal thickening or pachy vessels. There was no leakage seen on fluorescein angiography nor any choroidal hyperpermeability on indocyanine green angiography. There was no choroidal neovascular membrane noted. The left eye was clinically unaffected for both. The EOG showed a reduced light peak to dark trough (LP:DT) ratio in both the eyes of these patients confirming the diagnosis of Best VMD. No change was seen in the eye condition over 2 years.</p><p><strong>Conclusions: </strong>Best VMD can present in unilateral fashion in rare instances. EOG can be confirmatory along with genetic testing. It can be misdiagnosed as CSCR where multimodal imaging and EOG can help differentiate it as Best VMD.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":"111-116"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-channel pattern VEPs with full and half field stimulation: methods of interpretation and diagnostic evaluation.","authors":"Dorothy A Thompson, Oliver R Marmoy, Joanne Cowe, Siân E Handley","doi":"10.1007/s10633-025-10012-7","DOIUrl":"10.1007/s10633-025-10012-7","url":null,"abstract":"<p><strong>Aim: </strong>To describe methods of evaluating multichannel full and half field pattern VEPs using the ISCEV VEP Standard montage.</p><p><strong>Methods: </strong>The dependence of full field and half field pattern VEPs on retinal areas and cortical generators is reviewed and applied to the interpretation and evaluation of multichannel half field pattern VEPs.</p><p><strong>Results: </strong>There are predictable differences in the trans-occipital distributions of components of monocular full, and half field, pattern-reversal and full field, onset-offset VEPs. In combination, the differing distribution and dependence of these components on foveal and macular fields can help to identify and localise chiasmal and retro-chiasmal dysfunction and distinguish this from trans-occipital distribution due to individual variations of cortical architecture. A decision tree synthesising published evidence and current practice is suggested to guide interpretation of trans-occipital VEP distributions.</p><p><strong>Conclusion: </strong>The routine application of two additional lateral channels to acquire multichannel VEPs is quick, easy and adds clinical diagnostic value. The combination of full and half field pattern-reversal and fullfield, onset-offset VEPs can help evaluate chiasmal and retro-chiasmal visual pathway function, and minimise false positive interpretation of asymmetric VEP distributions, which may be due to cortical architecture or cranial anatomy alone.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":"87-95"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11991936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reference ranges of light-adapted full-field electroretinogram and associated factors in a large cohort of healthy school-aged children and adolescents.","authors":"Sonia Seen-Hang Chan, Kai Yip Choi, Natalie Yu-Yan Chan, Vivian Wai Ying Lo, Angela Hing-Yiu Hung, Henry Ho-Lung Chan","doi":"10.1007/s10633-025-10015-4","DOIUrl":"https://doi.org/10.1007/s10633-025-10015-4","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to establish a reference data set of light-adapted full-field electroretinograms (ffERG) of healthy primary and secondary schoolchildren and investigate the relationship among refraction, ocular biometry, and ffERG.</p><p><strong>Methods: </strong>Healthy children aged between 6 and 17 years were recruited. Cycloplegic spherical equivalent refraction (SER), axial length (AL) and keratometry (K) measurements were performed. Standardized ffERGs, including light-adapted flash and 30-Hz flicker, were measured using a portable device with skin electrodes. The percentiles of peak time and amplitude of a- and b-waves and 30-Hz flicker of ffERG waveform were reported, and their relationships with age, SER, AL, K were investigated.</p><p><strong>Results: </strong>Among the 445 participants (45.4% female), the SER (mean ± standard deviation) was - 0.72 ± 2.06 D and AL was 23.56 ± 1.15 mm. The 90% confidence interval (CI) of 5th reference limit of amplitudes of a- and b-wave were 5.0-5.8 µV and 15.0-17.6 µV, while 95th reference limit of peak times were 13.2-13.4 ms and 29.8-30.0 ms, respectively. The amplitude and peak time of the 30-Hz flicker waveform were 21.5-23.9 µV and 26.0-26.2 ms, respectively. In general, more myopic SER, and longer AL were associated with delayed and reduced ffERG waveforms. Older age and male sex were weakly correlated with ffERGs with minimal clinical significance.</p><p><strong>Conclusions: </strong>A reference data set of light-adapted ffERG in children and adolescents was established for clinical and research purposes.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hilbert transform analysis of the mouse scotopic electroretinogram reveals two distinct bursts of oscillatory potentials with progressively dimmer flashes.","authors":"Mercedes Gauthier, Anna Polosa, Jean-Marc Lina, Pierre Lachapelle","doi":"10.1007/s10633-025-10002-9","DOIUrl":"10.1007/s10633-025-10002-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Study the scotopic oscillatory potentials (OPs) in mice over a wide range of flash luminance levels using the Hilbert transform (HT) to extract new features of the high frequency components of the electroretinogram (ERG).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Scotopic ERGs [Intensity: - 6.3 to 0.9 log cd∙s∙m&lt;sup&gt;-2&lt;/sup&gt;; 12 h of dark-adaptation] were obtained from adult mice (C57BL/6; n = 7). The Hilbert transform (HT) was obtained within 3 consecutive frequency bands (65-90 Hz, 90-115 Hz and 115-140 Hz), with OPs being denoised, automatically identified and analyzed. Measurements included: number of OPs, duration of the OP response, surface-under-the-curve (SUC) of the HT envelopes, implicit times, and instantaneous frequency at the HT envelope peak, mean peak time differences (PTD) between the envelopes of each frequency band (measuring their synchrony), correlation coefficient and lag between consecutive HT envelopes, as well as the number of peaks on the HT envelopes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The OP response duration, number of OPs and PTD all peaked for flashes between the level corresponding to the RodVmax (maximal b-wave amplitude of the rod ERG; i.e., the first asymptote of the scotopic luminance-response curve) and K (the flash luminance at which the amplitude of the b-wave is half of that of the RodVmax;), i.e., between -3.9 and -2.4 log cd∙s∙m&lt;sup&gt;-2&lt;/sup&gt;. The correlation between consecutive envelopes is close to 1 at flashes &gt; -1.2 log cd∙s∙m&lt;sup&gt;-2&lt;/sup&gt;, with small lags (min. = 1.93 ± 0.45 ms at - 1.2 log cd∙s∙m&lt;sup&gt;-2&lt;/sup&gt;), then gradually drops to 0.81 ± 0.02 at the dimmest flash intensity (with a max. lag = 14.76 ± 8.92 ms at - 5.1 log cd∙s∙m&lt;sup&gt;-2&lt;/sup&gt;). Finally, we found that the single OP burst (i.e., a single HT envelope peak) seen at flash intensities &gt;  - 1.2 log cd∙s∙m&lt;sup&gt;-2&lt;/sup&gt; progressively divided in two (or more) OP bursts (i.e., multiple HT envelope peaks) with gradually dimmer flashes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our HT method enabled the analysis of the OP response without the subjective interpretation of the experimenter. Analysis of the scotopic OPs at dim flashes with the HT revealed a novel feature of the OP response not yet reported elsewhere, namely: a split of the OP response into two (or more) distinct bursts. Furthermore, the synchrony peak (measured with the PTD) matched the peak in OP response duration between K and RodVmax, suggesting a disorganization (or dephasing) of the retinal signal in ERGs evoked for weaker flashes. The increased synchronization and correlation of the single burst observed for the strongest flashes could suggest an optimization or saturation of the retinal response. We believe that these novel features of the OP components of the ERG went unnoticed given that previous studies did not use weak enough flashes and failed to recognize the added value that time and frequency domain analysis of the ERG (such as what is achieved with the HT) ","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":"1-15"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brief report: effects of methylphenidate on the light adapted electroretinogram.","authors":"Paul A Constable, David H Skuse, Dorothy A Thompson, Irene O Lee","doi":"10.1007/s10633-024-10000-3","DOIUrl":"10.1007/s10633-024-10000-3","url":null,"abstract":"<p><strong>Purpose: </strong>To explore changes in the electroretinogram (ERG) following methylphenidate use in attention-deficit/hyperactivity disorder (ADHD).</p><p><strong>Methods: </strong>Light adapted ERGs were recorded in five individuals (3 male and 2 female, age range 13.6-21.8 years) with a diagnosis of ADHD. Six flash strengths ranging from 71 to 446 Td.s were qualitatively evaluated following a minimum of 24 h without any medication and from 2 to 6 h following the individuals' standard slow-release (XL) methylphenidate dose that ranged from 18 to 60 mg.</p><p><strong>Results: </strong>Of the six flash strengths, the 178 Td.s strength revealed changes in four of the five participants with a median 27.4% increase in b-wave amplitude. For three individuals there was an increase in the a-wave amplitude and for two of the same individuals there was also a noticeable pronouncement of the oscillatory potentials. The a-wave amplitude showed a greatest median increase at the 446 Td.s flash strength of 25.8%. One individual - on the highest dose (60 mg) exhibited no morphologically distinct changes in the ERG. No differences in the time to peaks of the a- and b-wave were observed for any individual.</p><p><strong>Conclusion: </strong>The a- and b-wave amplitudes of the light adapted ERG could provide insights into the effect of methylphenidate in ADHD.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":"25-32"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-VEGF therapy for proliferative diabetic retinopathy in Kearns-Sayre syndrome.","authors":"Vannessa Leung, James G Wong, John R Grigg","doi":"10.1007/s10633-024-09999-2","DOIUrl":"10.1007/s10633-024-09999-2","url":null,"abstract":"<p><strong>Purpose: </strong>Multiple mitochondrial syndromes, such as Kearns-Sayre, involve the concurrence of diabetes mellitus and inherited pigmentary retinopathy. It is rare, however, for proliferative disease to develop in these patients as existing inner retinal dysfunction is thought to be protective.</p><p><strong>Methods: </strong>To our knowledge this is the first description of proliferative diabetic retinopathy (PDR) in Kearns-Sayre syndrome.</p><p><strong>Conclusion: </strong>A number of additional considerations need to be recognised when treating PDR in Kearns-Sayre syndrome. Given the risk of further visual field losses with panretinal photocoagulation, there should be a preference for primary anti-VEGF therapy in a compliant patient. PDR in inherited retinal disease appears to be very anti-VEGF responsive and may not require the standard monthly frequency of treatment, even from initiation.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":"41-46"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of functional, structural and vascular characteristics between dominant and nondominant eyes.","authors":"Mualla Hamurcu, Burcu Polat Gültekin, Melisa Tuncer Göçmen, Zarife Nurbanu Mendi","doi":"10.1007/s10633-024-10001-2","DOIUrl":"10.1007/s10633-024-10001-2","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to compare retinal and optic disc functions as well as vascular structures in dominant eyes (DE) and non-dominant eyes (NDE) among healthy adults using pattern electroretinogram (PERG), optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) tests.</p><p><strong>Methods: </strong>Seventy-two eyes of 36 healthy subjects with bilateral visual acuity of 1.0 were included. Parameters such as intraocular pressure (IOP), cycloplegic spherical equivalent value (SE), PERG, retinal nerve fiber layer (RNFL) thicknesses and OCTA measurements were evaluated. Ocular dominance was determined using the hole-in-the-card test.</p><p><strong>Results: </strong>Of the participants, 67% were female, with a median age of 28 (min-max.18-35) years. Right eye dominance was observed in 61.2% of cases, while left eye dominance was seen in 38.8%. There was no significant difference in refractive values between eyes with right and left eye dominance (0.60 ± 0.40 and 0.41 ± 0.28, p = 0.42). The dominant eyes showed significantly higher P50 amplitude (10.2 µV vs. 9.2 µV, p = 0.003) and shorter peak time (47.9 ms. vs. 48.6 ms, p = 0.01) when compared to the nondominant eyes. There were comparable values in the peak times and amplitudes of the N95 component between the dominant and nondominant eyes. The RNFL layer was thicker on average (p, 0.001) as well as in the nasal and inferior quadrants of the dominant eyes (p < 0.05). OCTA analysis revealed no significant differences in the peripapillary and macular capillary vascular densities between dominant and nondominant eyes (p > 0.05), except for the deep whole capillary density in the macula, which was significantly higher in the dominant eyes (p = 0.02).</p><p><strong>Conclusion: </strong>Our results indicate the existence of functional and structural relationships related to ocular dominance. Future studies provide further insights into ocular dominance and its relationship with eye structure.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":"17-23"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel CACNA1F pathogenic variant in pediatric incomplete X-linked CSNB: integrating portable ERG and genetic analysis.","authors":"Lijin Wen, Yuwen Liu, Zhengwei Yang, Shuping Mei, Yijing Xin, Shiying Li","doi":"10.1007/s10633-024-09998-3","DOIUrl":"10.1007/s10633-024-09998-3","url":null,"abstract":"<p><strong>Purpose: </strong>To report a novel hemizygous nonsense variant in the CACNA1F gene associated with congenital stationary night blindness (CSNB) in a pediatric patient, emphasizing the utility of portable electroretinography (ERG) and genetic testing in diagnosing unexplained visual impairments.</p><p><strong>Methods: </strong>The patient, a 5-year-old male, underwent comprehensive clinical evaluation, including detailed anterior segment and fundus examinations, full-field electroretinogram (ffERG) using a RETeval™ portable device, and whole exome sequencing (WES) to elucidate the genetic basis of his visual impairment. Structural modeling of the mutated protein was performed using SWISS-MODEL and PYMOL.</p><p><strong>Results: </strong>Best-corrected visual acuity was 0.4 logMAR bilaterally, with unremarkable anterior segment and fundus examinations. FFERG revealed significant abnormalities consistent with incomplete CSNB: severely reduced rod response in dark-adapted (DA) 0.01, negative waveform with b/a wave ratio < 1.0 in DA 3.0, and diminished cone response in light-adapted ERG. WES identified a novel pathogenic variant in the CACNA1F gene (c.1234G > T, p.E412*), inherited maternally. This variant introduces a premature stop codon at position 412, likely resulting in a truncated CACNA1F protein.</p><p><strong>Conclusions: </strong>This case highlights the importance of comprehensive clinical assessments and genetic testing in pediatric patients with unexplained visual impairments, revealing a novel CACNA1F variant that expands our understanding of CSNB. The use of a portable ERG device proved particularly valuable in assessing retinal function in this young patient. Further investigations are warranted to elucidate the clinical implications of this novel pathogenic variant.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":"33-39"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A modified analysis protocol for the PhNR test.","authors":"William H Ridder, Jeffrey D Farmer","doi":"10.1007/s10633-024-09995-6","DOIUrl":"10.1007/s10633-024-09995-6","url":null,"abstract":"<p><strong>Purpose: </strong>Several studies have reported that glaucoma patients have abnormal photopic negative response (PhNR) results compared to reference control subjects. The International Society for Clinical Electrophysiology of Vision (ISCEV) released an extended protocol for PhNR (I-PhNR) in 2018. The purpose of this study was to compare the I-PhNR protocol to a similar protocol modified (M-PhNR) to enhance the performance of the method in detecting glaucomatous damage.</p><p><strong>Methods: </strong>Thirty subjects were enrolled in this study (12 glaucoma patients, 10 glaucoma suspects, 8 normal controls). PhNR tests were conducted with a Diagnosys E3 mobile system (Diagnosys LLC, Lowell, MA). I-PhNR tests utilized all parameters specified by the ISCEV requirement. M-PhNR tests used the same parameters as the ISCEV tests with the exceptions of a 5-45 Hz bandpass filter and a novel, objective sweep-selection parameter. According to the ISCEV protocol, the PhNR relative to baseline (i.e., BT), a-wave and b-wave response amplitudes and BT/b-wave amplitude ratios were measured. Coefficients of variation, receiver operating characteristic (ROC) curves, and t-tests were used to assess the data from one randomly chosen eye per subject.</p><p><strong>Results: </strong>The M-PhNR protocol resulted in a decrease in the intra-subject repeat test coefficient of variation and a decrease in the average inter-subject coefficient of variation for the glaucoma subjects. The ROC curves demonstrated an increase in the area under the curve (AUC) for the M-PhNR compared to the I-PhNR protocol. The sensitivity and specificity were also greater for the M-PhNR protocol.</p><p><strong>Conclusions: </strong>The M-PhNR protocol resulted in a decrease in intra-subject and inter-subject data variability which resulted in a significant increase in the ROC AUC, sensitivity, and specificity for glaucoma. Thus, the M-PhNR protocol shows promise as a better diagnostic tool than the I-PhNR protocol for detecting glaucoma.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":"151-163"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}