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Subspecialties Glaucoma

Shifting Patterns in Glaucoma Management

Current methods of glaucoma diagnosis using visual field (VF) testing or OCT can fall short on their sensitivity to glaucomatous changes, partly because of their dependence on surrogate markers of VF deficits. Even markers which accurately reflect VF loss only signal neuronal cell death – which remains irreversible. Far better would be to diagnose the disease at an earlier stage, when retinal cells are only damaged rather than already dead. 

Pattern electroretinography (ERG) detects subtle changes in electrical responses within the retinal ganglion cell (RGC) layer, and is capable of sensing abnormalities well before these cells atrophy and die. As an objective measure of function, the test is much more sensitive to glaucomatous changes than either VF testing or OCT, and provides invaluable data to identify glaucoma suspects and inform the diagnosis and management of glaucoma patients.

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About the Author

Peter Good

Peter Good is the head of the Visual Function department at Birmingham Midland Eye Centre, Birmingham, UK.

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