Exploratory Study of the Association between the Severity of Idiopathic Intracranial Hypertension and Electroretinogram Photopic Negative Response Amplitude Obtained Using a Handheld Device

Raharja, Antony; Leo, Shaun M.; Chow, Isabelle; Indusegaran, Mathura; Hammond, Christopher J.; Mahroo, Omar A.; Wong, Sui H.

doi:10.3390/life11050437

Open AccessArticle

Exploratory Study of the Association between the Severity of Idiopathic Intracranial Hypertension and Electroretinogram Photopic Negative Response Amplitude Obtained Using a Handheld Device

by

Antony Raharja

^1,2

,

Shaun M. Leo

^3,4

,

Isabelle Chow

^2,5,

Mathura Indusegaran

^2,5,

Christopher J. Hammond

^2,5,

Omar A. Mahroo

^2,3,4,5

and

Sui H. Wong

^1,2,4,*

¹

Medical Eye Unit, St Thomas’ Hospital, London SE1 7EH, UK

²

Department of Ophthalmology, Guys & St Thomas’ NHS Foundation Trust, London SE1 7EH, UK

³

Institute of Ophthalmology, University College London, London EC1V 9EL, UK

⁴

Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK

⁵

Section of Ophthalmology, King’s College London, London SE1 7EH, UK

^*

Author to whom correspondence should be addressed.

Life 2021, 11(5), 437; https://doi.org/10.3390/life11050437

Submission received: 19 April 2021 / Revised: 7 May 2021 / Accepted: 11 May 2021 / Published: 13 May 2021

(This article belongs to the Special Issue Idiopathic Intracranial Hypertension)

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Abstract

The photopic negative response (PhNR) is a negative component of the photopic flash electroretinogram that follows the b-wave and is thought to arise from the retinal ganglion cells. Reduction in its amplitude in idiopathic intracranial hypertension (IIH) has been previously documented using formal electroretinography. This study explored the use of a handheld device (RETeval, LKC technologies, Gaithersburg, MD, USA) in 72 IIH patients of varying stages and severity (and seven controls) and investigated associations between PhNR parameters and disease severity. PhNR amplitudes at 72 ms (P₇₂) and p-ratio (ratio to b-wave peak value) differed significantly across groups, with a trend towards smaller amplitudes in those with severe IIH, defined as papilloedema with Modified Frisén Scale (MFS) ≥ 3, retinal nerve fibre layer (RNFL) ≥ 150 μm or atrophic papilloedema (p = 0.0048 and p = 0.018 for P72 and p-ratio, respectively). PhNR parameters did not correlate with MFS, RNFL thickness, standard automated perimetry mean deviation or macular ganglion cell layer volume. This study suggests that PhNR measurement using a handheld device is feasible and could potentially augment the assessment of disease severity in IIH. The clinical utility of PhNR monitoring in IIH patients requires further investigation.

Keywords: idiopathic intracranial hypertension; retina; electroretinography; retinal ganglion cells; papilledema; pseudotumor cerebri; optic nerve; vision; optical coherence tomography

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MDPI and ACS Style

Raharja, A.; Leo, S.M.; Chow, I.; Indusegaran, M.; Hammond, C.J.; Mahroo, O.A.; Wong, S.H. Exploratory Study of the Association between the Severity of Idiopathic Intracranial Hypertension and Electroretinogram Photopic Negative Response Amplitude Obtained Using a Handheld Device. Life 2021, 11, 437. https://doi.org/10.3390/life11050437

AMA Style

Raharja A, Leo SM, Chow I, Indusegaran M, Hammond CJ, Mahroo OA, Wong SH. Exploratory Study of the Association between the Severity of Idiopathic Intracranial Hypertension and Electroretinogram Photopic Negative Response Amplitude Obtained Using a Handheld Device. Life. 2021; 11(5):437. https://doi.org/10.3390/life11050437

Chicago/Turabian Style

Raharja, Antony, Shaun M. Leo, Isabelle Chow, Mathura Indusegaran, Christopher J. Hammond, Omar A. Mahroo, and Sui H. Wong. 2021. "Exploratory Study of the Association between the Severity of Idiopathic Intracranial Hypertension and Electroretinogram Photopic Negative Response Amplitude Obtained Using a Handheld Device" Life 11, no. 5: 437. https://doi.org/10.3390/life11050437

APA Style

Raharja, A., Leo, S. M., Chow, I., Indusegaran, M., Hammond, C. J., Mahroo, O. A., & Wong, S. H. (2021). Exploratory Study of the Association between the Severity of Idiopathic Intracranial Hypertension and Electroretinogram Photopic Negative Response Amplitude Obtained Using a Handheld Device. Life, 11(5), 437. https://doi.org/10.3390/life11050437

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Exploratory Study of the Association between the Severity of Idiopathic Intracranial Hypertension and Electroretinogram Photopic Negative Response Amplitude Obtained Using a Handheld Device

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