One of the most important factors in the success of glaucoma treatment is an ability to detect the disease before it has damaged ocular structures that result in damaged vision. Of equal importance is access to an intervention that introduces minimal risk while yielding definitive benefit at a time when vision and the health of the eye are not immediately threatened. It would appear that the combined use of PERG testing to detect early glaucoma indicators and SLT to improve aqueous outflow represents a mechanism that delivers on the promise of early diagnosis and treatment.
The case noted above demonstrates some important principles. Importantly, it shows it is feasible to detect and treat very early indicators of glaucoma. In this case, the drop in IOP suggests a successful SLT application, which was correlated with improvements in PERG signal.
Certainly, longer-term follow up is required to demonstrate a durable effect; however, the improvement in functionality in the retinal ganglion cell layer, shown by change in PERG signal, offers promise that treatment prolonged progression of the patient’s glaucoma.
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