|Articles|February 1, 2015

Electrophysiology's role in early detection of glaucoma

An office-based system (NOVA Testing System, Diopsys) represents an advance in electrophysiological technology that allows clinicians the ability to detect pathology they have been unable to see in the past, thereby detecting disease early.

 

Take home

An office-based system (NOVA Testing System, Diopsys) represents an advance in electrophysiological technology that allows clinicians the ability to detect pathology they have been unable to see in the past, thereby detecting disease early.

 

By Mark A. Latina, MD, Special to Ophthalmology Times

Boston-Since the conclusion of the Early Manifest Glaucoma Trial, ophthalmologists have known that the sooner glaucoma is treated, the better the prognosis.1 Making a definitive diagnosis is often difficult, however. Glaucoma can occur without high IOP, without visual field defects, and without thin corneas.

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The only characteristics patients with glaucoma have in common are the soma of ganglion cell loss. Detecting retinal nerve fiber layer (RNFL) thinning and/or ganglion cell loss at their earliest manifestation while the cells are beginning to lose function can be difficult.

Historically, visual evoked potentials (VEP) and electroretinography (ERG) tests have been in use in research facilities to analyze the functional integrity of the neuro-visual pathway. Though the information from these tests was always considered valuable, the nature of the testing made it impractical to integrate into everyday clinical practice.

VEP and ERG testing equipment used to be bulky, expensive, and fragile, and the extensive data generated required a neurophysiologist to decipher the results. ERG tests required sensors to be placed directly on the patient’s eye and remain there for 45 to 50 minutes, creating a long and invasive exam.

An office-based system (NOVA Testing System, Diopsys) represents an advance in electrophysiological technology that allows clinicians the ability to detect pathology they have been unable to see in the past, thereby detecting disease early.

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