Đặc điểm điện võng mạc trên bệnh nhân glôcôm tại Bệnh viện Đa khoa Tâm Anh

Glaucoma is a major cause of irreversible blindness globally, often progressing asymptomatically until advanced stages, when damage is irreparable. Early and accurate assessment of functional impairment in the retina and retinal ganglion cells (RGCs) is therefore paramount for effective management and preservation of vision. Electroretinography (ERG) has emerged as a valuable objective clinical tool, particularly the Photopic Negative Response (PhNR), for detecting RGC dysfunction even before conventional visual field defects appear. This study investigates the electrophysiological characteristics of the retina in glaucoma patients at Tam Anh General Hospital, aiming to provide practical data and enhance the diagnostic and monitoring utility of ERG in clinical practice.

Ophthalmologists, optometrists, researchers in ophthalmology, and medical professionals involved in the diagnosis, treatment, and monitoring of glaucoma patients.

This cross-sectional descriptive study, conducted on 34 eyes from 17 glaucoma patients at Tam Anh General Hospital between May and July 2025, utilized the RetEval electroretinography device to evaluate retinal functional parameters. Key metrics analyzed included the amplitude and implicit time of Photopic Negative Response (PhNR), a-wave, b-wave, and the W-ratio. The findings revealed significant reductions in the amplitude and altered implicit times of both PhNR and b-wave responses in glaucoma patients. Specifically, the PhNR amplitude was markedly reduced across all glaucoma types, with the most pronounced reduction observed in angle-closure glaucoma, indicating direct functional impairment of retinal ganglion cells. While a-wave amplitudes showed less variation, b-wave amplitudes were lower than normal, suggesting widespread impact on the inner retinal layers. Interestingly, the mean W-ratio was higher than the abnormal threshold, despite clear clinical signs of ganglion cell damage, suggesting its limitation as a sole diagnostic criterion. The study concludes that PhNR is a sensitive and objective indicator for detecting ganglion cell damage and monitoring disease progression in glaucoma. It highlights the utility of a multidimensional electroretinography assessment, combining PhNR amplitude, b-wave characteristics, and implicit times, to provide a comprehensive evaluation and facilitate early diagnosis and tailored management, even before structural damage becomes evident.