ArticleDocumenta ophthalmologica. Advances in ophthalmology2026
Photopic negative response (PhNR) of the full-field electroretinogram as a biomarker of retinal ganglion cell loss in glaucoma: a systematic review and meta-analysis.
Article in Documenta ophthalmologica. Advances in ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThe photopic negative response (PhNR) of the full-field electroretinogram reflects retinal ganglion cell (RGC) function and is reduced in glaucoma, yet no quantitative synthesis of PhNR amplitude data across glaucoma studies exists.
methodsPubMed, Embase, Web of Science, Scopus, and Cochrane Central were searched from inception to February 2025 for studies reporting full-field PhNR amplitude in glaucoma patients versus healthy controls. Random-effects meta-analysis (DerSimonian-Laird) was performed. Subgroup analyses examined glaucoma subtype (POAG, NTG, OHT/suspect), disease severity, and recording methodology. Meta-regression assessed intraocular pressure (IOP) as a moderator. Publication bias was evaluated by Egger and Begg tests. Quality was assessed using the Newcastle-Ottawa Scale.
resultsTwenty-eight studies (2847 eyes: 1624 glaucoma, 1223 controls) met inclusion criteria. Glaucoma patients demonstrated significantly reduced PhNR amplitude versus controls (pooled standardized mean difference [SMD] = - 37.82 μV, 95% CI - 40.14 to - 35.50, p < 0.001; I
conclusionsPhNR amplitude is a sensitive, non-invasive electroretinographic biomarker of RGC loss in glaucoma, reduced proportionally to disease severity and IOP. These findings support incorporation of PhNR into glaucoma electrophysiological assessment protocols. PROSPERO: CRD420261487121.
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