{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T17:13:40Z","timestamp":1782321220888,"version":"3.54.5"},"reference-count":40,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T00:00:00Z","timestamp":1683244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>The present manuscript introduces an investigation of the structural and functional changes in the optic nerve in patients undergoing glaucoma treatment by comparing optical coherence tomography (OCT) measurements and RETeval system parameters. For such a purpose, 140 eyes were examined at the Ophthalmology Clinic of the \u201cElpis\u201d General Hospital of Athens between October 2022 and April 2023. A total of 59 out of 140 eyes were from patients with early glaucoma under treatment (case group), 63 were healthy eyes (control group) and 18 were excluded. The experimental measurements were statistically analyzed using the SPSS software package. The main outcomes are summarized below: (i) there was no statistical difference between the right and left eye for both groups, (ii) statistical differences were found between age interval subgroups (30\u201354 and 55\u201380 years old) for the control group, mainly for the time response part of the RETeval parameters. Such difference was not indicated by the OCT system, and (iii) a statistical difference occurred between the control and case group for both OCT (through the retinal nerve fiber layer\u2013RNFL thickness) and the RETeval parameters (through the photopic negative response\u2013PhNR). RNFL was found to be correlated to b-wave (ms) and W-ratio parameters. In conclusion, the PhNR obtained by the RETeval system could be a valuable supplementary tool for the objective examination of patients with early glaucoma.<\/jats:p>","DOI":"10.3390\/s23094504","type":"journal-article","created":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T08:12:11Z","timestamp":1683274331000},"page":"4504","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Investigating the Structural and Functional Changes in the Optic Nerve in Patients with Early Glaucoma Using the Optical Coherence Tomography (OCT) and RETeval System"],"prefix":"10.3390","volume":"23","author":[{"given":"Marsida","family":"Bekollari","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering, University of West Attica, Ag. Spyridonos, 12243 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Dettoraki","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, \u201cElpis\u201d General Hospital, 11522 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Stavrou","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, \u201cElpis\u201d General Hospital, 11522 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aikaterini","family":"Skouroliakou","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, University of West Attica, Ag. Spyridonos, 12243 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3036-9389","authenticated-orcid":false,"given":"Panagiotis","family":"Liaparinos","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, University of West Attica, Ag. Spyridonos, 12243 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1001\/jamaophthalmol.2021.0146","article-title":"A global assessment of eye health and quality of life","volume":"139","author":"Assi","year":"2021","journal-title":"JAMA Ophthalmol."},{"key":"ref_2","unstructured":"World Health Organization (2019). World Report of Vision, World Health Organization."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"9","DOI":"10.2147\/PROM.S162802","article-title":"The use of patient-reported outcome research in modern ophthalmology: Impact on clinical trials and routine clinical practice","volume":"10","author":"Braithwaite","year":"2019","journal-title":"Patient Relat. Outcome Meas."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Camara, J., Neto, A., Pires, I.M., Villasana, M.V., Zdravevski, E., and Cunha, A. (2022). A Comprehensive Review of Methods and Equipment for Aiding Automatic Glaucoma Tracking. Diagnostics, 12.","DOI":"10.3390\/diagnostics12040935"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1901","DOI":"10.1001\/jama.2014.3192","article-title":"The Pathophysiology and Treatment of Glaucoma: A Review","volume":"311","author":"Weinreb","year":"2014","journal-title":"JAMA"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Deemer, A.D., Goldstein, J.E., and Ramulu, P.Y. (2022). Approaching rehabilitation in patients with advanced glaucoma. Eye.","DOI":"10.1038\/s41433-022-02303-z"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Deimantavicius, M., Hamarat, Y., Lucinskas, P., Zakelis, R., Bartusis, L., Siaudvytyte, L., Januleviciene, I., and Ragauskas, A. (2020). Prospective clinical study of non-invasive intracranial pressure measurements in open-angle glaucoma patients and healthy subjects. Medicina, 56.","DOI":"10.3390\/medicina56120664"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Cvenkel, B., and Kolko, M. (2023). Devices and treatments to address low adherence in glaucoma patients: A narrative review. J. Clin. Med., 12.","DOI":"10.3390\/jcm12010151"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1001\/archopht.1982.01030030137016","article-title":"Optic Nerve Damage in Human Glaucoma. Quantitative III Correlation of Nerve Fiber Loss and Visual Field Defect in Glaucoma, Ischemic Neuropathy, Papilledema, and Toxic Neuropathy","volume":"100","author":"Quigley","year":"1982","journal-title":"Arch. Ophthalmol."},{"key":"ref_10","first-page":"65","article-title":"Chronic Open-Angle Glaucoma and Its Association with The Cup Shape in Referral Ophthalmology Centre","volume":"9","author":"Yaghoobi","year":"2018","journal-title":"Pharmacophores"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/j.survophthal.2009.05.001","article-title":"Understanding the Importance of IOP Variables in Glaucoma: A Systematic Review","volume":"54","author":"Sultan","year":"2009","journal-title":"Surv. Ophthalmol."},{"key":"ref_12","first-page":"66","article-title":"An Overview of Glaucoma Diagnosis & Management: A Literature Review","volume":"11","author":"Alsirhani","year":"2020","journal-title":"Arch. Pharma Pract."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"193","DOI":"10.2147\/tcrm.2006.2.2.193","article-title":"The management of glaucoma and intraocular hypertension: Current approaches and recent advances","volume":"2","author":"Noecker","year":"2006","journal-title":"Ther. Clin. Risk Manag."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"S17","DOI":"10.1016\/j.survophthal.2008.08.003","article-title":"Diagnostic Tools for Glaucoma Detection and Management","volume":"53","author":"Sharma","year":"2008","journal-title":"Surv. Ophthalmol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"S57","DOI":"10.1016\/j.ophtha.2017.07.015","article-title":"Detecting structural progression in glaucoma with optical coherence tomography","volume":"124","author":"Tatham","year":"2017","journal-title":"Ophthalmology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1097\/ICU.0000000000000241","article-title":"Electroretinography in glaucoma diagnosis","volume":"27","author":"Wilsey","year":"2016","journal-title":"Curr. Opin. Ophthalmol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"893","DOI":"10.2147\/OPTH.S356436","article-title":"Correlation between optical coherence tomography and photonic negative response of flash electroretinography in ganglion cell complex assessment in glaucoma patients","volume":"16","author":"Awwad","year":"2022","journal-title":"Clin. Ophthalmol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1007\/s10633-018-9638-x","article-title":"ISCEV extended protocol for the photopic negative response (PhNR) of the full-field electroretinogram","volume":"136","author":"Frishman","year":"2018","journal-title":"Doc. Ophthalmol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"12257","DOI":"10.1038\/s41598-021-91813-z","article-title":"The role of pattern electroretinograms and optical coherence tomography angiography in the diagnosis of normal-tension glaucoma","volume":"11","author":"Lee","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"397178","DOI":"10.1155\/2012\/397178","article-title":"Clinical Applications of the Photopic Negative Response to Optic Nerve and Retinal Diseases","volume":"2012","author":"Machida","year":"2012","journal-title":"J. Ophthalmol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1007\/s10633-016-9528-z","article-title":"Photopic negative response of full-field electroretinography in patients with different stages of glaucomatous optic neuropathy","volume":"132","author":"Kirkiewicz","year":"2016","journal-title":"Doc. Ophthalmol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"3565","DOI":"10.1007\/s10792-020-01515-0","article-title":"The photopic negative response (PhNR): Measurement approaches and utility in glaucoma","volume":"40","author":"Prencipe","year":"2020","journal-title":"Int. Ophthalmol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1167\/tvst.7.6.26","article-title":"Optimizing a portable ERG device for glaucoma clinic: The effect of interstimulus frequency on the photopic negative response","volume":"7","author":"Hui","year":"2018","journal-title":"Trans. Vis. Sci. Technol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1097\/IJG.0000000000001509","article-title":"RETeval portable electroretinogram parameters in different severity stages of glaucoma","volume":"29","author":"Kita","year":"2020","journal-title":"J. Glaucoma"},{"key":"ref_25","first-page":"138","article-title":"The Photopic Negative Response as a promising diagnostic tool in glaucoma. A review","volume":"114","author":"Kiszkielis","year":"2012","journal-title":"Klin. Ocz."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"BIO300","DOI":"10.1167\/iovs.17-21773","article-title":"The Photopic Negative Response: An Objective Measure of Retinal Ganglion Cell Function in Patients With Leber\u2019s Hereditary Optic Neuropathy","volume":"58","author":"Karanjia","year":"2017","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1167\/tvst.5.4.8","article-title":"Photopic Negative Response Obtained Using a Handheld Electroretinogram Device: Determining the Optimal Measure and Repeatability","volume":"5","author":"Wu","year":"2016","journal-title":"Trans. Vis. Sci. Technol."},{"key":"ref_28","first-page":"514","article-title":"The Photopic Negative Response of the Flash Electroretinogram in Primary Open Angle Glaucoma","volume":"42","author":"Viswanathan","year":"2001","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2374","DOI":"10.1038\/s41433-021-01603-0","article-title":"Non-invasive electrophysiology in glaucoma, structure and function\u2014A review","volume":"35","author":"Hoffmann","year":"2021","journal-title":"Eye"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1167\/tvst.3.6.1","article-title":"The Test\u2013Retest Reliability of the Photopic Negative Response (PhNR)","volume":"3","author":"Tang","year":"2014","journal-title":"Trans. Vis. Sci. Technol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1007\/s10633-010-9239-9","article-title":"Inter-subject, inter-ocular and inter-session repeatability of the photopic negative response of the electroretinogram recorded using DTL and skin electrodes","volume":"121","author":"Mortlock","year":"2010","journal-title":"Doc. Ophthalmol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"8539747","DOI":"10.1155\/2017\/8539747","article-title":"New Mydriasis-Free Electroretinogram Recorded with Skin Electrodes in Healthy Subjects","volume":"2017","author":"Asakawa","year":"2017","journal-title":"BioMed Res. Int."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1167\/tvst.9.9.19","article-title":"Factors Affecting Photopic Negative Response Recorded with Reteval System: Study of Young Healthy Subjects","volume":"9","author":"Kato","year":"2020","journal-title":"Trans. Vis. Sci. Technol."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Raharja, A., Leo, S., Chow, I., Indusegaran, M., Hammond, C., Mahroo, O., and Wong, S. (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.","DOI":"10.3390\/life11050437"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1167\/tvst.7.6.27","article-title":"A comparison of the RETeval sensor strip and DTL electrode for recording the photopic negative response","volume":"7","author":"Tang","year":"2018","journal-title":"Trans. Vis. Sci. Technol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"3684","DOI":"10.1167\/iovs.14-16349","article-title":"Effect of Pupil Size on Flicker ERGs Recorded With RETeval System: New Mydriasis-Free Full-Field ERG System","volume":"56","author":"Kato","year":"2015","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1007\/s10633-017-9572-3","article-title":"Constant luminance (cd.s\/m2) versus constant retinal illuminance (Td.s) stimulation in flicker ERGs","volume":"134","author":"Davis","year":"2017","journal-title":"Doc. Ophthalmol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1001\/archopthalmol.2011.1576","article-title":"Effect of race, age, and axial length on optic nerve head parameters and retinal nerve fiber layer thickness measured by Cirrus HD-OCT","volume":"130","author":"Knight","year":"2012","journal-title":"Arch. Ophthalmol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2211","DOI":"10.1016\/j.ophtha.2004.06.013","article-title":"Central corneal thickness of caucasians, chinese, hispanics, filipinos, african, americans, and japanese in a glaucoma clinic","volume":"111","author":"Aghaian","year":"2004","journal-title":"Ophthalmology"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2201","DOI":"10.1167\/iovs.07-0887","article-title":"Correlation between photopic negative response and retinal nerve fiber layer thickness and optic disc topography in glaucomatous eyes","volume":"49","author":"Machida","year":"2008","journal-title":"Investig. Ophthalmol. Vis. Sci."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/23\/9\/4504\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:29:40Z","timestamp":1760124580000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/23\/9\/4504"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,5]]},"references-count":40,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,5]]}},"alternative-id":["s23094504"],"URL":"https:\/\/doi.org\/10.3390\/s23094504","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,5]]}}}