Chronic glaucoma has been shown preferentially to damage larger retinal cells and optic nerve fibres that provide the input to the magnocellular visual pathway. We compared the motion-onset visual evoked potentials (primarily the magnocellular system) with those to standard pattern reversal in 20 patients with bilateral chronic glaucoma. For motion-onset visual evoked potentials, the pattern (isolated 40' checks of 10% contrast) moved in four cardinal directions (varied randomly from trial to trial) at a velocity of 10 deg/s for 20 ms, with an interstimulus interval of 1 s. In pattern-reversal stimulation, the checkerboard reversed at a rate of 2 reversals per second. In 60% of the eyes investigated, the results of both types of visual evoked potentials correlated, showing either normal (27.5%) or increased (32.5%) latencies. In the remaining 40% of the eyes, the normal pattern-reversal visual evoked potential latencies were accompanied by prolonged motion-onset visual evoked potentials. The high occurrence of delayed motion-onset visual evoked potentials in our patients confirms the primary magnocellular loss in chronic glaucoma and suggests that the motion-onset VEPs are suitable for detection of glaucomatous changes.
The authors refer to the experiences with the treatment of glaucoma with isoglaucon of 6 months’ duration. The intraocular pressure and the frequency of droppings during the entire period of examination were statistically significantly lower (p < 0.01) in comparison to the starting values. Neither the visus nor the range of the visual field changed. No statistically significant difference between the starting value for blood pressure and the systolic-diastolic difference during the treatment with isoglaucon ( > 0.05) could be determined. For 3 of the 29 patients the treatment with isoglaucon had to be discontinued; these 3 patients were later operated upon.
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