Objective Perimetry in Glaucoma

Graham, Stuart L.; Klistorner, Alexander; Grigg, John; Billson, Francis A.; Ao,

doi:10.1016/s0039-6257(99)00011-9

Cited by 36 publications

(8 citation statements)

References 37 publications

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“…Nevertheless, the ability of the mfVEP to detect progression will be limited by its repeatability 8,11,20. Recent evidence suggests that the mfVEP can have a clear role for monitoring and detecting progression of glaucoma, based on good repeatability figures 4–7. The important issue of early detection of glaucoma has yet to be thoroughly explored, although if glaucoma is diagnosed at an early stage and treated early, visual impairment caused by the disease progression may be limited or minimal.…”

Section: Discussionmentioning

confidence: 99%

“…Despite its disadvantages, which are clearly evident based on the long test duration and variability, full threshold perimetry is considered the gold standard method for visual field assessment in clinical practice and glaucoma related clinical trials 1,3. There is a strong demand for an objective measure of the visual field that can supplement clinical information derived by automated perimetry and other psychophysical tests in the evaluation of glaucoma 4. The multifocal visual evoked potential (mfVEP) is a method for objective assessment of visual field.…”

Section: Introductionmentioning

confidence: 99%

“…The multifocal visual evoked potential (mfVEP) is a method for objective assessment of visual field. It has been shown over the past decades that this method can detect glaucomatous visual field defects with high sensitivity and specificity, and it can have a clear role in the detection and monitoring of glaucomatous progression based on good repeatability figures 4–7. The mfVEP is an objective tool that has yet to find its place within accepted clinical practice.…”

Section: Introductionmentioning

confidence: 99%

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The role of hemifield sector analysis in multifocal visual evoked potential objective perimetry in the early detection of glaucomatous visual field defects

Mousa¹,

Cubbidge²,

Al-Mansouri³

et al. 2013

OPTH

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ObjectiveThe purpose of this study was to examine the effectiveness of a new analysis method of mfVEP objective perimetry in the early detection of glaucomatous visual field defects compared to the gold standard technique.Methods and patientsThree groups were tested in this study; normal controls (38 eyes), glaucoma patients (36 eyes), and glaucoma suspect patients (38 eyes). All subjects underwent two standard 24-2 visual field tests: one with the Humphrey Field Analyzer and a single mfVEP test in one session. Analysis of the mfVEP results was carried out using the new analysis protocol: the hemifield sector analysis protocol.ResultsAnalysis of the mfVEP showed that the signal to noise ratio (SNR) difference between superior and inferior hemifields was statistically significant between the three groups (analysis of variance, P < 0.001 with a 95% confidence interval, 2.82, 2.89 for normal group; 2.25, 2.29 for glaucoma suspect group; 1.67, 1.73 for glaucoma group). The difference between superior and inferior hemifield sectors and hemi-rings was statistically significant in 11/11 pair of sectors and hemi-rings in the glaucoma patients group (t-test P < 0.001), statistically significant in 5/11 pairs of sectors and hemi-rings in the glaucoma suspect group (t-test P < 0.01), and only 1/11 pair was statistically significant (t-test P < 0.9). The sensitivity and specificity of the hemifield sector analysis protocol in detecting glaucoma was 97% and 86% respectively and 89% and 79% in glaucoma suspects. These results showed that the new analysis protocol was able to confirm existing visual field defects detected by standard perimetry, was able to differentiate between the three study groups with a clear distinction between normal patients and those with suspected glaucoma, and was able to detect early visual field changes not detected by standard perimetry. In addition, the distinction between normal and glaucoma patients was especially clear and significant using this analysis.ConclusionThe new hemifield sector analysis protocol used in mfVEP testing can be used to detect glaucomatous visual field defects in both glaucoma and glaucoma suspect patients. Using this protocol, it can provide information about focal visual field differences across the horizontal midline, which can be utilized to differentiate between glaucoma and normal subjects. The sensitivity and specificity of the mfVEP test showed very promising results and correlated with other anatomical changes in glaucomatous visual field loss. The intersector analysis protocol can detect early field changes not detected by the standard Humphrey Field Analyzer test.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The role of hemifield sector analysis in multifocal visual evoked potential objective perimetry in the early detection of glaucomatous visual field defects

Mousa¹,

Cubbidge²,

Al-Mansouri³

et al. 2013

OPTH

View full text Add to dashboard Cite

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“…Many individuals, especially older patients, are weak on subjective tests. [ 4 , 5 , 6 ] Subjective perimetry is associated with a learning curve leading to complicating interpretation of the results in new patients. As a result, the test should be performed two to three times to obtain a valid result.…”

Section: Introductionmentioning

confidence: 99%

P100 Wave Latency and Amplitude in Visual Evoked Potential Records in Different Visual Quadrants of Normal Individuals

Saba

Hashemi

Jafarzadehpour

et al. 2023

JOVR

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Purpose: Assessment of the pattern visual evoked potential (PVEP) responses in different areas of visual fields in individuals with normal vision. Methods: This study was conducted on 80 eyes of normal subjects aged 18–35 years. All participants underwent refraction and visual acuity examination. Visual evoked potential (VEP) responses were recorded in different areas of field. The repeated measure test was used to compare the P100 latency and amplitude of PVEP among different areas. Results: The repeated measures analysis of variance showed a statistically significant difference among different areas in terms of amplitude and latency of P100 (P = 0.002 and P < 0.001, respectively). According to the results, the highest and lowest amplitude of P100 was observed in inferior-nasal and superior areas, respectively. The highest and lowest latency of P100 was related to the temporal and inferior-nasal areas, respectively. Conclusion: This study partially revealed the details of local PVEP distribution in the visual field and there was a significant difference in the amplitude and latency of PVEP wave in different areas of the visual field.

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“…Refinement of recording methods and analysis, including multiple channel recordings Hood et al, 2002), interocular analyses (Graham et al, 2000;Hood et al, 2000b), and signal-to-noise ratio (SNR) or noise-scaled amplitude analyses (Klistorner & Graham, 2001;Zhang et al, 2002), have helped improve the clinical diagnostic accuracy of the mfVEP. Ultimately, however, the diagnostic power of the mfVEP will depend in large part on its SNR as demonstrated by Hood and colleagues (Hood & Greenstein, 2003;Zhang & Hood, 2004a).…”

Section: Introductionmentioning

confidence: 99%

Multifocal visual evoked potential responses to pattern-reversal, pattern-onset, pattern-offset, and sparse pulse stimuli

2009

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The purpose of the present study was to compare standard multifocal visual evoked potential (mfVEP) pattern-reversal responses with those produced by pattern-onset, pattern-offset, and pulsed pattern stimuli. mfVEP recordings were obtained from five normal subjects using VERIS and a 4-electrode array. The standard reversal stimulus had 2(15) m-sequence steps (7.5-min duration). Pattern-onset and -offset responses were evaluated using sequences that all had 32 frames per m-step and 2(10) total steps (7.5 min); but the duration of the contrast step varied so that it was 1, 2, 4, 8, 12, or 16 of the 32 frames. The same series was also inverted so that adapting contrast was high and the stimulus step began with a contrast decrement. The effect of temporal sparseness was studied with positive contrast pulses (two-frame duration) within 16, 20, 24, 28, or 32 frames per m-step (all had 2(11) total steps). Four stimulus locations were isolated to study the effect of spatial sparseness. Standard mfVEP reversal responses were virtually identical to onset responses throughout the field, but ~3.5 times smaller. Responses to pattern onset were about twice as large as those for offset, especially in the lower hemifield, irrespective of adapting contrast level. Offset responses exhibited a different waveform compared with reversal, onset, or brief pulse responses. Though temporally sparse pattern-pulse responses were ~3.5 times larger than standard reversal responses, there was no improvement in signal-to-noise ratio (SNR). However, spatial isolation increased SNR by 22% for reversal responses and by 62% for temporally sparse pulses. Temporally sparse pattern-pulse stimuli do not improve mfVEP SNR unless they are also spatially sparse, suggesting that lateral inhibitory mechanisms have a greater impact than temporal contrast gain control mechanisms. The mfVEP response depends on the polarity of a contrast step, irrespective of the state of contrast adaptation.

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Objective Perimetry in Glaucoma

Cited by 36 publications

References 37 publications

The role of hemifield sector analysis in multifocal visual evoked potential objective perimetry in the early detection of glaucomatous visual field defects

The role of hemifield sector analysis in multifocal visual evoked potential objective perimetry in the early detection of glaucomatous visual field defects

P100 Wave Latency and Amplitude in Visual Evoked Potential Records in Different Visual Quadrants of Normal Individuals

Multifocal visual evoked potential responses to pattern-reversal, pattern-onset, pattern-offset, and sparse pulse stimuli

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