Multifocal blue-on-yellow visual evoked potentials in early glaucoma

Ophthalmology. 2007 Sep;114(9):1613-21. doi: 10.1016/j.ophtha.2006.11.037.

Abstract

Objective: To determine the sensitivity and specificity of blue-on-yellow multifocal visual evoked potentials (mfVEPs) in early glaucoma.

Design: Cross-sectional study.

Participants: Fifty patients with a confirmed diagnosis of early glaucoma and 60 normal participants.

Methods: Black-and-white mfVEPs and blue-on-yellow mfVEPs were recorded using the Accumap version 2.0 (ObjectiVision Pty. Ltd., Sydney, Australia). All patients also underwent achromatic standard automated perimetry (SAP).

Main outcome measures: Multifocal VEP amplitude and latency values in glaucoma patients were analyzed and compared with those of the normal controls.

Results: Based on the definition of visual field defect, in the group of glaucomatous eyes with SAP defects, amplitude of blue-on-yellow mfVEP was abnormal in all 64 cases (100% sensitivity), whereas black-and-white mfVEP missed 5 cases (92.2% sensitivity). Generally, larger scotomata were noted on blue-on-yellow mfVEP compared with black-and-white mfVEP for the same eyes. There was high topographic correspondence between SAP and amplitude of blue-on-yellow mfVEP and significant (P<0.0001) correlation between them (correlation coefficient, 0.73). Abnormal amplitude was detected in 3 of 60 eyes of control subjects (95% specificity). There was, however, no correlation between visual field defect and latency delay in glaucoma patients. Although there was a significant difference between averaged latency of control and glaucoma eyes, values considerably overlapped.

Conclusions: The blue-on-yellow mfVEP is a sensitive and specific tool for detecting early glaucoma based on amplitude analysis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cross-Sectional Studies
  • Diagnostic Techniques, Ophthalmological*
  • Evoked Potentials, Visual*
  • False Negative Reactions
  • Glaucoma, Open-Angle / diagnosis*
  • Humans
  • Middle Aged
  • Optic Disk / pathology
  • Optic Nerve Diseases / diagnosis*
  • Predictive Value of Tests
  • Reproducibility of Results
  • Scotoma / diagnosis*
  • Sensitivity and Specificity
  • Visual Field Tests
  • Visual Fields*