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Abstract #27357 Published in IGR 12-4
Comparison of multifocal visual evoked potential and Heidelberg retinal tomography in glaucoma diagnosis
Yang X-G; Liu Z; Yu J-N; Li P; Pan A-Z; Chen YChinese Ophthalmic Research 2010; 28: 739-744
Background: The early diagnosis of glaucoma is very important for the effective treatment. Perimetry is thought to be a conventional examination for the diagnosis of glaucoma. But the subjective outcome is the primary limit for perimetry. So far multifocal visual evoked potential (mVEP) and Heidelberg retina tomography (HRT) have been used in the diagnosis of glaucoma. Objective: Present trial was to compare the sensitivity, specificity and agreement of mVEP, HRT-II and perimetry in diagnosis of glaucoma. Methods: Forty-nine glaucoma patients and 30 matched normal volunteers accepted Humphrey visual field (HVF), mVEP and HRT-II tests. One eye per individual was included in the study. Individuals were evaluated with validity and reliability of diagnostic test. The agreement of these three tests was assessed using Kappa statistical method. Informed consent was obtained from all participants to include the data in this study, and the study followed the principles of the Helsinki Declaration. Results: The mean deviation (MD) and pattern standard deviation (PSD) were (-0.4 (plus or minus) 1.8) dB and (-0.4(plus or minus) 1.8) dB respectively in control group and (-7.0 (plus or minus) 6.0) dB and (6.5 (plus or minus) 3.7) dB in trial group. Sensitivity, specificity and Kappa values of mVEP were 92%, 97% and 86. 82% respectively and those of HRT-II were 61% -82%, 93% -97% and 51.85% -71.73% respectively. Topographic comparison of the presence of visual field defects on HVF and mVEP in different areas of the visual field showed good agreement. Comparison of optic nerve head structural abnormality with corresponding field defects areas between HVF and mVEP showed a poor to moderate agreement. The area under the curve of moorfield regression analysis, FSM discriminant function and RB discriminant function of HRT-II was 0.87 (95% CI:0.76-0.92), 0.78 (95% CI: 0.68-0.89) and 0.86 (95% CI:0.73-0.91) respectively. Conclusion: The mVEP and HRT can indicate glaucomatous damage in both function and structure but show limited correlation. HVF and mVEP have better correlation with each other than with HRT. It remains important to look for the information both functional and structural changes in screen of glaucoma cases. LA: Chinese
X.-G. Yang. Shanxi Ophthalmic Medical Center, Xi' an Fourth Hospital, Medical School of Xi' an Jiaotong University, Xi' an 710004, China. xinguang.yang@hotmail.com
Classification:
6.7 Electro-ophthalmodiagnosis (Part of: 6 Clinical examination methods)
6.9.1.1 Confocal Scanning Laser Ophthalmoscopy (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis > 6.9.1 Laser scanning)