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Abstract #3487 Published in IGR 4-2
Detection of optic neuropathy in glaucomatous eyes with normal standard visual fields using a test battery of short-wavelength automated perimetry and pattern electroretinography
Bayer AU; Maag KP; Erb COphthalmology 2002; 109: 1350-1361
PURPOSE: To evaluate the clinical use of a test battery of short-wavelength automated perimetry (SWAP), frequency-doubling technology (FDT) perimetry, and pattern-electroretinography (PERG) in patients with definite primary open-angle glaucoma (POAG) but normal results on standard automated perimetry (SAP). STUDY DESIGN: Prospective, comparative, observational case series. PARTICIPANTS: Thirty-six patients with POAG with standard visual field defects in one eye and normal standard visual fields in the contralateral eye and 36 normal controls were enrolled. MAIN OUTCOME MEASURES: SWAP, PERG, FDT, and SAP were performed in all eyes, and global indices and amplitudes were used for statistical analysis. RESULTS: When contralateral POAG eyes with asymmetric glaucomatous damage was compared, a paired t test showed significant differences in SAP mean deviation (MD) (p < 0.0001), SWAP-MD (p = 0.0003), FDT-MD (p = 0.0008), and PERG amplitudes (p < 0.0001). When comparing between POAG eyes with normal results on SAP and normal controls, Student's t test showed significant differences for SWAP-MD (p < 0.0001), FDT-MD (p = 0.0006), PERG N1P1-amplitude (p = 0.0486) and P1N2-amplitude (p < 0.0001); receiver operating characteristic analysis revealed promising accuracy for SWAP-MD of 73.6% (p < 0.0001). SWAP-MD (p < 0.0001) and FDT-MD (p < 0.0001) correlated significantly with SAP-MD and with each other (range, p < 0.0001 to p = 0.0020). Regression analysis revealed that PERG P1N2-amplitude could improve the power of SWAP-MD from 73.6% to detect early POAG in eyes with normal results on SAP to an accuracy of 81.9%. CONCLUSIONS: A test battery of SWAP-MD and PERG P1N2-amplitude could detect glaucomatous optic neuropathy in POAG eyes with normal standard visual fields, whereas FDT-MD and SWAP-MD significantly correlated with each other and with SAP-MD. All tests were able to detect the eye with the more severe glaucomatous optic neuropathy in patients with asymmetric POAG.
Dr. A.U. Bayer, Department of Ophthalmology, Hospital of Weilheim-Schongau, Puetrichstrasse 32, 82362 Weilheim, Germany
Classification:
6.6.2 Automated (Part of: 6 Clinical examination methods > 6.6 Visual field examination and other visual function tests)
6.6.3 Special methods (e.g. color, contrast, SWAP etc.) (Part of: 6 Clinical examination methods > 6.6 Visual field examination and other visual function tests)
6.7 Electro-ophthalmodiagnosis (Part of: 6 Clinical examination methods)