Comparison of isolated-check visual evoked potential and standard automated perimetry in early glaucoma and high-risk ocular hypertension

摘要

AIM:To compare the diagnostic performance of isolatedcheck visual evoked potential(ic VEP) and standard automated perimetry(SAP),for evaluating the application values of ic VEP in the detection of early glaucoma.METHODS:Totally 144 subjects(288 eyes) were enrolled in this study.ic VEP testing was performed with the Neucodia visual electrophysiological diagnostic system.A 15% positive-contrast(bright) condition pattern was used in this device to differentiate between glaucoma patients and healthy control subjects.Signal-to-noise ratios(SNR) were derived based on a multivariate statistic.The eyes were judged as abnormal if the test yielded an SNR≤1.SAP testing was performed with the Humphrey Field Analyzer II.The visual fields were deemed as abnormality if the glaucoma hemifield test results outside normal limits;or the pattern standard deviation with P<0.05;or the cluster of three or more non-edge points on the pattern deviation plot in a single hemifield with P<0.05,one of which must have a P<0.01.Disc photographs were graded as either glaucomatous optic neuropathy or normal by two experts who were masked to all other patient information.Moorfields regression analysis(MRA) used as a separate diagnostic classification was performed by Heidelberg retina tomograph(HRT).RESULTS:When the disc photograph grader was used as diagnostic standard,the sensitivity for SAP and ic VEP was 32.3% and 38.5% respectively and specificity was 82.3% and 77.8% respectively.When the MRA Classifier was used as the diagnostic standard,the sensitivity for SAP and ic VEP was 48.6% and 51.4% respectively and specificity was 84.1% and 78.0% respectively.When the combined structural assessment was used as the diagnostic standard,the sensitivity for SAP and ic VEP was 59.2%and 53.1% respectively and specificity was 84.2% and 84.6% respectivlely.There was no statistical significance between the sensitivity or specificity of SAP and ic VEP,regardless of which diagnostic standard was based on.CONCLUSION:The diagnostic performance of ic VEP is not better than that of SAP in the detection of early glaucoma.