Blue-on-yellow perimetry can predict the development of glaucomatous visual field loss.
OBJECTIVE
The purpose of this investigation was to determine whether blue-on-yellow (B/Y) perimetry is capable of predicting the onset and location of impending glaucomatous visual field loss in patients with ocular hypertension.


METHODS
A Humphrey Field Analyzer (Humphrey Instruments, San Leandro, Calif) was modified to perform B/Y perimetry to isolate and measure the sensitivity of short-wavelength-sensitive mechanisms. Participants were tested annually with standard white-on-white (W/W) and B/Y automated perimetry for a period of 5 years.


METHODS
The study population consisted of 38 patients with ocular hypertension and 62 age-matched normal control subjects.


RESULTS
Initially, all 76 ocular hypertensive eyes had normal W/W automated perimetry results, with 67 eyes having normal and nine eyes having abnormal B/Y test results. Five years later, five of the nine ocular hypertensive eyes with initial B/Y abnormal results developed glaucomatous visual field loss measured by standard W/W automated perimetry, while none of the 67 ocular hypertensive eyes with initially normal B/Y results developed abnormal W/W perimetry results.


CONCLUSIONS
Blue-on-yellow perimetry deficits are an early indicator of glaucomatous damage and are predictive of impending glaucomatous visual field loss for standard W/W automated perimetry. To our knowledge, this is the first prospective, long-term longitudinal study that demonstrates the ability to predict the onset of glaucomatous visual field loss in patients with ocular hypertension on the basis of psychophysical testing.
Johnson
C A
CA
Department of Ophthalmology, University of California, Davis, Sacramento 95816.
Adams
A J
AJ
Casson
E J
EJ
Brandt
J D
JD
D000328:Adult; D000368:Aged; D003117:Color Vision Defects / Q000175:diagnosis*; D005260:Female; D005901:Glaucoma / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000175:diagnosis; D011446:Prospective Studies; D011601:Psychophysics; D012680:Sensitivity and Specificity; D014786:Vision Disorders / Q000175:diagnosis* / Q000503:physiopathology; D058609:Visual Field Tests / Q000379:methods*; D014794:Visual Fields