A method for comparing electrophysiological, psychophysical, and structural measures of glaucomatous damage.
OBJECTIVE
To develop a method for comparing multifocal visual-evoked potential (mfVEP) responses and behaviorally determined visual fields with structural measures of the optic nerve head.


METHODS
Humphrey 24-2 visual fields and mfVEPs were obtained from each eye of 20 patients with open-angle glaucoma. Monocular and interocular analyses were performed to identify locations with abnormal mfVEP responses. Optic discs were assessed with a confocal scanning laser ophthalmoscope (Heidelberg Retina Tomograph II). The image of the optic nerve head was divided into 6 sectors. The rim and disc area measurements for each sector were compared with those in a normal database using Moorfields regression analysis. The optic nerve head measurements for the 6 sectors were related to the Humphrey visual field locations and the 60 sectors of the mfVEP display.


RESULTS
Of 240 sectors tested (40 eyes x 6 sectors), 18.8% on Humphrey visual field, 22.1% on mfVEP, and 10.8% on confocal scanning laser ophthalmoscopic testing were significantly different from those of control subjects. There were no significant deficits in 165 sectors. There was agreement for 86.7% of the sectors when the Humphrey visual field and mfVEP results were compared. The confocal scanning laser ophthalmoscopic results were in agreement for 84.6% of these sectors.


CONCLUSIONS
The method used allows for a comparison among measures of visual function and a structural measure of the optic nerve head. In general, the results of the functional and structural measures showed agreement; however, there were clear examples of disagreements that merit further study.
Greenstein
Vivienne C
VC
Department of Ophthalmology, College of Physicians and Surgeons, Columbia University, 635 W 168th Street, New York, NY 10032, USA.
Thienprasiddhi
Phamornsak
P
Ritch
Robert
R
Liebmann
Jeffrey M
JM
Hood
Donald C
DC
D000328:Adult; D000368:Aged; D004594:Electrophysiology; D005074:Evoked Potentials, Visual; D005902:Glaucoma, Open-Angle / Q000175:diagnosis*; D006801:Humans; D007429:Intraocular Pressure; D008875:Middle Aged; D009887:Ophthalmoscopy; D009898:Optic Disk / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000175:diagnosis*; D011601:Psychophysics; D015203:Reproducibility of Results; D014786:Vision Disorders / Q000175:diagnosis*; D014792:Visual Acuity; D014794:Visual Fields