title: Psychophysical and electrophysiological testing in ocular hypertension.
abstract: OBJECTIVE
  The purpose of this study was to compare psychophysical and electrophysiological testings in early optic nerve dysfunction in a group of clinically asymptomatic subjects with suspect ocular hypertension (OHT).
  
  
  METHODS
  Forty eyes of 40 patients with suspect OHT and asymmetrical horizontal cup/disc ratio (0.2/0.4), 22 eyes of 22 patients with open-angle glaucoma (OAG), and 40 eyes of 40 healthy controls were evaluated by using frequency-doubling technology perimetry (FDT), contrast sensitivity (CS), pattern electroretinography (PERG), and pattern visual-evoked potentials (VEP). The VEP were elicited by checkerboard stimuli with large (VEP 120), medium (VEP 45), and small (VEP 15) checks; then the values of the amplitude (A) and latency (L) of P100 peaks were studied. Receiver operator characteristic (ROC) curves were calculated to determine the sensitivity, specificity, and optimal cutoff points of abnormal values. A logistic regression analysis was performed to determine which tests were providing the most useful information. In addition, Kruskal-Wallis test was performed to test the differences between the control group and the OHT group.
  
  
  RESULTS
  VEP P100 peak latency (VEP L15 and VEP L45) and amplitude (VEP A120), PERG N95 peak amplitude, CS at medium spatial frequencies (CS 4SF), and FDT pattern standard deviation (PSD) yielded the greatest sensitivity (85.0 to 60.0%) and specificity (80.0 to 60.0%) ratio, displaying the largest ROC curve areas; whereas PERG N95 peak latency ROC curve had the smallest areas. Kruskal-Wallis test showed that most diagnostic tests were able to differentiate the OHT group from the control group. Stepwise logistic regression analysis identified VEP L15 (p < 0.001), CS 4SF (p = 0.023), FDT PSD (p = 0.032), and VEP A120 (p = 0.072) as tests that could be useful to distinguish controls from OHT.
  
  
  CONCLUSIONS
  Our data confirm that psychophysical and electrophysiological tests are useful for early detection of patients at risk of developing OAG.
authors.affiliation: Department of Ophthalmology, Centre of Ocular Electrophysiology, University of Rome "Sapienza," Rome, Italy. marcella.nebbioso@uniroma1.it
authors.forename: Marcella
authors.initials: M
authors.lastname: Nebbioso
authors.forename: Fabio De
authors.initials: FD
authors.lastname: Gregorio
authors.forename: Laura
authors.initials: L
authors.lastname: Prencipe
authors.forename: Irene
authors.initials: I
authors.lastname: Pecorella
mesh_terms: D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D004596:Electroretinography / Q000379:methods*; D005074:Evoked Potentials, Visual / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D009898:Optic Disk / Q000503:physiopathology*; D009901:Optic Nerve Diseases / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D010775:Photic Stimulation; D011601:Psychophysics / Q000379:methods*; D012372:ROC Curve; D015203:Reproducibility of Results; D058609:Visual Field Tests / Q000379:methods*