Multifocal visual evoked potential responses in glaucoma patients with unilateral hemifield defects

Thienprasiddhi, Phamornsak; Greenstein, Vivienne C; Chen, Candice S; Liebmann, Jeffrey M; Ritch, Robert; Hood, Donald C

doi:10.1016/S0002-9394(03)00080-1

« Previous Next »American Journal of Ophthalmology
Volume 136, Issue 1 , Pages 34-40, July 2003

Multifocal visual evoked potential responses in glaucoma patients with unilateral hemifield defects☆

This study was presented in part at the Annual Meeting of the Association for Research in Vision and Ophthalmology, Fort Lauderdale, Florida, May 2002.

Phamornsak Thienprasiddhi, MD
- Department of Ophthalmology, The New York Eye and Ear Infirmary (P.T., R.R.), New York, New York, USA
Vivienne C Greenstein, PhD
- Department of Ophthalmology, College of Physicians and Surgeons, Columbia University (V.C.G.), New York, New York, USA
- Department of Ophthalmology, New York University School of Medicine (V.C.G.), New York, New York, USA
Candice S Chen, MD
- Department of Psychology, Columbia University (C.S.C., D.C.H.), New York, New York, USA
Jeffrey M Liebmann, MD
- Department of Ophthalmology (J.M.L.), Manhattan Eye, Ear, and Throat Hospital and New York University School of Medicine, New York, New York, USA
Robert Ritch, MD
- Department of Ophthalmology, The New York Eye and Ear Infirmary (P.T., R.R.), New York, New York, USA
- Inquries to Robert Ritch, MD, Glaucoma Service, The New York Eye and Ear Infirmary, 310 East 14th St, New York, NY 10003, USA; fax: (212) 420-8743
Donald C Hood, PhD
- Department of Psychology, Columbia University (C.S.C., D.C.H.), New York, New York, USA

Accepted 3 January 2003.

Abstract

Purpose

To determine whether the multifocal visual evoked potential (mfVEP) technique can detect damage to the visual system in the unaffected hemifields of patients with glaucoma and unilateral hemifield defects.

Design

Experimental study.

Methods

Monocular mfVEPs and achromatic automated perimetry (AAP) were obtained in both eyes of 16 patients with open-angle glaucoma and unilateral hemifield defects. The mfVEPs were obtained using a pattern-reversal dartboard array with 60 sectors; the entire display was 44.5 degrees in diameter. For each pair of mfVEP responses an interocular ratio of root-mean-square amplitude was calculated. These values were compared with the mean values obtained from 30 control subjects. Probability plots for MfVEP were derived. A cluster analysis was used to determine whether an mfVEP hemifield was normal or abnormal.

Results

Three of 60 (5.0%) mfVEP hemifields from control subjects had significant mfVEP deficits based upon a cluster of abnormal points. Significant mfVEP deficits were detected in the affected AAP hemifield in 15 of 16 (93.8%) glaucoma patients and in 6 of 16 patients in hemifields with apparently normal AAP. The percentage of hemifields with abnormal mfVEPs, but normal AAP, was significantly higher for the glaucoma patients than for the controls (37.5% vs 5.0%, P < .001, chi square).

Conclusion

In glaucomatous eyes with achromatic visual fields defects limited to one hemifield, the mfVEP technique can detect evidence of glaucomatous damage in the unaffected hemifield.

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☆ This study was supported in part by NIH/NEI Grant EY02115 and by The Steven and Shelley Einhorn Research Fund of the New York Glaucoma Research Institute, New York, New York.

PII: S0002-9394(03)00080-1

doi:10.1016/S0002-9394(03)00080-1

« Previous Next »American Journal of Ophthalmology
Volume 136, Issue 1 , Pages 34-40, July 2003

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