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....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.展开更多
AIM：To evaluate the refractive correction for standard automated perimetry（SAP）in eyes with refractive multifocal contact lenses（CL）in healthy young participants.METHODS：Twenty-nine eyes of 29 participants were ...AIM：To evaluate the refractive correction for standard automated perimetry（SAP）in eyes with refractive multifocal contact lenses（CL）in healthy young participants.METHODS：Twenty-nine eyes of 29 participants were included.Accommodation was paralyzed in all participants with 1%cyclopentolate hydrochloride.SAP was performed using the Humphrey SITA-standard 24-2 and 10-2 protocol under three refractive conditions：monofocal CL corrected for near distance（baseline）;multifocal CL corrected for distance（m CL-D）;and m CL-D corrected for near vision using a spectacle lens（m CL-N）.Primary outcome measures were the foveal threshold,mean deviation（MD）,and pattern standard deviation（PSD）.RESULTS：The foveal threshold of m CL-N with both the24-2 and 10-2 protocols significantly decreased by 2.2-2.5 d B（P〈0.001）,while that of m CL-D with the 24-2 protocol significantly decreased by 1.5 d B（P=0.0427）,as compared with that of baseline.Although there was no significant difference between the MD of baseline and m CL-D with the24-2 and 10-2 protocols,the MD of m CL-N was significantly decreased by 1.0-1.3 d B（P〈0.001）as compared with that of both baseline and m CL-D,with both 24-2 and 10-2 protocols.There was no significant difference in the PSD among the three refractive conditions with both the 24-2 and 10-2 protocols.CONCLUSION：Despite the induced mydriasis and the optical design of the multifocal lens used in this study,our results indicated that,when the dome-shaped visual field test is performed with eyes with large pupils and wearing refractive multifocal CLs,distance correction without additional near correction is to be recommended.展开更多
AIM：To evaluate and compare structural optical coherence tomography（OCT）-based parameters,such as Bruch’s membrane opening-minimum rim width（BMO-MRW）,and retinal nerve fiber layer（RNFL）thickness in glaucoma pa...AIM：To evaluate and compare structural optical coherence tomography（OCT）-based parameters,such as Bruch’s membrane opening-minimum rim width（BMO-MRW）,and retinal nerve fiber layer（RNFL）thickness in glaucoma patients with visual field（VF）defects,and to correlate both to mean deviation（MD）values of obtained standard achromatic perimetry（SAP）examinations.METHODS：Patients with glaucoma and glaucomatous VF defects were enrolled in this prospective study and compared to age-matched healthy individuals.All study participants underwent a full ophthalmic examination and VF testing with SAP.Peripapillary RNFL thickness and BMO-MRW were acquired with SD-OCT.Correlation analyses between obtained global functional and global as well as sectorial structural parameters were calculated.RESULTS：A consecutive series of 30 glaucomatous right eyes of 30 patients were included and compared to 36healthy right eyes of 36 individuals in the control group.Global MD of values correlated significantly with global RNFL（Pearson corr.coeff：0.632,P=0.001）and global BMO-MRW（Pearson corr.coeff：0.746,P〈0.001）values in the glaucoma group.Global MD and sectorial RNFL or BMO-MRW values correlated less significantly.In the control group,MD values did not correlate with RNFL or BMO-MRW measurements.A subgroup analysis of myopic patients（〉4 diopters）within the glaucoma group（n=6）revealed a tendency for higher correlations between MD and BMO-MRW than MD and RNFL measurements.CONCLUSION：In a clinical setting,RNFL thickness and BMO-MRW correlate similarly with global VF sensitivity in glaucoma patients with BMO-MRW showing higher correlations in myopic glaucoma patients.展开更多
AIM: To validate the ability of the Heidelberg Edge Perimeter(HEP) in detecting glaucomatous visual field(VF) defects compared to the Octopus Visual Field(OVF) Analyzer and to determine the test-retest repeatability o...AIM: To validate the ability of the Heidelberg Edge Perimeter(HEP) in detecting glaucomatous visual field(VF) defects compared to the Octopus Visual Field(OVF) Analyzer and to determine the test-retest repeatability of both modalities.METHODS: This prospective, cross-sectional study was conducted at Wills Eye Hospital, Philadelphia, PA. Glaucoma subjects and unaffected controls underwent VF testing using HEP standard automated perimetry(SAP) Ⅲ 30-2 Adaptive Staircase Thresholding Algorithm(ASTA) FAST protocol and OVF G-TOP white-on-white strategy. Testing order was randomized. Pearson's correlation coefficient was calculated for both mean deviation(MD) and pattern standard deviation/square root of loss of variance(PSD/s LV). Receiver operating characteristic(ROC) curves were used to determine the diagnostic abilities of both modalities. Glaucoma subjects returned for repeat testing and intraclass correlation coefficients(ICCs) were calculated to assess test-retest repeatability. RESULTS: Seventy-nine subjects with glaucoma and 36 unaffected controls were enrolled. HEP and OVF were significantly correlated for both MD(r=-0.84; P<0.01) and PSD/s LV(r=0.79; P<0.01). Areas under the ROC curves(AUCs) were also comparable between HEP and OVF for both MD(0.74 and 0.79, respectively; P=0.26) and PSD/sL V(0.74 and 0.82; P=0.08). ICC was high for both HEP (0.96 for MD, 0.95 for PSD/s LV) and OVF(0.82 and 0.88, respectively). Mean test duration(min) was significantly shorter for OVF(2.63) compared to HEP(5.15; P<0.01). CONCLUSION: HEP and OVF show strong correlation for both MD and PSD/s LV, and have similar validity for detecting glaucoma. The test-retest repeatability is high for both HEP and OVF, however the average testing duration of HEP is significantly longer than that of OVF.展开更多
To investigate associations between central visual function and inner retinal structure in primary open-angle glaucoma(POAG). This study enrolled 78 POAG patients and 58 healthy controls. POAG was classified into earl...To investigate associations between central visual function and inner retinal structure in primary open-angle glaucoma(POAG). This study enrolled 78 POAG patients and 58 healthy controls. POAG was classified into early glaucoma and moderate to advanced glaucoma. The following tests were performed on all participants: isolated-check visual evoked potential(ic VEP) testing, 24-2 standard automated perimetry(SAP), and Cirrus optical coherence tomography(OCT) examinations. Signal-to-noise ratio(SNR) measures obtained from ic VEP responses to isolated checks presented at four depths of modulation(DOMs;8%, 14%, 22%, and 32%) were explored. Mean macular sensitivity(mMS) was assessed by calculating the mean sensitivities of central 12 SAP points. Ganglion cell layer+ inner plexiform layer thickness(GCL+IPLT) and peripapillary retinal nerve fiber layer thickness(pRNFLT) were measured by OCT scanning. For each group of subjects, linear relationships among the following measures were analyzed: SNR, mMS, GCL+IPLT, and pRNFLT. SNR, mMS, GCL+IPLT, and pRNFLT were all more significantly decreased in glaucoma than in controls(P<0.001). A significant positive association was found between SNR at 14% DOM and GCL+IPLT at the inferior sector in early glaucoma(r=0.465, P=0.004). In moderate to advanced glaucoma, significant correlations were found between SNR at 32% DOM and mean GCL+IPLT(r=0.364, P=0.023), superior GCL+IPLT(r=0.358, P=0.025), and mean p RNFLT(r=0.396, P=0.025). In addition, in moderate to advanced glaucoma, there were significant correlations between mMS and all relevant measures of retinal thickness(r=0.330–0.663, P< 0.010). In early glaucoma, significant correlations were found between mean mMS and minimum GCL+IPLT(r=0.373, P=0.023), and between inferior mMS and superior GCL+IPLT(r=0.470, P=0.003). Linear models provided a good explanation for the relationship between SNR and inner retinal thickness(IRT), whereas nonlinear models better explained the relationship between mMS and IRT. In early glaucoma, both SNR and mMS were related moderately and significantly to IRT, whereas in moderate to advanced glaucoma, mMS was more strongly correlated with IRT than SNR.展开更多
基金Supported by the Plan of Wenzhou Science and Technology(No.Y20160439)
文摘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.
基金Supported by School of Allied Health Sciences,Kitasato University,Kanagawa,Japan
文摘AIM：To evaluate the refractive correction for standard automated perimetry（SAP）in eyes with refractive multifocal contact lenses（CL）in healthy young participants.METHODS：Twenty-nine eyes of 29 participants were included.Accommodation was paralyzed in all participants with 1%cyclopentolate hydrochloride.SAP was performed using the Humphrey SITA-standard 24-2 and 10-2 protocol under three refractive conditions：monofocal CL corrected for near distance（baseline）;multifocal CL corrected for distance（m CL-D）;and m CL-D corrected for near vision using a spectacle lens（m CL-N）.Primary outcome measures were the foveal threshold,mean deviation（MD）,and pattern standard deviation（PSD）.RESULTS：The foveal threshold of m CL-N with both the24-2 and 10-2 protocols significantly decreased by 2.2-2.5 d B（P〈0.001）,while that of m CL-D with the 24-2 protocol significantly decreased by 1.5 d B（P=0.0427）,as compared with that of baseline.Although there was no significant difference between the MD of baseline and m CL-D with the24-2 and 10-2 protocols,the MD of m CL-N was significantly decreased by 1.0-1.3 d B（P〈0.001）as compared with that of both baseline and m CL-D,with both 24-2 and 10-2 protocols.There was no significant difference in the PSD among the three refractive conditions with both the 24-2 and 10-2 protocols.CONCLUSION：Despite the induced mydriasis and the optical design of the multifocal lens used in this study,our results indicated that,when the dome-shaped visual field test is performed with eyes with large pupils and wearing refractive multifocal CLs,distance correction without additional near correction is to be recommended.
文摘AIM：To evaluate and compare structural optical coherence tomography（OCT）-based parameters,such as Bruch’s membrane opening-minimum rim width（BMO-MRW）,and retinal nerve fiber layer（RNFL）thickness in glaucoma patients with visual field（VF）defects,and to correlate both to mean deviation（MD）values of obtained standard achromatic perimetry（SAP）examinations.METHODS：Patients with glaucoma and glaucomatous VF defects were enrolled in this prospective study and compared to age-matched healthy individuals.All study participants underwent a full ophthalmic examination and VF testing with SAP.Peripapillary RNFL thickness and BMO-MRW were acquired with SD-OCT.Correlation analyses between obtained global functional and global as well as sectorial structural parameters were calculated.RESULTS：A consecutive series of 30 glaucomatous right eyes of 30 patients were included and compared to 36healthy right eyes of 36 individuals in the control group.Global MD of values correlated significantly with global RNFL（Pearson corr.coeff：0.632,P=0.001）and global BMO-MRW（Pearson corr.coeff：0.746,P〈0.001）values in the glaucoma group.Global MD and sectorial RNFL or BMO-MRW values correlated less significantly.In the control group,MD values did not correlate with RNFL or BMO-MRW measurements.A subgroup analysis of myopic patients（〉4 diopters）within the glaucoma group（n=6）revealed a tendency for higher correlations between MD and BMO-MRW than MD and RNFL measurements.CONCLUSION：In a clinical setting,RNFL thickness and BMO-MRW correlate similarly with global VF sensitivity in glaucoma patients with BMO-MRW showing higher correlations in myopic glaucoma patients.
基金Supported by Wills Eye Innovation Grant#WEF15064
文摘AIM: To validate the ability of the Heidelberg Edge Perimeter(HEP) in detecting glaucomatous visual field(VF) defects compared to the Octopus Visual Field(OVF) Analyzer and to determine the test-retest repeatability of both modalities.METHODS: This prospective, cross-sectional study was conducted at Wills Eye Hospital, Philadelphia, PA. Glaucoma subjects and unaffected controls underwent VF testing using HEP standard automated perimetry(SAP) Ⅲ 30-2 Adaptive Staircase Thresholding Algorithm(ASTA) FAST protocol and OVF G-TOP white-on-white strategy. Testing order was randomized. Pearson's correlation coefficient was calculated for both mean deviation(MD) and pattern standard deviation/square root of loss of variance(PSD/s LV). Receiver operating characteristic(ROC) curves were used to determine the diagnostic abilities of both modalities. Glaucoma subjects returned for repeat testing and intraclass correlation coefficients(ICCs) were calculated to assess test-retest repeatability. RESULTS: Seventy-nine subjects with glaucoma and 36 unaffected controls were enrolled. HEP and OVF were significantly correlated for both MD(r=-0.84; P<0.01) and PSD/s LV(r=0.79; P<0.01). Areas under the ROC curves(AUCs) were also comparable between HEP and OVF for both MD(0.74 and 0.79, respectively; P=0.26) and PSD/sL V(0.74 and 0.82; P=0.08). ICC was high for both HEP (0.96 for MD, 0.95 for PSD/s LV) and OVF(0.82 and 0.88, respectively). Mean test duration(min) was significantly shorter for OVF(2.63) compared to HEP(5.15; P<0.01). CONCLUSION: HEP and OVF show strong correlation for both MD and PSD/s LV, and have similar validity for detecting glaucoma. The test-retest repeatability is high for both HEP and OVF, however the average testing duration of HEP is significantly longer than that of OVF.
基金Project supported by the Wenzhou Medical University(No.QTJ13009)the Health Innovation Talents in Zhejiang Province(2016,No.25)the Eye Hospital of Wenzhou Medical University(the Value of IsolatedCheck Visual Evoked Potential in Glaucoma Diagnosis and Monitoring),China。
文摘To investigate associations between central visual function and inner retinal structure in primary open-angle glaucoma(POAG). This study enrolled 78 POAG patients and 58 healthy controls. POAG was classified into early glaucoma and moderate to advanced glaucoma. The following tests were performed on all participants: isolated-check visual evoked potential(ic VEP) testing, 24-2 standard automated perimetry(SAP), and Cirrus optical coherence tomography(OCT) examinations. Signal-to-noise ratio(SNR) measures obtained from ic VEP responses to isolated checks presented at four depths of modulation(DOMs;8%, 14%, 22%, and 32%) were explored. Mean macular sensitivity(mMS) was assessed by calculating the mean sensitivities of central 12 SAP points. Ganglion cell layer+ inner plexiform layer thickness(GCL+IPLT) and peripapillary retinal nerve fiber layer thickness(pRNFLT) were measured by OCT scanning. For each group of subjects, linear relationships among the following measures were analyzed: SNR, mMS, GCL+IPLT, and pRNFLT. SNR, mMS, GCL+IPLT, and pRNFLT were all more significantly decreased in glaucoma than in controls(P<0.001). A significant positive association was found between SNR at 14% DOM and GCL+IPLT at the inferior sector in early glaucoma(r=0.465, P=0.004). In moderate to advanced glaucoma, significant correlations were found between SNR at 32% DOM and mean GCL+IPLT(r=0.364, P=0.023), superior GCL+IPLT(r=0.358, P=0.025), and mean p RNFLT(r=0.396, P=0.025). In addition, in moderate to advanced glaucoma, there were significant correlations between mMS and all relevant measures of retinal thickness(r=0.330–0.663, P< 0.010). In early glaucoma, significant correlations were found between mean mMS and minimum GCL+IPLT(r=0.373, P=0.023), and between inferior mMS and superior GCL+IPLT(r=0.470, P=0.003). Linear models provided a good explanation for the relationship between SNR and inner retinal thickness(IRT), whereas nonlinear models better explained the relationship between mMS and IRT. In early glaucoma, both SNR and mMS were related moderately and significantly to IRT, whereas in moderate to advanced glaucoma, mMS was more strongly correlated with IRT than SNR.
