Clinical Ability of High Frequency Pattern VEP and Flicker ERG Examination to Detect Glaucomatous Visual Field Change

ABSTRACT

PURPOSE: We investigated whether pattern visual evoked potential (VEP) and flicker electroretinogram (ERG) are helpful in detecting the progression of glaucomatous field defect on standard automated perimetry. METHODS: We investigated 50 eyes with primary open-angle glaucoma (POAG) (n=18), glaucoma suspect (n=21), and control (n=11) tested with high frequency pattern VEP and flicker ERG at first visit in our hospital from 1998 to 2002. The results were applied as a prospective study. RESULTS: Thirteen eyes (study group) showed progressive defects, whereas 37 eyes (control group) showed no progression. The hit ratio, sensitivity and specificity were 78.0%, 84.6% and 75.7%, respectively, according to retino-cortical time (RCT) of 88 msec using the receiver operating characteristic curves. The mean survival time for the group with RCT less than 88.0 msec (41.95 months) was longer than that for the group with RCT more than 88.0 msec (31.0 months). The group which had more than 88.0 msec in RCT showed a hazard ratio of glaucomatous field defect progression of 7.855 compared to the other group (RCT: difference between P100 latency in VEP and a wave implicit time in ERG). CONCLUSIONS: Our study showed that high frequency pattern VEP and flicker ERG were significant in the progression of glaucomatous field defect.