蓝色视野检测早期青光眼的临床研究

目的 探讨蓝色(蓝/白)视野检测早期青光眼的敏感性.方法 采用美国HumphreyⅡ-740型全自动视野计,对32例(32只眼)早期青光眼患者(其中早期原发性开角型青光眼患者16例(16只眼),早期原发性慢性闭角型青光眼患者16例(16只眼)及38例(38只眼)正常对照组进行蓝色(蓝/白)及白色(白/白)视野检测,两组的年龄及性别相匹配.视野检查采用全阈值C-30-2程序,将中心30°内全视网膜光敏感度均值及各象限光敏感度均值(dB值)进行组间比较和分析.结果 两种视野检测方法检测正常人,蓝色视野比白色视野全视网膜光敏感度均值低,差异有显著意义(t=43.46,P<0.001);白色视野检测各点的视网膜光敏感度均值>蓝色视野检测的各对应点,差异有非常显著意义(t=74.642,P<0.001).两种视野检测方法检测早期青光眼,白色视野检测全视网膜光敏感度均值(23.71±4.05)dB;蓝色视野检测全视网膜光敏感度均值(14.16±4.55)dB,较白色视野检测值低,差异有显著意义(t=15.81,P<0.001).两种检测结果有明显相关性(r=0.678,P<0.001).32只眼中,蓝色视野检测异常者29只眼,阳性率84%(27/32);白色视野检测异常者25只眼,阳性率63%(20/32);两种视野计检测的阳性率比较,差异有显著意义(x2=3.864,P=0.049).结论 蓝色与白色视野检测结果有良好的符合性.检测早期青光眼性视野改变,蓝色较白色敏感,表现为早期青光眼的检出率高.     

蓝/黄视野与标准白色视野检测在早期青光眼诊断中敏感性的比较

目的　探讨蓝 /黄视野计与标准白色视野计检查在原发性开角型青光眼早期诊断中的价值。方法　采用瑞士产Octopus10 1型全自动视野计对早期原发性开角型青光眼 2 2例 44眼、对照组正常人 2 0例 40眼进行B/Y及W /W检测 ,视野检测采用tG2 测试程序 ,将中心 3 0°视野内全视网膜光敏感度均值及各象限光敏感度均值 (dB)进行比较。结果　两种视野计检测正常人B/Y较W/W检测全视网膜光敏感度均值低 ,相差 4 2 4dB。早期开角型青光眼B/Y较W /W检测全视网膜光敏感度均值差为 5 5 8dB ,对应各象限视网膜光敏感度均值差 5dB以上 ,视网膜光敏感度均值依次为鼻下>颞下 >鼻上 >颞上 ,以B/Y检测出的缺损面积大且深。早期开角型青光眼组 44眼B/Y检测视野阳性 3 2眼 ,( 72 73 % ) ,W /W检测视野阳性 17眼 ( 3 8 64 % ) ,两种视野计检测结果的异常率有显著差异 (P <0 0 5 )。结论　B/Y与W/W检测结果有良好的符合性 ,检测早期开角型青光眼的视野改变B/Y较W/W敏感。     

多焦视觉诱发电位在原发性青光眼诊断中的应用

目的比较青光眼患者和正常人多焦视觉诱发电位（multifocal visilal evoked potential．mVEP）的差异,以探讨mVEP在原发性青光眼诊断中的作用。方法49例原发性青光眼患者和30例正常人分别行双眼mVEP检查,进而各选一眼纳入研究．采用student—t检验．对比分析两组的信噪比（signal to noise ratio．SNR）和潜伏期。并与视野检查结果行相关性分析。结果正常人潜伏期为（97．84±8．22）ms,青光眼患者潜伏期为（108．40±15．29）mS,两组相比,青光眼患者的潜伏期明显延长（P〈0．011;正常人的信噪比为2．63±0．59,青光眼患者信噪比为2．19±0．74,两组相比,青光眼患者的信噪比明显降低（P〈0．011。经相关性分析,信噪比与视野平均缺损fmeandeviation,MD）具有显著正相关（r=0．64,P〈0．05）;潜伏期与MD具有负相关（r=-0．47,P〈0．051。结论mVEP能较客观地反映青光眼患者不同视野区域的视功能损害情况：在评价mVEP方面．信噪比优于潜伏期。     

早期原发性开角型青光眼倍频视野的改变

目的　探讨早期原发性开角型青光眼(POAG)倍频视野(FDP)的表现。 方法　应用FDP的N 30全阈值程序和HFA视野计(HFA)中心 30 2全阈值程序检查早期青光眼患者 35例 37眼、进展期青光眼患者 36例 43眼、晚期青光眼患者 6例 7眼;正常人 21例 25眼作为对照组。 结果　早期青光眼的FDP主要表现为相对性旁中心暗点和 /或相对性的弓状暗点,上方弓形区(尤其是 10°~20°的视野)和鼻侧视野在青光眼早期最易受到损害。FDP显示的视野损害与HFA的基本一致,但暗点的范围更大,部分早期青光眼病例HFA显示视野正常的部位FDP也可发现局限性暗点。早期青光眼FDP的三个视野指数(FMS、FMD、FPSD)与正常人比较差异有显著性意义,FDP的FMD与HFA的MD有较好的相关性(相关系数r=0 326,P=0 026)。 结论　早期青光眼FDP的改变与HFA有较高的一致性,在POAG早期诊断中FDP可作为一种快速敏感的视功能检测方法。     

早期开角青光眼视网膜光阈值长期波动与昼夜眼压波动关系

用Humphrey视野分析仪测量了早期开角青光眼19例(33眼)及正常人13例(26眼)24小时眼压波动的高峰及低峰时间的视网膜中心30度视野内76点视网膜光阈值长期波动及中心视野10度、15度、30度环上视网膜光阈值。结果显示两组阈值波动差异有高度显著性(P=0.001),阈值长期波动的高低与昼夜眼压波动无相关关系(r=0.09)。中心视野在20度上的波动阈值两组具有高度显著性差异(P=0.001)。表明早期青光眼的中心视野改变在Bjerrum区内。     

OCT检测视网膜神经纤维层厚度及视盘参数在青光眼早期诊断应用

目的 通过光学相干断层成像术(OCT)检测视网膜神经纤维层(RNFL)厚度及视盘结构参数,结合视野改变,探讨OCT在青光眼早期诊断中的应用价值.方法 采用OCT对34只眼疑似闭角型青光眼(SG)患者、36只眼慢性闭角型青光眼(CACG)早中期患者、10只眼正常人行RNFL及视盘扫描,观察各组的RNFL厚度及视盘结构的图像特征;将各象限RNFL厚度和平均RNFL厚度的均数进行总体比较及任意两组间比较;将视乳头水平、垂直杯盘比及杯/盘面积比的均数进行比较;将平均RNFL厚度与视野指数进行相关分析.结果 三组间各象限RNFL厚度、平均RNFL厚度、视盘参数差异有统计学意义(P<0.05);正常人与SG组下方、上方及平均RNFL厚度差异有统计学意义(P<0.05);正常人与CACG早中期组各象限RNFL厚度及平均RNFL厚度差异均有统计学意义(P<0.05);CACG早中期组与SG组上方、下方、鼻侧及平均RNFL厚度差异有统计学意义(P相似文献   

蓝/黄视野计与标准白色视野计检测早期青光眼的敏感性比较

目的　探讨蓝 /黄视野计 (blue on yellowperimetry ,B/Y)又称短波视野计 (short wavelengthperimetry)及自动标准白色视野计 (white on whiteperimetry ,W/W)检测早期青光眼的敏感性。方法　采用自行改装的德国Twinfield视野计 ,对 36例 (46只眼 )早期原发性开角型青光眼患者及 38例对照组正常人 (46只眼 )进行B/Y及W/W检测 ,两组的年龄及性别相匹配。视野检查采用 2 4 2程序 ,将中心 2 5°内全视网膜光敏感度均值及各象限光敏感度均值 (dB值 )进行组间比较和分析。结果　两种视野计检测正常人 ,B/Y较W/W检测全视网膜光敏感度均值低 ,差异有显著意义 (t=3 57,P <0 0 0 1 ) ,但两者仅相差 1 63dB ;两种视野计检测的各对应象限间视网膜光敏感度均值比较 ,差异均有显著意义 (t=3 45 ,P <0 0 0 1 ) ,W/W检测的各象限视网膜光敏感度均值 >与之相对应象限的B/Y检测结果。两种视野计检测早期青光眼 ,全视网膜光敏感度均值差为 2 87dB ,差异有显著意义 (t=4 57,P <0 0 0 1 ) ;各对应象限间视网膜光敏感度均值差 >2 5dB ,差异有显著意义 (t=3 42 ,P <0 0 0 1 ) ;光敏感度均值依次为鼻下 >颞下 >鼻上 >颞上 ;以B/Y检测出的视野缺损面积大且深。按视岛 (islandofvision)矫正的偏差图 (correcteddeviation)     

光学相干断层成像术测量视网膜神经纤维层厚度在青光眼早期诊断中的意义

目的:探讨光学相干断层成像术(optical coherence tomography,OCT)测量视网膜神经纤维层厚度(retinal nerve fiber layer,RNFL)在青光眼早期诊断中的意义.方法:应用OCT测量正常人62例101眼和青光眼患者41例64眼的RNFL厚度,将正常人和青光眼患者的各象限和平均RNFL厚度进行比较;并比较各期青光眼的RNFL厚度;计算平均RNFL厚度和视野平均缺损的相关性,计算OCT测量平均RNFL厚度的敏感性和特异性.结果:青光眼患者和早期青光眼患者的各象限和平均RNFL厚度均比正常人减少,差异有统计学意义(P＜0.05).随着青光眼病程的发展,RNFL厚度逐渐下降.平均RNFL厚度和视野平均缺损呈高度正相关(r=0.722,P=0.000),OCT测量平均RNFL厚度的敏感性为85.9%,特异性为97.0%.结论:OCT测量RNFL厚度为青光眼早期诊断提供了一种新的手段.     

蓝/黄视野计与标准白色视野计在早期青光眼诊断中的意义

目的　评价蓝 /黄视野计 (blue- on- yellow perimetry B/Y又叫短波视野计 short- wavelength perime-try)与标准白色视野计 (white- on- white perim etry W/W)检测早期青光眼的敏感性。方法　采用瑞士产 Octo-pus10 1型全自动视野计对早期原发性开角型青光眼 17例 (34只眼 ) ,对照组正常人 8例 (16只眼 ) ,进行 B/Y及W/W检测 ,视野检测采用 t G2 测试程序 ,将中心 30°视野内全视网膜光敏感度均值及各象限光敏感度均值 d B进行比较分析。结果　两种视野计检测正常人 B/Y较 W/W检测全视网膜光敏感度均值低 ,两者相差 3.96 d B,差异有显著意义 (t=5 .11,P <0 .0 0 1) ,对应各象限视网膜光敏感度均值比较 ,差异均有显著意义 (P <0 .0 0 1) ,早期开角型青光眼 B/Y较 W/W检测全视网膜光敏感度均值差为 5 .34d B,差异有显著意义 (t=5 .87,P <0 .0 0 1)。早期开角型青光眼组 34只眼 B/Y检测视野阳性者 2 4只眼 ,阳性率为 70 .5 9% ,W/W检测视野阳性者 14只眼 ,阳性率为 4 1.18% ,两种视野计检测结果的异常率有显著差异 (χ2 =5 .33,P <0 .0 5 )。结论　 B/Y与 W/W检测结果有良好的一致性 ,检测早期开角型青光眼的视野改变 B/Y较 W/W敏感 ,表现为早期青光眼检测阳性率高 ,检测出的视野缺损范围大而且深     

蓝/黄视野计与标准白色视野计在早期青光眼诊断中的意义

目的 :评价蓝 /黄视野计 (blue on yellowperimetry ,B/Y)又叫短波视野计short wavelengthperimetry与标准白色视野计 (white on whiteperimetry ,W /W )检测早期青光眼的敏感性。方法 :采用瑞士产Octopus 10 1型全自动视野计对早期原发性开角型青光眼 17例 3 4只眼 ,对照组正常人 8例 16只眼 ,进行B/Y及W /W检测 ,视野检测采用tG2 测试程序 ,将中心 3 0°视野内全视网膜光敏感度均值及各象限光敏感度均值 (dB)进行比较分析。结果 :两种视野计检测正常人B/Y较W /W检测全视网膜光敏感度均值低 ,两者相差 3 96dB ,差异有显著意义 (t =5 11,P <0 0 0 1) ,对应各象限视网膜光敏感度均值比较 ,差异均有显著意义 (P <0 0 0 1) ,早期开角型青光眼B/Y较W /W检测全视网膜光敏感度均值差为 5 3 4dB ,差异有显著意义 (t =5 87,P <0 0 0 1) ,对应各象限视网膜光敏感度均值差 5dB以上 ,差异有显著性 (P <0 0 0 1) ,视网膜光敏感度均值依次为鼻下 >颞下 >鼻上 >颞上 ,以B/Y检测出的缺损面积大且深 ,按矫正偏差图 (cor rectedprobability)计算P <2以上缺损点数 ,显示B/Y检测结果大于W /W检测结果 ,前者为后者的 2 2 3倍 ,差异有显著意义( χ2 =13 0 4,P <0 0 0 5 ) ,早期开角型青光眼组 3 4只眼B/Y检测视野     

斜视性弱视多焦VEP与多焦ERG的对比研究

目的对比研究斜视性弱视患者多焦视觉诱发电位(multifoeal VEP)及多焦视网膜电图(mERG)的特征性变化，探讨弱视发病的可能机制。方法采用VERIS Science^TM4．2多焦电生理系统记录并比较正常组30例、斜视性弱视患者20例各眼mVEP及mERG。结果弱视眼不同视网膜区域mVEP、mERG的特征峰反应振幅密度都较对侧眼和正常眼明显降低，mVEP的特征峰潜时延长。弱视眼mVEP、mERG波形异常程度随离心度增加而减小，mVEP波形异常程度大于mERG，且与弱视眼的视力异常程度有相关性。结论斜视性弱视患者的mVEP和mERG具有明显的特征性改变，表明弱视患者的视网膜、视皮层都存在明显损害。     

Objective VEP perimetry in glaucoma: asymmetry analysis to identify early deficits

PURPOSE: The multifocal visual evoked potential (VEP) shows markedly symmetrical responses between the two eyes of control subjects. Patients with glaucoma and patients considered at high risk for glaucoma were examined to determine if VEP asymmetry could be identified and used for diagnosis and detection of early damage. METHODS: Multifocal pattern VEP recordings were performed using a single channel bipolar occipital electrode position and the Visual Evoked Response Imaging System (VERIS). There were 125 subjects: 24 control subjects, 70 patients with glaucoma, and 31 patients considered at high risk for glaucoma. A between-eye relative asymmetry coefficient (RAC) was determined for each of the 60 test points in the VEP field. The RAC for patients with glaucoma and patients considered at risk for glaucoma were compared with values from control subjects. Correlation between Humphrey thresholds and RAC scores was performed. RESULTS: Patients with glaucoma and patients considered at risk for glaucoma both showed significantly larger mean quadrant RAC values. When point by point analysis was performed, 69 out of 70 scotomas were identified with a cluster of at least 3 points of P < 0.05. For those considered at high risk for glaucoma, 10 out of 31 patients had abnormal areas in the VEP field. There was a strong correlation (r = 0.82) between quadrantic RAC mean values and Humphrey quadrant threshold scores in an asymmetric glaucoma subgroup. Abnormal VEP responses were identified in parts of the visual field that were still normal on perimetry. CONCLUSIONS: Asymmetry analysis correctly identifies patients with glaucomatous field loss and shows abnormalities in many patients considered at high risk for glaucoma who still have normal fields. Asymmetry analysis is able to identify objectively the extent of glaucomatous damage and may be able to detect changes before subjective field loss occurs.     

屈光参差性弱视同步记录多焦视觉诱发电位和多焦视网膜电图的对比研究

目的探讨弱视发病的可能机制。方法采用VERIS Science^TM4．2多焦电生理系统对24例屈光参差性弱视患者双眼分别进行多焦图形视觉诱发电位(VEP)、视网膜电图(ERG)同步记录和多焦闪光VEP、ERG同步记录,并与30例正常对照的结果进行比较。结果在不同视网膜区域弱视眼多焦图形VEP、ERG反应和多焦闪光VEP、ERG二阶反应振幅均降低,VEP特征峰潜时延长,ERG潜时无改变。弱视眼多焦闪光一阶反应VEP、ERG的反应振幅密度均降低,潜时无明显改变。多焦图形VEP波形异常程度中心区大于周边区,且与弱视眼的视力异常程度有相关性。弱视眼多焦图形和闪光二阶反应的视网膜．皮层传导时间(RCT)显著延长,闪光一阶反应RCT三组无明显差异。结论弱视眼的mVEP和mERG具有明显的特征性改变,表明弱视眼的视网膜、视觉传导通路和视皮层都存在明显损害,且中心区损害重于周边区,中枢损害重于视网膜。(中华眼科杂志,2005,41：41-46)     

Comparison of pattern visual-evoked potentials to perimetry in the detection of visual loss in children with optic pathway gliomas.

PURPOSE: We sought to compare visual evoked potentials (VEPs) with standard visual field testing in children with visual pathway gliomas. METHODS: Fifteen of 40 children with visual pathway gliomas verified on magnetic resonance imaging scan who cooperated with Goldmann visual field (GVF) and 3-channel VEPs were studied. GVFs were obtained in 25 eyes with adequate vision. VEP amplitudes, latencies, and signal-to-noise ratios (SNRs) were compared with control subjects. Four of the patients (5 eyes) also had Humphrey visual field testing. RESULTS: Twenty-two of 25 eyes had a field defect, 15 eyes showed a relative or absolute hemianopia, 7 eyes showed a central or generalized depression, and 3 eyes were normal. In hemianopic eyes, 87% showed a depression (GVF) or reduced sensitivity (Humphrey field) in the opposite hemifield. VEP amplitudes and SNRs, normally largest at the midline electrode, were significantly reduced in all eyes with visual field loss. By comparison, lateral electrodes showed significantly lower amplitudes and SNRs in patients and controls. Interhemispheric VEP asymmetry (>2:1 ratio) was seen in 67% of patients with hemianopia and 53% of controls. CONCLUSIONS: Reduction of amplitude and SNR at the midline VEP electrode was a sensitive indicator of visual field loss. Interhemispheric VEP asymmetry was not reliable in detection of a hemianopic field defect. VEPs can be a reliable and objective alternative for the detection of visual loss due to optic pathway glioma in children who are intolerant to visual field testing. We recommend the test protocol include pattern-onset and check reversal stimuli of at least one high and one low spatial frequency.     

An interocular comparison of the multifocal VEP: a possible technique for detecting local damage to the optic nerve

PURPOSE: To develop a quantitative measure of local damage to the ganglion cells/optic nerve based on an interocular comparison of multifocal visual evoked potentials (mVEP). METHODS: Multifocal VEPs were recorded from both eyes of six normal subjects and four patients; each eye was stimulated separately. Two of the patients had glaucoma, one had ischemic optic neuropathy, and one had unilateral optic neuritis. All four patients had considerably more damage in one eye than in the other, as indicated by their Humphrey visual fields. The multi-input procedure of Sutter was used to obtain 60 VEP responses to a scaled checkerboard pattern. The amplitude in each response was obtained using a root mean square measure of response magnitude. For each of the 60 pairs of responses, a ratio between the amplitude of the responses from the two eyes was obtained as a measure of the relative health of one eye compared with the other. The mean and SD of this ratio measure for the control group were used to specify confidence intervals for each of the 60 locations. All patients had Humphrey 24-2 visual fields performed. To allow a comparison of the mVEPs to the visual fields, a procedure was developed for displaying the results of both tests on a common set of coordinates. RESULTS: Except for a small interocular difference in timing attributable to nasotemporal retinal differences, the pairs of mVEP responses from the two eyes of the control subjects were essentially identical. Many of the pairs of responses from the patients were significantly different. In general, there was reasonably good agreement with the Humphrey 24-2 visual field data. Although some regions with visual field defects were not detected in the mVEP due to small responses from the better eye, other abnormalities were detected that were hard to discern in the visual fields. CONCLUSIONS: Local monocular damage to the ganglion cell/optic nerve can be quantitatively measured by an interocular comparison of the mVEP.     

Tracking the recovery of local optic nerve function after optic neuritis: a multifocal VEP study

PURPOSE: To explore the multifocal visual evoked potential (mVEP) as a technique for tracking local optic nerve damage after unilateral optic neuritis (ON). METHODS: Humphrey visual fields and mVEP recordings were obtained from three patients within 7 days of an episode of ON. Patients were retested during the recovery phase, approximately 4 to 7 weeks later. The multi-input procedure of Sutter was used to obtain 60 local VEP responses (the mVEP) to a scaled checkerboard pattern. The mVEPs were recorded separately for monocular stimulation of both eyes. RESULTS: Initially, all three patients had extensive visual field defects, reduced visual acuity, and depressed mVEP amplitude in regions of poor visual field sensitivity. By 4 to 7 weeks, the fields recovered to near normal sensitivity in most locations, and visual acuity returned to 20/20. The mVEP recovered to nearly full amplitude in all regions, but substantial delays were present in many locations. The delayed responses were associated with regions of visual field loss documented during the acute phase. CONCLUSIONS: The mVEP can be used to track local optic nerve damage after unilateral ON. This technique should be useful in observing the effects of treatments as well as in testing hypotheses about the mechanisms underlying both the acute loss of vision and the subsequent recovery.     

Frequency doubling technology perimetry using a 24--2 stimulus presentation pattern.

PURPOSE: To assess whether smaller targets and a 24-2 stimulus presentation pattern would improve the ability of frequency doubling technology (FDT) perimetry to detect and characterize early glaucomatous visual field loss. METHODS: One hundred normal subjects between the ages of 20 and 85 participated in this study. In addition, 53 patients who either had early glaucomatous visual field loss (n = 23) or were high-risk glaucoma suspects with normal conventional visual fields (n = 30) were evaluated with the commercial version of FDT perimetry (full threshold test) with 17 stimuli (four 10 degrees diameter square targets per quadrant and a central 5 degrees circular target) and a custom version of FDT perimetry using 54 stimuli (4 degrees targets with 6 degrees grid spacing) arranged in a 24-2 stimulus presentation pattern. RESULTS: The custom FDT test using a 24-2 stimulus presentation pattern had a similar dynamic range, and demonstrated normal aging characteristics and test-retest reliability that were similar to the commercial version of FDT perimetry using 17 larger stimuli. Both FDT tests showed an age-related sensitivity reduction of approximately 0.6 dB per decade, and exhibited an average test-retest reliability of 1 to 1.5 dB. The custom 24-2 FDT perimetry test had a greater variation of sensitivity with eccentricity than the commercial version of FDT perimetry that was probably related to the difference in stimulus size. The custom 24-2 FDT perimetry test had a greater percentage of abnormal test locations than the commercial FDT test for both early glaucomas and high-risk glaucoma suspects. CONCLUSIONS: FDT perimetry can be performed with smaller targets using a presentation pattern that is similar to conventional automated perimetry. In comparison to the commercially available 17 target display, the 24-2 stimulus pattern appears to have modestly higher sensitivity for detection of early glaucomatous loss and provides better characterization of the pattern of visual field loss, but the test takes approximately twice as long.     

Evaluation of VEP perimetry in normal subjects and glaucoma patients

PURPOSE: To estimate sensitivity to glaucomatous visual field loss using multifocal visual evoked potential (VEP) perimetry, to compare these findings to those of conventional achromatic perimetry and to determine specificity of VEP perimetry in normal subjects. METHODS: A total of 33 glaucoma patients with known visual field defects in at least one eye on standard computerized perimetry and 33 healthy subjects were tested with VEP perimetry. The glaucoma patients were also tested with standard computerized perimetry using the 30-2 SITA Fast program of the Humphrey Field Analyzer (HFA). Visual evoked potential perimetry classification and VEP probability maps were used to determine the sensitivity and specificity of the technique. RESULTS: Visual evoked potential perimetry classified 68% of all eyes in the glaucoma group (45/66) as pathological; sensitivity increased to 81% (38/47) when considering only those eyes with HFA field defects. It also identified more test locations with significant loss at the p < 5% level in both groups (48% and 37%, respectively) than did HFA, while HFA identified more loss at the higher significance levels p < 2%, and p < 1%. Visual evoked potential perimetry showed more significant loss in eyes with almost normal or slightly damaged standard fields, while HFA identified more significant field loss in eyes with severe conventional field damage. The mean VEP amplitude of the 66 glaucoma eyes was 1.46e(-7) V; it was 1.676e(-7) V for the 66 control eyes. This difference was significant (p = 0.0033), but the overlap between groups was large. Visual evoked potential perimetry classified 42% of the control eyes as 'outside normal limits', and VEP probability maps showed 30.0% of test segments as significantly depressed at the p < 5% level, 10.8% of sites at p < 2%, and 4.6% at the p < 1% level. CONCLUSION: Mean VEP amplitude differed significantly between normal and glaucoma eyes, but the overlap was considerable. Visual evoked potential perimetry falsely classified a large number of normal eyes as pathological and showed many more significantly depressed test locations than expected. Agreement between VEP and standard perimetry was relatively poor for the glaucoma group. Further refinements are needed before VEP perimetry can be regarded as a reliable clinical method of mapping glaucomatous visual fields.     

Temporal contrast sensitivity with peripheral and central stimulation in glaucoma diagnosis.

AIMS: To evaluate temporal contrast sensitivity with full field, peripheral, and central stimulation and to determine the most sensitive corresponding retinal area for glaucoma damage. METHODS: Temporal contrast sensitivity was determined either with a full field, a peripheral annular area from 30 degrees to 90 degrees, or a central area from 0 degree to 30 degrees at a frequency of 37.1 Hz. 232 eyes of 232 subjects were included. They were classified into four groups: eyes with ocular hypertension (OHT, n = 54), "preperimetric" glaucomas (n = 73) with glaucomatous optic disc abnormalities but no visual field loss, "perimetric" glaucomas (n = 53) with visual field loss, and 52 normals. RESULTS: In all four groups, temporal contrast sensitivity was almost equal with full field and peripheral, but significantly higher than with central stimulation (p < 0.001). With regard to the diagnostic power of the three different stimulus areas, OHTs and glaucomas were found to be best discriminated from normals by peripheral stimulation. CONCLUSIONS: According to these results, temporal contrast sensitivity seems to be determined by peripheral retinal areas. As the diagnostic power of the three different stimulus areas was best with the peripheral stimulation, this condition should be used for early glaucoma diagnosis.     

联合多种视功能检查对原发性开角型青光眼早期诊断的意义

了解原发性开角型青光眼视觉电生理和计算机自动视野检查结果的变化特征并对其视功能状况进行综合分析以寻找比较敏感和特异的参数，为原发性开角型青光眼较早期和早期诊断提供依据。方法：对３６例原发性开角型青光眼患者，８例可疑性青光眼患者，３０例正常对照者分别进行视网膜振荡电位，视网膜电图，视诱发电位和Ｈｕｍｐｈｅｒｙ计算机自动视野检查。