Applications of Isolated-Check Visual Evoked Potential in Early Stage of Open-Angle Glaucoma Patient

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Background:Standard automated perimetry does not sufficiently detect early open-angle glaucoma (OAG) in the clinic.New visual function tests for early glaucoma damage are therefore needed.The present study evaluated whether an isolated-check visual evoked potential (icVEP) could be used to detect visual function abnormalities in early-stage OAG and to explore potential related factors.Methods:This was a cross-sectional study.Thirty-seven OAG patients with early-stage visual field loss (mean deviation ≥-6.00 dB) detected by the Humphrey Field Analyzer (30-2 SITA program) and 26 controls were included in this study.Optical coherence tomography (OCT) was used to detect retinal nerve fiber layer (RNFL) defects.The icVEP preferentially evaluates the magnocellular-ON pathway.VEPs were recorded and signal-to-noise ratios (SNRs) were derived based on multivariate analysis.Eyes that yielded an SNR ≤1 were considered abnormal.Receiver operating characteristic (ROC) curve analysis was used to estimate the accuracy of group classification.Correlations between SNRs and related factors were analyzed.Results:Based on an SNR criterion of 1,the icVEP had a sensitivity of 62.2% and a specificity of 92.3% for diagnosing early-stage OAG with 74.6% classification accuracy.The ROC curve analysis,however,suggested that an SNR criterion of 0.93 would produce the highest classification accuracy (77.3%).Both RNFL thinning in the temporal superior quadrant on OCT and number of abnormal test points in the central 11° visual field (pattem deviation,P < 0.5%) significantly correlated with the SNR (P < 0.05).Conclusions:The icVEP detected visual function abnormalities in approximately 3/5 of eyes with early-stage OAG with greater than 90% specificity.SNR correlated with both a decrease in RNFL thickness and severity of central visual field loss.
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