Utility of the Modified Isolated-check Visual Evoked Potential Technique in Functional Glaucoma Assessment

• Published in: Journal of glaucoma Vol. 29; no. 4; pp. 258 - 263
• Main Authors: Kolomeyer, Natasha N., Drinkwater, Owen J., Drivas, Eleni, Zakik, Amir, Zemon, Vance, Sidoti, Paul A., Tsai, James C., Panarelli, Joseph F.
• Format: Journal Article
• Language: English
• Published: United States Wolters Kluwer Health, Inc. All rights reserved 01-04-2020; Copyright Wolters Kluwer Health, Inc. All rights reserved
• Subjects: Adult; Aged; Cross-Sectional Studies; Evoked Potentials, Visual - physiology; Female; Glaucoma - physiopathology; Humans; Intraocular Pressure - physiology; Male; Middle Aged; Ocular Hypertension - physiopathology; Prospective Studies; Visual Acuity - physiology; Visual Cortex - physiopathology; Visual Field Tests - methods; Visual Fields - physiology
• ISSN: 1057-0829; 1536-481X
• DOI: 10.1097/IJG.0000000000001439

PRE[COMBINING ACUTE ACCENT]CIS:Cortical response to low-contrast stimuli, as measured by isolated-check visual evoked potential (icVEP) technology, has the potential to provide functional assessment that may complement standard achromatic perimetry in assessing glaucomatous change.
PURPOSE:To evaluate the utility of modified icVEP testing in detecting functional glaucomatous damage.
MATERIALS AND METHODS:Subjects who met predetermined criteria of controls, glaucoma suspects, preperimetric glaucoma, or glaucoma were enrolled in this prospective cross-sectional study from a single tertiary care center. Glaucoma patients were further categorized as early, moderate, advanced, or severe on the basis of Hodapp-Anderson-Parrish criteria. icVEP testing was performed with ten 2-second runs per qualified eye using the EvokeDx testing software. Multivariate statistics were used to calculate signal-to-noise ratios (SNR) and perform outlier analysis.
RESULTS:In total, 140 eyes met criteria (mean±SD; age of 63±14 y; 49% male; logMAR visual acuity, 0.11±0.089). There was no significant difference in age, sex, or logMAR visual acuity among the groups. Controls had a significantly higher SNR than all other groups (P<0.003), including patients with preperimetric glaucoma. Among those with glaucoma, the early glaucoma patients had significantly higher SNR than the moderate, advanced, or severe glaucoma cohorts (P<0.04). The optimal SNR cutoff for differentiating between glaucomatous and nonglaucomatous eyes was 0.95, both with (sensitivity 82%, specificity 76%) and without (sensitivity 82%, specificity 100%) glaucoma suspects included in analysis.
CONCLUSIONS:icVEP technology has the potential to complement standard achromatic perimetry in functional assessment of glaucomatous defects.