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Multifocal VEP Responses in Glaucoma Patients With Unilateral Hemifield Defects

, : Multifocal VEP Responses in Glaucoma Patients With Unilateral Hemifield Defects. ARVO Annual Meeting Abstract Search & Program Planner : Abstract No 2180

Purpose: To determine whether the multifocal visual evoked potential (mfVEP) technique can detect damage in the unaffected normal hemifields of glaucoma patients with unilateral hemifield defects, as defined by HVF 24-2. Methods: mfVEPs were obtained from 30 control subjects and 10 patients with open-angle glaucoma (OAG). The patients with OAG had unilateral hemifield defects, based on the HVF 24-2. HVF hemifields were considered abnormal if 2 or more adjacent points in the total deviation probability plot exceeded 1%, or 3 or more adjacent points exceeded 5%. The difference between the HVF total deviation values for two eyes (diffHVF) was calculated and compared to the normal data. From this a probability plot was obtained (1). Monocular mfVEPs were obtained from each eye using a pattern-reversal dartboard array with 60 sectors, the diameter of the display was 44.5 deg. The electrodes were placed at the inion (I), 4 cm above I, and 1 cm above and 4 cm either to the left or right side of I. An interocular mfVEP ratio (RMS amplitude(OD)/RMS amplitude(OS)) was obtained for each pair of responses. These ratios were compared to those from the control group, and a probability plot similar to that of the HVF was obtained (2,3). The diffHVF and mfVEP hemifields were considered abnormal if 2 or more adjacent points exceeded 3SD, or 3 or more adjacent points exceeded 2SD. Results: None of the 30 control subjects had mfVEP hemifields defined as abnormal by our criteria. All OAG patients had abnormal mfVEPs in the hemifields defined as abnormal by HVF 24-2. In the patients' unaffected hemifields (defined by HVF), 4 of the 10 patients had abnormal mfVEPs. With the diffHVF, 4 patients showed an abnormality in the unaffected hemifields as defined by HVF, 2 of these patients also had abnormal mfVEPs. Conclusion: The mfVEP is able to detect visual field defects in glaucoma patients (3,4). Defects can be detected with the mfVEP in areas with normal perimetry results.


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