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D.C. Hood, P. Thienprasiddhi, V.C. Greenstein, B.J. Winn, X. Zhang, N. Ohri, J.M. Liebmann, R. Ritch; A Comparison of Visual Field Abnormalities Detected by Multifocal VEPs and Static Achromatic Automated Perimetry . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1042.
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Purpose: To better understand the relationship between local field abnormalities detected by the multifocal VEP (mfVEP) and static achromatic automated perimetry. Methods: The 49 patients selected for this study had: 1. a mean deviation (MD) of better than –8 dB in both eyes on the 24-2 Humphrey Visual Field (HVF) and 2. glaucomatous damage in at least one eye as defined by an abnormal disc and an abnormal HVF (PSD<5% and/or GHT outside of normal limits). Monocular mfVEPs were obtained from each eye using a pattern-reversal dartboard array, 44.5 deg in dia., and containing 60 sectors. Recording electrodes were placed at the inion (I) and I+4 cm, and also at two lateral locations up 1 cm and over 4 cm from I. Monocular and interocular analyses were performed [1,2]. For both the HVF and mfVEP tests, a hemifield was classified as abnormal on a cluster test [e.g. 2-4], if 2 or more contiguous points were significant at <1% or 3 or more contiguous points were significant at <5%, with at least one at <1%. Results: Of the 196 hemifields tested (49 patients X 2 eyes X 2 hemifields), 76 showed significant clusters on the HVF while 61 (interocular test) and 78 (monocular test) showed significant clusters on the mfVEP. Overall, the HVF and mfVEP agreed for 76% of the hemifields, 87 hemifields were normal and 61 were abnormal on both the mfVEP (interocular and/or monocular abnormal) and HVF cluster tests. Of the 48 disagreements, 33 hemifields had a significant cluster on the mfVEP, but not the HVF, while the reverse was true for 15 hemifields. A case-by-case analysis indicated that misses and false positives occurred on both the HVF and mfVEP tests. Conclusions: As predicted from a theoretical analysis [1,2], the HVF and monocular mfVEP tests detect a comparable number of defects and, with the addition of the interocular test, the mfVEP detects more abnormalities than the HVF. However, there are abnormalities detected by the HVF that can be missed by the mfVEP. 1. Hood et al (2002) AO. 2. Hood & Greenstein (2003), Prog Ret Eye Res. 3. Chauhan et al, (1988) Doc Ophth. 4. Goldberg et al (2002) AJO.
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