Abstract
BakgroundTo evaluate objectively the anatomical and functional changes of optic nerve in eyes with primary open angle glaucoma (POAG) by the joint use of optical coherence tomography (OCT) and multifocal visual evoked potentials (mfVEP).Methods29 eyes with open angle glaucoma and visual field defects, as well as 20 eyes of 10 age-matched control normal subjects were tested. All participants underwent a complete ophthalmological examination. Moreover, Humphrey visual field test, OCT examination and recording of mfVEP were performed. Amplitude and implicit time of mfVEP, as well as RNFL thickness were measured. Differences in density components of mfVEP and in RNFL thickness among POAG eyes and control eyes were examined using Student’s t-test.ResultsIn glaucomatous eyes the mean Retinal Response Density (RRD) was lower than normal in ring 1, 2 and 3 of mfVEP (p < 0.0001). Specifically the mean amplitude of mfVEP in POAG eyes was estimated at 34.2 ± 17.6 nV/deg2, 6.9 ± 4.8 nV/deg2 and 2.6 ± 1.6 nV/deg2 in rings 1, 2 and 3 respectively. In contrast the mean implicit time was similar to control eyes. In addition, the mean RNFL thickness in POAG eyes was estimated at 76.8 ± 26.6 μm in the superior area, 52.1 ± 16.3 μm in the temporal area, 75.9 ± 32.5 μm in the inferior area and 58.6 ± 19.4 μm in the nasal area. There was a statistically significant difference in RNFL thickness in all peripapillary areas (p < 0.0001) between POAG eyes and controls, with superior and inferior area to present the highest decrease.ConclusionsOur study shows that, although Standard Automatic Perimetry is the gold standard to evaluate glaucomatous neuropathy, the joint use of mfVEP and OCT could be useful in better monitoring glaucoma progression.
Highlights
Glaucoma affects over 70 million people worldwide and is considered to be the second most frequent cause of blindness [1,2]
It is estimated that a loss of 20% of retinal ganglion cells (RGCs) is necessary to detect a 5 dB decrease in mean deviation (MD) of the standard automatic perimetry (SAP) [5]
In light of the above, the purpose of this study is to evaluate the joint use of optical coherence tomography (OCT) and multifocal visual evoked potentials (mfVEP) in the assessment of the structural and functional changes of optic nerve in eyes with primary open angle glaucoma (POAG) and visual field defects
Summary
Glaucoma affects over 70 million people worldwide and is considered to be the second most frequent cause of blindness [1,2]. It is estimated that a loss of 20% of retinal ganglion cells (RGCs) is necessary to detect a 5 dB decrease in mean deviation (MD) of the standard automatic perimetry (SAP) [5]. Examination by SAP is not always adequate for early diagnosis and monitoring of glaucoma. Different studies report that mfVEP as well as OCT can detect and monitor visual field defects more accurately than SAP, which depends on the subject’s response criterion [8,9,10]. In light of the above, the purpose of this study is to evaluate the joint use of OCT and mfVEP in the assessment of the structural and functional changes of optic nerve in eyes with primary open angle glaucoma (POAG) and visual field defects
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