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Vivienne C. Greenstein, PhD; Phamornsak Thienprasiddhi, MD; Robert Ritch, MD; Jeffrey M. Liebmann, MD; Donald C. Hood, PhD

Arch Ophthalmol. 2004;122:1276-1284.

Objective  To develop a method for comparing multifocal visual-evoked potential (mfVEP) responses and behaviorally determined visual fields with structural measures of the optic nerve head.

Methods  Humphrey 24-2 visual fields and mfVEPs were obtained from each eye of 20 patients with open-angle glaucoma. Monocular and interocular analyses were performed to identify locations with abnormal mfVEP responses. Optic discs were assessed with a confocal scanning laser ophthalmoscope (Heidelberg Retina Tomograph II). The image of the optic nerve head was divided into 6 sectors. The rim and disc area measurements for each sector were compared with those in a normal database using Moorfields regression analysis. The optic nerve head measurements for the 6 sectors were related to the Humphrey visual field locations and the 60 sectors of the mfVEP display.

Results  Of 240 sectors tested (40 eyes x 6 sectors), 18.8% on Humphrey visual field, 22.1% on mfVEP, and 10.8% on confocal scanning laser ophthalmoscopic testing were significantly different from those of control subjects. There were no significant deficits in 165 sectors. There was agreement for 86.7% of the sectors when the Humphrey visual field and mfVEP results were compared. The confocal scanning laser ophthalmoscopic results were in agreement for 84.6% of these sectors.

Conclusions  The method used allows for a comparison among measures of visual function and a structural measure of the optic nerve head. In general, the results of the functional and structural measures showed agreement; however, there were clear examples of disagreements that merit further study.

From the Departments of Ophthalmology, College of Physicians and Surgeons, Columbia University (Dr Greenstein), New York University School of Medicine (Drs Greenstein and Liebmann), and The New York Eye and Ear Infirmary (Drs Thienprasiddhi, Ritch, and Liebmann), New York; and the Department of Psychology, Columbia University (Dr Hood). The authors have no relevant financial interest in this article.

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