Li Juan Xu1,2, Liang Zhang1, Sha Ling Li1, Vance Zemon3, Gianni Virgili4, Yuan Bo Liang5,6. 1. Clinical and Epidemiological Eye Research Center, Eye Hospital, School of Optometry and Ophthalmology, Wenzhou Medical University, No. 270, Xue Yuan Xi Road, Wenzhou, 325027, Zhejiang, China. 2. Jinhua Municipal Central Hospital, Jinhua, Zhejiang, 321000, China. 3. Ferkauf Graduate School of Psychology, Albert Einstein College of Medicine Campus, Yeshiva University, New York, USA. 4. Department of Ophthalmology, Careggi Hospital Eye Clinic, University of Florence, Florence, Italy. 5. Clinical and Epidemiological Eye Research Center, Eye Hospital, School of Optometry and Ophthalmology, Wenzhou Medical University, No. 270, Xue Yuan Xi Road, Wenzhou, 325027, Zhejiang, China. yuanboliang@126.com. 6. Global Eye Health, Centre for Public Health, Queens University, Belfast, UK. yuanboliang@126.com.
Abstract
PURPOSE: The aim of this study was to determine the diagnostic accuracy, sensitivity and specificity of isolated-check visual evoked potentials (icVEP) in primary open-angle glaucoma (POAG). METHODS: Ninety POAG patients and sixty-six healthy controls were recruited consecutively. All subjects underwent icVEP and visual field testing. Swept icVEP response functions were obtained by increasing contrast in six stimulus steps, recording the electroencephalogram synchronized to the stimulus display's frame rate and calculating the corresponding signal-to-noise ratio (SNR) of the response at the fundamental frequency to evaluate visual function. Depth of modulation of the check luminance was increased as follows: 2, 4, 8, 14, 22 and 32%, about an equal level of standing contrast, so that the pattern appeared and disappeared at a frequency of 10.0 Hz. SNR above 0.85 was deemed to be significant at the 0.1 level and SNR above 1 significant at the 0.05 level. RESULTS: The results show that SNR is contrast dependent. It significantly rose as contrast increased. The areas under receiver-operating-characteristic curves (AUCs) indicating classification accuracy for all POAG cases in comparison with normal subjects were 0.790 (sensitivity 91.1%, specificity 69.7%) with the cutoff SNR of 0.85, and 0.706 (sensitivity 95.6%, specificity 51.5%) with the cutoff SNR of 1. The AUC of early glaucoma cases (EG) in comparison with normal subjects was 0.801 (sensitivity 93.3%, specificity 69.7%) with the cutoff SNR of 0.85, and 0.717 (sensitivity 97.8%, specificity 51.5%) with the cutoff SNR of 1. CONCLUSION: icVEP has good diagnostic accuracy (high sensitivity and moderate specificity) in distinguishing early POAG patients from healthy subjects. It might be a promising device to use in conjunction with complementary functional and structural measures for early POAG detection.
PURPOSE: The aim of this study was to determine the diagnostic accuracy, sensitivity and specificity of isolated-check visual evoked potentials (icVEP) in primary open-angle glaucoma (POAG). METHODS: Ninety POAG patients and sixty-six healthy controls were recruited consecutively. All subjects underwent icVEP and visual field testing. Swept icVEP response functions were obtained by increasing contrast in six stimulus steps, recording the electroencephalogram synchronized to the stimulus display's frame rate and calculating the corresponding signal-to-noise ratio (SNR) of the response at the fundamental frequency to evaluate visual function. Depth of modulation of the check luminance was increased as follows: 2, 4, 8, 14, 22 and 32%, about an equal level of standing contrast, so that the pattern appeared and disappeared at a frequency of 10.0 Hz. SNR above 0.85 was deemed to be significant at the 0.1 level and SNR above 1 significant at the 0.05 level. RESULTS: The results show that SNR is contrast dependent. It significantly rose as contrast increased. The areas under receiver-operating-characteristic curves (AUCs) indicating classification accuracy for all POAG cases in comparison with normal subjects were 0.790 (sensitivity 91.1%, specificity 69.7%) with the cutoff SNR of 0.85, and 0.706 (sensitivity 95.6%, specificity 51.5%) with the cutoff SNR of 1. The AUC of early glaucoma cases (EG) in comparison with normal subjects was 0.801 (sensitivity 93.3%, specificity 69.7%) with the cutoff SNR of 0.85, and 0.717 (sensitivity 97.8%, specificity 51.5%) with the cutoff SNR of 1. CONCLUSION: icVEP has good diagnostic accuracy (high sensitivity and moderate specificity) in distinguishing early POAG patients from healthy subjects. It might be a promising device to use in conjunction with complementary functional and structural measures for early POAG detection.
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