The role of hemifield sector analysis in multifocal visual evoked potential objective perimetry in the early detection of glaucomatous visual field defects

Mohammad F Mousa,1 Robert P Cubbidge,2 Fatima Al-Mansouri,1 Abdulbari Bener3,41Department of Ophthalmology, Hamad Medical Corporation, Doha, Qatar; 2School of Life and Health Sciences, Aston University, Birmingham, UK; 3Department of Medical Statistics and Epidemiology, Hamad Medical Corporation, De...

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Autores principales:	Mousa MF, Cubbidge RP, Al-Mansouri F, Bener A
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2013
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/14286766313f4f12804a86a8dac20cab
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spelling	oai:doaj.org-article:14286766313f4f12804a86a8dac20cab2021-12-02T09:16:17ZThe role of hemifield sector analysis in multifocal visual evoked potential objective perimetry in the early detection of glaucomatous visual field defects1177-54671177-5483https://doaj.org/article/14286766313f4f12804a86a8dac20cab2013-05-01T00:00:00Zhttp://www.dovepress.com/the-role-of-hemifield-sector-analysis-in-multifocal-visual-evoked-pote-a12990https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Mohammad F Mousa,1 Robert P Cubbidge,2 Fatima Al-Mansouri,1 Abdulbari Bener3,41Department of Ophthalmology, Hamad Medical Corporation, Doha, Qatar; 2School of Life and Health Sciences, Aston University, Birmingham, UK; 3Department of Medical Statistics and Epidemiology, Hamad Medical Corporation, Department of Public Health, Weill Cornell Medical College, Doha, Qatar; 4Department Evidence for Population Health Unit, School of Epidemiology and Health Sciences, University of Manchester, Manchester, UKObjective: The purpose of this study was to examine the effectiveness of a new analysis method of mfVEP objective perimetry in the early detection of glaucomatous visual field defects compared to the gold standard technique.Methods and patients: Three groups were tested in this study; normal controls (38 eyes), glaucoma patients (36 eyes), and glaucoma suspect patients (38 eyes). All subjects underwent two standard 24-2 visual field tests: one with the Humphrey Field Analyzer and a single mfVEP test in one session. Analysis of the mfVEP results was carried out using the new analysis protocol: the hemifield sector analysis protocol.Results: Analysis of the mfVEP showed that the signal to noise ratio (SNR) difference between superior and inferior hemifields was statistically significant between the three groups (analysis of variance, P < 0.001 with a 95% confidence interval, 2.82, 2.89 for normal group; 2.25, 2.29 for glaucoma suspect group; 1.67, 1.73 for glaucoma group). The difference between superior and inferior hemifield sectors and hemi-rings was statistically significant in 11/11 pair of sectors and hemi-rings in the glaucoma patients group (t-test P < 0.001), statistically significant in 5/11 pairs of sectors and hemi-rings in the glaucoma suspect group (t-test P < 0.01), and only 1/11 pair was statistically significant (t-test P < 0.9). The sensitivity and specificity of the hemifield sector analysis protocol in detecting glaucoma was 97% and 86% respectively and 89% and 79% in glaucoma suspects. These results showed that the new analysis protocol was able to confirm existing visual field defects detected by standard perimetry, was able to differentiate between the three study groups with a clear distinction between normal patients and those with suspected glaucoma, and was able to detect early visual field changes not detected by standard perimetry. In addition, the distinction between normal and glaucoma patients was especially clear and significant using this analysis.Conclusion: The new hemifield sector analysis protocol used in mfVEP testing can be used to detect glaucomatous visual field defects in both glaucoma and glaucoma suspect patients. Using this protocol, it can provide information about focal visual field differences across the horizontal midline, which can be utilized to differentiate between glaucoma and normal subjects. The sensitivity and specificity of the mfVEP test showed very promising results and correlated with other anatomical changes in glaucomatous visual field loss. The intersector analysis protocol can detect early field changes not detected by the standard Humphrey Field Analyzer test.Keywords: objective perimetry, multifocal VEP, visual field testing, glaucomatous field loss, glaucoma suspect, SAP, HFAMousa MFCubbidge RPAl-Mansouri FBener ADove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2013, Iss default, Pp 843-858 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Mousa MF Cubbidge RP Al-Mansouri F Bener A The role of hemifield sector analysis in multifocal visual evoked potential objective perimetry in the early detection of glaucomatous visual field defects
description	Mohammad F Mousa,1 Robert P Cubbidge,2 Fatima Al-Mansouri,1 Abdulbari Bener3,41Department of Ophthalmology, Hamad Medical Corporation, Doha, Qatar; 2School of Life and Health Sciences, Aston University, Birmingham, UK; 3Department of Medical Statistics and Epidemiology, Hamad Medical Corporation, Department of Public Health, Weill Cornell Medical College, Doha, Qatar; 4Department Evidence for Population Health Unit, School of Epidemiology and Health Sciences, University of Manchester, Manchester, UKObjective: The purpose of this study was to examine the effectiveness of a new analysis method of mfVEP objective perimetry in the early detection of glaucomatous visual field defects compared to the gold standard technique.Methods and patients: Three groups were tested in this study; normal controls (38 eyes), glaucoma patients (36 eyes), and glaucoma suspect patients (38 eyes). All subjects underwent two standard 24-2 visual field tests: one with the Humphrey Field Analyzer and a single mfVEP test in one session. Analysis of the mfVEP results was carried out using the new analysis protocol: the hemifield sector analysis protocol.Results: Analysis of the mfVEP showed that the signal to noise ratio (SNR) difference between superior and inferior hemifields was statistically significant between the three groups (analysis of variance, P < 0.001 with a 95% confidence interval, 2.82, 2.89 for normal group; 2.25, 2.29 for glaucoma suspect group; 1.67, 1.73 for glaucoma group). The difference between superior and inferior hemifield sectors and hemi-rings was statistically significant in 11/11 pair of sectors and hemi-rings in the glaucoma patients group (t-test P < 0.001), statistically significant in 5/11 pairs of sectors and hemi-rings in the glaucoma suspect group (t-test P < 0.01), and only 1/11 pair was statistically significant (t-test P < 0.9). The sensitivity and specificity of the hemifield sector analysis protocol in detecting glaucoma was 97% and 86% respectively and 89% and 79% in glaucoma suspects. These results showed that the new analysis protocol was able to confirm existing visual field defects detected by standard perimetry, was able to differentiate between the three study groups with a clear distinction between normal patients and those with suspected glaucoma, and was able to detect early visual field changes not detected by standard perimetry. In addition, the distinction between normal and glaucoma patients was especially clear and significant using this analysis.Conclusion: The new hemifield sector analysis protocol used in mfVEP testing can be used to detect glaucomatous visual field defects in both glaucoma and glaucoma suspect patients. Using this protocol, it can provide information about focal visual field differences across the horizontal midline, which can be utilized to differentiate between glaucoma and normal subjects. The sensitivity and specificity of the mfVEP test showed very promising results and correlated with other anatomical changes in glaucomatous visual field loss. The intersector analysis protocol can detect early field changes not detected by the standard Humphrey Field Analyzer test.Keywords: objective perimetry, multifocal VEP, visual field testing, glaucomatous field loss, glaucoma suspect, SAP, HFA
format	article
author	Mousa MF Cubbidge RP Al-Mansouri F Bener A
author_facet	Mousa MF Cubbidge RP Al-Mansouri F Bener A
author_sort	Mousa MF
title	The role of hemifield sector analysis in multifocal visual evoked potential objective perimetry in the early detection of glaucomatous visual field defects
title_short	The role of hemifield sector analysis in multifocal visual evoked potential objective perimetry in the early detection of glaucomatous visual field defects
title_full	The role of hemifield sector analysis in multifocal visual evoked potential objective perimetry in the early detection of glaucomatous visual field defects
title_fullStr	The role of hemifield sector analysis in multifocal visual evoked potential objective perimetry in the early detection of glaucomatous visual field defects
title_full_unstemmed	The role of hemifield sector analysis in multifocal visual evoked potential objective perimetry in the early detection of glaucomatous visual field defects
title_sort	role of hemifield sector analysis in multifocal visual evoked potential objective perimetry in the early detection of glaucomatous visual field defects
publisher	Dove Medical Press
publishDate	2013
url	https://doaj.org/article/14286766313f4f12804a86a8dac20cab
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The role of hemifield sector analysis in multifocal visual evoked potential objective perimetry in the early detection of glaucomatous visual field defects

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