COMPARISON OF PSYCHOPHYSICAL AND ELECTROPHYSIOLOGICAL TESTING IN EARLY GLAUCOMA

Purpose. To compare the sensitivity and specificity of a wide range of psychophysical and electrophysiological tests in the detection of ear ly glaucomatous damage. Methods. Forty-three normals and 43 patients w ith early glaucoma, some still without field defects, were tested with differential light threshold perimetry, short-wavelength automated pe rimetry, high-pass resolution perimetry, motion detection, flicker con trast sensitivity, flickering and isoluminantly matched letter tests, and pattern and flash electroretinography, including photopic, scotopi c, oscillatory potentials, and 30 Hz flicker. Receiver operating chara cteristic analysis was applied to continuous variables derived from ea ch of the tests. Results. Most parameters reflected glaucomatous loss to some degree, even though only single variables were analyzed separa tely in the receiver operating characteristic analysis. The pattern el ectroretinogram and some of the letter acuity tests had the best sensi tivity and specificity, followed by short-wavelength automated perimet ry and high-pass resolution perimetry. Motion detection, flicker contr ast, and flash electroretinogram parameters scored poorly. Six patient s with normal results on the Humphrey field test had abnormal results on many of the other tests. Conclusions. Applying different psychophys ical and electrophysiological tests may add to our ability to detect e arly glaucomatous damage.