BLUE-ON-YELLOW PERIMETRY CAN PREDICT THE DEVELOPMENT OF GLAUCOMATOUS VISUAL-FIELD LOSS

Objective.-The purpose of this investigation was to determine whether blue-on-yellow (B/Y) perimetry is capable of predicting the onset and location of impending glaucomatous visual field loss in patients with ocular hypertension. Design.-A Humphrey Field Analyzer (Humphrey Instr uments, San Leandro, Calif) was modified to perform B/Y perimetry to i solate and measure the sensitivity of short-wavelength-sensitive mecha nisms. Participants were tested annually with standard white-on-white (W/W) and B/Y automated perimetry for a period of 5 years. Patients.-T he study population consisted of 38 patients with ocular hypertension and 62 age-matched normal control subjects. Results.-Initially, all 76 ocular hypertensive eyes had normal W/W automated perimetry results, with 67 eyes having normal and nine eyes having abnormal B/Y test resu lts. Five years later, five of the nine ocular hypertensive eyes with initial B/Y abnormal results developed glaucomatous visual field loss measured by standard W/W automated perimetry, while none of the 67 ocu lar hypertensive eyes with initially normal B/Y results developed abno rmal W/W perimetry results. Conclusions.-Blue-on-yellow perimetry defi cits are an early indicator of glaucomatous damage and are predictive of impending glaucomatous visual field loss for standard W/W automated perimetry. To our knowledge, this is the first prospective, long-term longitudinal study that demonstrates the ability to predict the onset of glaucomatous visual field loss in patients with ocular hypertensio n on the basis of psychophysical testing.