Lindenberg Thomas, Peters Andrea, Horn Folkert K, Lausen Berthold, Korth Matthias
Augenklinik mit Poliklinik, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen, Germany,
Graefes Arch Clin Exp Ophthalmol. 2004 May;242(5):361-7. doi: 10.1007/s00417-003-0823-5. Epub 2004 Apr 15.
The diagnostic value of multifocal visual evoked potentials (mf VEP) in glaucoma research is still under debate. Several previous studies proclaim it to be a useful tool for clinical applications, but according to other studies, different problems (low specificity, poor records, and interindividual variation) still retard its clinical use. The aim of the present study was to examine whether the mf VEP data obtained with the RETIscan system are appropriate for formulating a classification rule for glaucoma.
We examined and evaluated 65 eyes in 38 advanced glaucoma patients and 27 normal subjects, using four occipital gold cup electrodes (cross layout) for bipolar recording and a CRT monitor (display diameter 60 degrees, chequerboard pattern reversal, 60 segments in dartboard layout) for stimulation. In each case, eight cumulative measurements (77 s each) were made. The data of the 60 segments were cross-correlated with a RETIscan-internal VEP norm ("VEP finder"), combined in 16 sectors, and evaluated via the classification technique "double-bagging" and the Wilcoxon U-test.
In three out of the 16 sectors, the VEP amplitudes of the patients were significantly reduced (Wilcoxon U-test). Applying double-bagging on the cross-correlated data (with VEP finder) resulted in a sensitivity of 75% and a specificity of 71%, and the estimated misclassification rate was 27%. For uncorrelated data (without VEP finder), the same analysis achieved a sensitivity of about 60% and a specificity of 40%.
Estimated sensitivity and specificity suggest that by using the RETIscan system for recording, a classification of the VEP data--i.e. a separation between normal and glaucoma subjects--is possible.
多焦视觉诱发电位（mfVEP）在青光眼研究中的诊断价值仍存在争议。此前的多项研究宣称它是一种临床应用的有用工具，但根据其他研究，不同问题（低特异性、记录不佳和个体差异）仍阻碍其临床应用。本研究的目的是检验使用RETIscan系统获得的mfVEP数据是否适合制定青光眼的分类规则。
我们检查并评估了38例晚期青光眼患者的65只眼和27名正常受试者，使用四个枕部金盘电极（交叉布局）进行双极记录，并使用阴极射线管显示器（显示直径60度，棋盘格图案反转，飞镖靶布局60个区域）进行刺激。每种情况下进行8次累积测量（每次77秒）。将60个区域的数据与RETIscan内部的VEP标准（“VEP finder”）进行互相关，合并为16个扇区，并通过“双重套袋”分类技术和威尔科克森U检验进行评估。
在16个扇区中的3个扇区，患者的VEP振幅显著降低（威尔科克森U检验）。对互相关数据（使用VEP finder）应用双重套袋法，灵敏度为75%，特异性为71%，估计错误分类率为27%。对于不相关数据（不使用VEP finder），相同分析的灵敏度约为60%，特异性为40%。
估计的灵敏度和特异性表明，通过使用RETIscan系统进行记录，可以对VEP数据进行分类，即区分正常人和青光眼患者。
