Chen Xiang-Wu, Zhao Ying-Xi
Department of Outpatient Service, the Eye Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China.
Int J Ophthalmol. 2017 Apr 18;10(4):599-604. doi: 10.18240/ijo.2017.04.16. eCollection 2017.
To compare the diagnostic performance of isolated-check visual evoked potential (icVEP) and standard automated perimetry (SAP), for evaluating the application values of icVEP in the detection of early glaucoma.
Totally 144 subjects (288 eyes) were enrolled in this study. icVEP testing was performed with the Neucodia visual electrophysiological diagnostic system. A 15% positive-contrast (bright) condition pattern was used in this device to differentiate between glaucoma patients and healthy control subjects. Signal-to-noise ratios (SNR) were derived based on a multivariate statistic. The eyes were judged as abnormal if the test yielded an SNR≤1. SAP testing was performed with the Humphrey Field Analyzer II. The visual fields were deemed as abnormality if the glaucoma hemifield test results outside normal limits; or the pattern standard deviation with <0.05; or the cluster of three or more non-edge points on the pattern deviation plot in a single hemifield with <0.05, one of which must have a <0.01. Disc photographs were graded as either glaucomatous optic neuropathy or normal by two experts who were masked to all other patient information. Moorfields regression analysis (MRA) used as a separate diagnostic classification was performed by Heidelberg retina tomograph (HRT).
When the disc photograph grader was used as diagnostic standard, the sensitivity for SAP and icVEP was 32.3% and 38.5% respectively and specificity was 82.3% and 77.8% respectively. When the MRA Classifier was used as the diagnostic standard, the sensitivity for SAP and icVEP was 48.6% and 51.4% respectively and specificity was 84.1% and 78.0% respectively. When the combined structural assessment was used as the diagnostic standard, the sensitivity for SAP and icVEP was 59.2% and 53.1% respectively and specificity was 84.2% and 84.6% respectivlely. There was no statistical significance between the sensitivity or specificity of SAP and icVEP, regardless of which diagnostic standard was based on.
The diagnostic performance of icVEP is not better than that of SAP in the detection of early glaucoma.
比较单通道视觉诱发电位（icVEP）和标准自动视野计（SAP）在评估icVEP检测早期青光眼应用价值方面的诊断性能。
本研究共纳入144例受试者（288只眼）。使用Neucodia视觉电生理诊断系统进行icVEP检测。该设备采用15%阳性对比（明亮）条件模式来区分青光眼患者和健康对照者。基于多变量统计得出信噪比（SNR）。若检测得出的SNR≤1，则判定该眼异常。使用Humphrey视野分析仪II进行SAP检测。若青光眼半视野检测结果超出正常范围；或模式标准差<0.05；或在单个半视野的模式偏差图上有三个或更多非边缘点聚集且<0.05，其中之一必须<0.01，则视视野为异常。由两位对所有其他患者信息均不知情的专家将视盘照片分级为青光眼性视神经病变或正常。使用海德堡视网膜断层扫描仪（HRT）进行单独诊断分类的 Moorfields 回归分析（MRA）。
以视盘照片分级者作为诊断标准时，SAP和icVEP的敏感性分别为32.3%和38.5%，特异性分别为82.3%和77.8%。以MRA分类器作为诊断标准时，SAP和icVEP的敏感性分别为48.6%和51.4%，特异性分别为84.1%和78.0%。以联合结构评估作为诊断标准时，SAP和icVEP的敏感性分别为59.2%和53.1%，特异性分别为84.2%和84.6%。无论基于哪种诊断标准，SAP和icVEP的敏感性或特异性之间均无统计学意义。
在检测早期青光眼方面，icVEP的诊断性能并不优于SAP。
