Li Qiang, Liu Dongyue, Zhang Min
Department of Ophthalmology Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), 1017 Dongmen North Road Luohu District, Shenzhen, Guangdong, 518020, P.R. China.
The Second Clinical Medical College, Jinan University, 1017 Dongmen North Road, Luohu District, Shenzhen, Guangdong, 518020, P.R. China.
BMC Ophthalmol. 2025 Aug 25;25(1):483. doi: 10.1186/s12886-025-04319-x.
Early detection of primary open-angle glaucoma (POAG) is crucial, as current diagnostic methods often miss early-stage damage. Combining blue-on-yellow perimetry with isolated-check visual evoked potential (Ic-VEP) could enhance the sensitivity and specificity of early POAG detection.
To evaluate the diagnostic efficacy of Ic-VEP combined with blue-on-yellow perimetry for early POAG detection.
This study included 66 POAG patients and 35 healthy controls, all of whom underwent comprehensive ophthalmologic assessments, including intraocular pressure (IOP), fundus examination, and optical coherence tomography (OCT) to measure retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness. Ic-VEP and Humphrey 24 - 2 blue-on-yellow perimetry were performed to assess the sensitivity, specificity, and ROC curve for early POAG diagnosis. The correlation between Ic-VEP. results, GCC thickness, and visual field loss was also analyzed.
Ic-VEP demonstrated 74% sensitivity and 91% specificity for detecting POAG, with an area under the ROC curve (AUC) of 0.785, indicating reliable diagnostic performance. The Ic-VEP signal-to-noise ratio (SNR) showed significant correlation with the mean deviation (MD) of blue-on-yellow perimetry and GCC thickness (p < 0.05). The Kappa coefficient for consistency between Ic-VEP and blue-on-yellow perimetry was 0.226 in early-stage POAG, increasing to 0.672 in moderate to severe stages suggesting enhanced diagnostic value in later stages.
Combining Ic-VEP with blue-on-yellow perimetry shows promise for enhancing the early diagnosis of POAG, with Ic-VEP's high specificity (91%) complementing the sensitivity of perimetry. This approach could lead to earlier diagnosis and improved patient outcomes.
原发性开角型青光眼（POAG）的早期检测至关重要，因为当前的诊断方法常常会遗漏早期损伤。将蓝黄视野检查与单刺激视觉诱发电位（Ic-VEP）相结合，可提高POAG早期检测的敏感性和特异性。
评估Ic-VEP联合蓝黄视野检查对POAG早期检测的诊断效能。
本研究纳入66例POAG患者和35名健康对照者，所有受试者均接受了全面的眼科评估，包括眼压（IOP）、眼底检查以及光学相干断层扫描（OCT）以测量视网膜神经纤维层（RNFL）和神经节细胞复合体（GCC）厚度。进行Ic-VEP和Humphrey 24-2蓝黄视野检查，以评估POAG早期诊断的敏感性、特异性和ROC曲线。还分析了Ic-VEP结果、GCC厚度与视野缺损之间的相关性。
Ic-VEP检测POAG的敏感性为74%，特异性为91%，ROC曲线下面积（AUC）为0.785，表明具有可靠的诊断性能。Ic-VEP信噪比（SNR）与蓝黄视野检查的平均偏差（MD）和GCC厚度显著相关（p<0.05）。在早期POAG中，Ic-VEP与蓝黄视野检查一致性的Kappa系数为0.226，在中重度阶段增加到0.672，表明在后期诊断价值增强。
Ic-VEP与蓝黄视野检查相结合在增强POAG早期诊断方面显示出前景，Ic-VEP的高特异性（91%）补充了视野检查的敏感性。这种方法可能会实现更早的诊断并改善患者预后。
