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Accuracy of isolated-check visual evoked potential technique for diagnosing primary open-angle glaucoma

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Abstract

Purpose

The aim of this study was to determine the diagnostic accuracy, sensitivity and specificity of isolated-check visual evoked potentials (icVEP) in primary open-angle glaucoma (POAG).

Methods

Ninety POAG patients and sixty-six healthy controls were recruited consecutively. All subjects underwent icVEP and visual field testing. Swept icVEP response functions were obtained by increasing contrast in six stimulus steps, recording the electroencephalogram synchronized to the stimulus display’s frame rate and calculating the corresponding signal-to-noise ratio (SNR) of the response at the fundamental frequency to evaluate visual function. Depth of modulation of the check luminance was increased as follows: 2, 4, 8, 14, 22 and 32%, about an equal level of standing contrast, so that the pattern appeared and disappeared at a frequency of 10.0 Hz. SNR above 0.85 was deemed to be significant at the 0.1 level and SNR above 1 significant at the 0.05 level.

Results

The results show that SNR is contrast dependent. It significantly rose as contrast increased. The areas under receiver-operating-characteristic curves (AUCs) indicating classification accuracy for all POAG cases in comparison with normal subjects were 0.790 (sensitivity 91.1%, specificity 69.7%) with the cutoff SNR of 0.85, and 0.706 (sensitivity 95.6%, specificity 51.5%) with the cutoff SNR of 1. The AUC of early glaucoma cases (EG) in comparison with normal subjects was 0.801 (sensitivity 93.3%, specificity 69.7%) with the cutoff SNR of 0.85, and 0.717 (sensitivity 97.8%, specificity 51.5%) with the cutoff SNR of 1.

Conclusion

icVEP has good diagnostic accuracy (high sensitivity and moderate specificity) in distinguishing early POAG patients from healthy subjects. It might be a promising device to use in conjunction with complementary functional and structural measures for early POAG detection.

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Funding

The study is funded by Wenzhou Medical University R&D fund, No. QTJ13009 and Health Innovation Talents in Zhejiang Province (2016). No. 25. The sponsor had no role in the design or conduct of this research.

Author information

Authors and Affiliations

  1. Clinical and Epidemiological Eye Research Center, Eye Hospital, School of Optometry and Ophthalmology, Wenzhou Medical University, No. 270, Xue Yuan Xi Road, Wenzhou, 325027, Zhejiang, China

    Li Juan Xu, Liang Zhang, Sha Ling Li & Yuan Bo Liang

  2. Global Eye Health, Centre for Public Health, Queens University, Belfast, UK

    Yuan Bo Liang

  3. Jinhua Municipal Central Hospital, Jinhua, Zhejiang, 321000, China

    Li Juan Xu

  4. Ferkauf Graduate School of Psychology, Albert Einstein College of Medicine Campus, Yeshiva University, New York, USA

    Vance Zemon

  5. Department of Ophthalmology, Careggi Hospital Eye Clinic, University of Florence, Florence, Italy

    Gianni Virgili

Authors
  1. Li Juan Xu
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  2. Liang Zhang
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  3. Sha Ling Li
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  4. Vance Zemon
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  5. Gianni Virgili
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  6. Yuan Bo Liang
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Corresponding author

Correspondence to Yuan Bo Liang.

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Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript, with the exception of Zemon who, as a principal in VeriSci Corp., has a financial interest in Huzhou Medconova Medical Technology Co. LTD.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and with the 1964 Helsinki declaration and its later amendments.

Statement of human rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Statement on the welfare of animals

No animals were involved in the study.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Xu, L.J., Zhang, L., Li, S.L. et al. Accuracy of isolated-check visual evoked potential technique for diagnosing primary open-angle glaucoma. Doc Ophthalmol 135, 107–119 (2017). https://doi.org/10.1007/s10633-017-9598-6

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  • DOI: https://doi.org/10.1007/s10633-017-9598-6

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