Anmeldung zur Tagung
Registration
Grußwort
Invitation
Themen
Topics
Allgemeiner Ablauf
General overview
Wissenschaftliches Programm
Scientific program
Kurse
Courses
Symposien
Symposiums
Frühstück mit Spezialisten
Breakfast with specialists
Arzthelferinnen-Fortbildung
Rahmenprogramm
Social program
DOG Information
DOG Information
Allgemeine Informationen
General Information
Autorenindex
Index of Authors
Ausstellerliste
Exhibitors
Sponsoren
Sponsors
Teilnahmegebühren
Registration fees
Impressum
Mf-VEP as an Electrophysiological Assessment Technique in the Detection of Glaucomatous Lesions versus Glaucomatous Scotomas in Conventional Perimetry in OAG
1Bullin M., 1Tesnau R., 2Gaa J., 3Hoerauf K., 1Welt R.
1Augenklinik Ludwigshafen am Rhein, Bremserstraße 79, D-67063 LU, 2Univ.-Klinik f.Radiologie, Klinikum Mannheim d. Univ. Heidelberg, D-68167 MA, 3Univ.-Klinik f.Anästhesie, Universität Wien, Währinger Gürtel 18-20, A-1090 Wien
Purpose: To analyze glaucomatous scotomas in conventional perimetry
and to examine their reproducibility performing an optimized multifocal
objective perimetry by simultaneously mf-VEP in order to detect early
preperimetric glaucomatous lesions.
Methods: 98 eyes of 50 patients with OAG versus 98 eyes of 49 healthy
volunteers were examined. Each of them underwent visual acuity, perimetry(program
30-2), measurement of the IOP by tonometry,a total ophthalmological eye
exam including fundus examination.All glaucoma patients presented with
at least a scotoma in the perimetry of one eye.The vertical occipital
electrodes were placed 4cm below inion and 2,5cm above,the horizontal
ones 4cm on both sides of the inion and a fore-head electrode served as
the ground. Recording (Retiscan device,RolandConsult) was done monocular
with a corrected required visual acuity of at least 0,5; stimu-lation
by a pattern reversal CRT display which was a scaled, 60 sector, dartboard
array, ±30° in diameter. One performance consisted in 3 cycles
per 140 sec.
Results: In agreement with our former reported results in the group
of the healthy volunteers we obtained a noticeable reduction of the amplitude
b in the upper part of the visual field with glaucoma patients too.Trying
to influence the intersubject variability, both groups were matched to
age /sex.In general we noticed a tendency in decreasing amplitudes towards
the periphery in glaucoma patients as well as in normalsighted subjects.For
the evaluation of our results we regarded 1.according to scotomas in the
conventional perimetry the corresponding areas of the mf-VEP, 2.the asymmetry
demonstrated by the graphical 3-D-plots of the Retiscan device, 3.different
calculation paradigm due to the performed stimulation design in order
to receive the most reliable and reproducible result even in preperimetric
glaucoma suspects.Following these criteria we're able to confirm in 89
glaucoma eyes a sco-toma in perimetry by mf-VEP, in 9 glaucomatous fellow
eyes (without scotoma) we used the asymmetry between one individual's
eyes to identify suspicious defects.
Conclusion: Due to the simultaneously recording of the mf-VEP,this
additional electrophysiological technique allows in comparison to the
conventional perimetry a quantified and localized analyse in damaged ganglion
cell function especially in glaucoma patients in order to detect and characterize
small scotomas. This technique provides a functional and morphological
assessment in mapping an objective topography of visual field.