Comparison of psychophysical and electrophysiological testing in early glaucoma

Stuart L. Graham*, Stephen M. Drance, Balwantray C. Chauhan, Nicholas V. Swindale, Peter Hnik, Frederick S. Mikelberg, Gordon R. Douglas

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

119 Citations (Scopus)


Purpose. To compare the sensitivity and specificity of a wide range of psychophysical and electrophysiological tests in the detection of early glaucomatous damage. Methods. Forty-three normals and 43 patients with early glaucoma, some still without field defects, were tested with differential light threshold perimetry, short-wavelength automated perimetry, high-pass resolution perimetry, motion detection, flicker contrast sensitivity, flickering and isoluminantly matched letter tests, and pattern and flash electroretinography, including photopic, scotopic, oscillatory potentials, and 30 Hz flicker. Receiver operating characteristic analysis was applied to continuous variables derived from each of the tests. Results. Most parameters reflected glaucomatous loss to some degree, even though only single variables were analyzed separately in the receiver operating characteristic analysis. The pattern electroretinogram and some of the letter acuity tests had the best sensitivity and specificity, followed by short-wavelength automated perimetry and high-pass resolution perimetry. Motion detection, flicker contrast, and flash electroretinogram parameters scored poorly. Six patients with normal results on the Humphrey field test had abnormal results on many of the other tests. Conclusions. Applying different psychophysical and electrophysiological tests may add to our ability to detect early glaucomatous damage.

Original languageEnglish
Pages (from-to)2651-2662
Number of pages12
JournalInvestigative Ophthalmology and Visual Science
Issue number13
Publication statusPublished - Dec 1996
Externally publishedYes


  • glaucoma
  • magnocellular pathway
  • pattern electroretinogram
  • perimetry
  • psychophysical testing


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