Objective perimetry in glaucoma: Recent advances with multifocal stimuli

Stuart L. Graham*, Alexander Klistorner, John R. Grigg, Francis A. Billson, Ao

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

44 Citations (Scopus)


The introduction of multifocal stimulus recording has enhanced our ability to examine the human visual field with electrophysiologic techniques. We have adapted the multifocal pattern visual evoked potential (PVEP) to detect visual field loss. In glaucoma patients we sought to determine the extent to which the PVEP amplitudes correlate with perimetric thresholds. Multifocal pseudorandomly alternated pattern stimuli, which were cortically scaled in size, were presented with use of the VERIS-Scientific system. Bipolar occipital straddle electrode positions were used. The visual field up to 25 of eccentricity was investigated. Forty-three glaucoma patients with reproducible visual field defects were tested. The bipolar PVEP corresponded well with Humphrey visual field defects, showing loss of signal in the scotoma area. For Humphrey quadrant threshold totals and PVEP quadrant amplitudes, the correlation coefficient was strong (r = 0.49, P < 0.0001). The multifocal PVEP demonstrates good correspondence with the topography of the visual field. This technique represents the first practical application of the multifocal PVEP to objective detection of visual field defects in glaucoma.

Original languageEnglish
Pages (from-to)S199–S209
Number of pages11
JournalSurvey of Ophthalmology
Issue number6 SUPPL.
Publication statusPublished - Jun 1999
Externally publishedYes


  • Electrophysiology
  • Glaucoma
  • Multifocal techniques
  • Visual-evoked response visual field


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