Abstract
It is not clear whether glaucomatous optic nerve damage is the end result of one pathological process or whether there are several mechanisms by which the final disease is manifest. The use of electrophysiological and psychophysical tests which measure the function of specific subdivisions of the visual pathways have been shown to be of use in the early diagnosis of glaucoma. In addition these results may help to elucidate the mechanisms of loss of visual function in patients with early glaucoma. One hundred and ninety-three patients with ocular hypertension (intraocular pressure > 24 mmHg, with normal visual fields and optic discs), 30 with glaucoma and 35 controls underwent pattern electroretinogram (PERG) peripheral colour contrast thresholds, motion detection thresholds (MDT) and Humphrey automated visual fields at the same visit. For each test there was a significant proportion of patients with abnormal results as has been found in previous studies of these techniques. However, there was a significant lack of correlation between the groups with only a small number of patients having abnormalities on more than one test. Of the patients demonstrating abnormal PERGs, 36% had abnormal colour contrast and 32% abonormal MDT, but only 15% were abnormal on both tests. Early glaucomatous damage may be focal or diffuse in nature. Similarly there may be preferential damage to ganglion cells subserving different visual functions or damage at different retinal layers. The results lend support to these hypotheses and give further evidence that more than one pathomechanism may be involved early in the glaucomatous process.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Gunduz K, Arden GB, Perry S, Weinstein G, Hitchings RA . Colour vision defects in ocular hypertension and glaucoma: quantification with a computer driven colour television system. Arch Ophthalmol 1988;108:929–35.
Fitzke FW, Poinoosawmy D, Nagasubramanian S, Hitchings RA . Peripheral displacement thresholds in glaucoma and ocular hypertension. Perimetry Update 1988:[1988/1989]:399–405.
Drance SM, Lakowski R, Schulzer M, Douglas GR . Acquired colour vision changes in glaucoma. Arch Ophthalmol 1981;99:829–31.
Johnson CA, Adams AJ, Casson EJ, Quigg JM . Can short wavelength sensitivity losses predict the development of glaucomatous visual field defects? Invest Ophthalmol Vis Sci 1991;32:1191.
Yu TC, Falcao-Reis FM, Spileers W, Arden GB . Peripheral Colour Contrast: a new screening test for pre-glaucomatous visual loss. Invest Opthalmol Vis Sci 1991;32:2779–89.
Joffe KM, Raymond JE, Crichton A . Motion perimetry in glaucoma. Invest Ophthalmol Vis Sci 1991;32:1103.
Maffei L, Fiorentini A . Electroretinographic responses to alternating gratings before and after section of the optic nerve. Science 1984;211:953–5.
May JG, Ralston JV, Reed JL, van Dyk HJL . Loss in pattern-elicited electroretinograms in optic nerve dysfunction. Am J Ophthalmol 1982;93:418–22.
Ringens PJ, Viifvinkel-Bruinenga S, Van Lith GHM . The pattern elicited electroretinogram. I. A tool in the early detection of glaucoma. Ophthalmologica 1986;192:171–5.
Quigley HA, Dunkelberger BS, Green WR . Retinal ganglion cell atrophy correlated with automated perimetry in human eyes with glaucoma. Am J Ophthalmol 1989;107:453–64.
Quigley HA, Dunkelberger GR, Green WR . Chronic human glaucoma causing selectively greater loss of large optic nerve fibres. Ophthalmology 1988;95:357–64.
Quigley HA, Sanchez RM, et al. Chronic glaucoma selectively damages large optic nerve fibres. Invest Ophthalmol Vis Sci 1987;28:913–20.
Jonas JB, Gusek GC, Naumann GOH . Optic disc morphometry in chronic open angle glaucoma. I. Morphometric intrapapillary characteristics. Graefes Arch Clin Exp Ophthalmol 1988;226:522–30.
Sommer A, Pollack I, Maumenee AE . Optic disc parameters and the onset of glaucomatous field loss. II. Static screening criteria. Arch Opthalmol 1979;97:1449–54.
Airaksinen PJ, Drance SM, Schulzer M . Neuroretinal rim area in early glaucoma. Am J Ophthalmol 1985;99:1–4.
Drance SM . Correlation of optic nerve and visual field defects in simple glaucoma. Trans Ophthalmol Soc UK 1975;95:288.
Livingstone MS, Hubel DH . Psychophysical evidence for separate channels for the perception of form, colour, movement and depth. J Neurosci 1987;7:3416–3468.
Hubel DH, Livingstone MS . Segregation of form, colour and stereopsis in primate area 18. J Neurosci 1987;7:3378–415.
Schiller HN, Logothetis NK, Charles ER . Functions of the colour-opponent and broad-band channels of the visual system. Nature 1990;343:68–70.
Tytla ME, Trope GE, Buncic RJ . Flicker sensitivity in treated ocular hypertension. Ophthalmology 1990;97:36–44.
Bullimore M, Wood, J, Swenson K . Motion perception in glaucoma. Invest Ophthalmol Vis Sci 1993;34:3526–33.
Wu J, Fitzke F, Poinoosawmy D, Hitchings R . Four years follow-up of the fellow eye of unilateral glaucoma patients using motion sensitivity. Invest Ophthalmol Vis Sci 1994;35:2185.
Watkins R, Buckingham T . Motion perception hyperacuity is abnormal in primary open glaucoma and ocular hypertension. Invest Ophthalmol Vis Sci 1991;32:1103.
Falcao-Reis FM, Spileers W, O'Sullivan F, Arden GB, et al. Macular colour contrast sensitivity in ocular hypertension and glaucoma. Br J Ophthalmol 1991;75:598–602.
Sample PA, Mantzioros N, Fechtner R, Weinreb RN . Progressive colour visual field loss in eyes with primary open angle glaucoma. Invest Ophthalmol Vis Sci 1991;32:1193.
Johnson C, Casson E, Shapiro L . Progression of glaucomatous visual field loss over five years: a comparison of white-on-white and blue-on-yellow perimetry. Invest Ophthalmol Vis Sci 1992;33:1384.
Johnson C, Brandt J, Khong A, Adams A . Short wavelength automated perimetry (SWAP) in low, medium and high risk ocular hypertensives. Invest Ophthalmol Vis Sci 1984;35:2188.
Weinstein GW, Arden GB, Hitchings RA, et al. The pattern electroretinogram (PERG) in ocular hypertension and glaucoma. Arch Ophthalmol 1988; 106:928–31.
O'Donoghue E, Arden G, O'Sullivan F, et al. The pattern electroretinogram in glaucoma and ocular hypertension. Br J Ophthalmol 1992;76:387–94.
Klein B, Klein R, Sponsel W, et al. Prevalence of glaucoma. The Beaver Dam eye study. Ophthalmology 1992;99:1499–504.
Arden GB, Gunduz K, Perry S . Colour vision testing with a computer graphics system. Clin Vis Sci 1988;2:203.
Yablonski ME, Zimmerman TJ, Kass MA, Becker B . Prognostic significance of optic disc cupping in ocular hypertensive patients. Am J Ophthalmol 1980;89:585–92.
Hollows FC, Graham PA . Intraocular pressure, glaucoma and glaucoma suspects in a defined population. Br J Ophthalmol 1966;50:570–86.
Elshnig A . Glaucoma without high pressure and high pressure without glaucoma. Z Augenklinik 1924;52:287–96.
Wu X, Wormald R, Fitzke FW, Poinoosawmy D, et al. Laptop computer perimetry for glaucoma screening. Invest Ophthalmol Vis Sci 1991;32:810.
Drance SM, Airaksinen PJ, Price M . et al. The use of psychophysical, structural and electro-diagnostic parameters to identify glaucomatous damage. Graefes Arch Clin Exp Ophthalmol 1987;225:365.
Arden GB, Vaegan, Hogg CR . Clinical and experimental evidence that the pattern e.r.g. is generated by the innermost retinal layers. Ann NY Acad Sci 1982;388:580–601.
Sieving PA, Linsenmeir RA, Steinberg RH . Current source density (CSD) analysis shows main pattern ERG (PERG) source in proximal retina. Invest Ophthalmol Vis Sci 1984;25(Suppl):259.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ruben, S., Hitchings, R., Fitzke, F. et al. Electrophysiology and psychophysics in ocular hypertension and glaucoma: Evidence for different pathomechanisms in early glaucoma. Eye 8, 516–520 (1994). https://doi.org/10.1038/eye.1994.128
Issue date:
DOI: https://doi.org/10.1038/eye.1994.128
Keywords
This article is cited by
-
Movement detection threshold and ocular hypertension
Eye (2001)
-
Glaucoma
Eye (1997)
