Aim: To assess the accuracy of optical coherence tomography (OCT) in detecting damage to a hemifield, patients with hemifield defects confirmed on both static automated perimetry (SAP) and multifocal visual evoked potentials (mfVEP) were studied.
Methods: Eyes of 40 patients with concomitant SAP and mfVEP glaucomatous loss and 25 controls underwent OCT retinal nerve fibre layer (RNFL), mfVEP and 24-2 SAP tests. For the mfVEP and 24-2 SAP, a hemifield was defined as abnormal based upon cluster criteria. On OCT, a hemifield was considered abnormal if one of the five clock hour sectors (3 and 9 o’clock excluded) was at <1% (red) or two were at <5% (yellow).
Results: Seventy seven (43%) of the hemifields were abnormal on both mfVEP and SAP tests. The OCT was abnormal for 73 (95%) of these. Only 1 (1%) of the 100 hemifields of the controls was abnormal on OCT. Sensitivity/specificity (one eye per person) was 95/98%.
Conclusions: The OCT RNFL test accurately detects abnormal hemifields confirmed on both subjective and objective functional tests. Identifying abnormal hemifields with a criterion of 1 red (1%) or 2 yellow (5%) clock hours may prove useful in clinical practice.
- GHT, glaucoma hemifield test
- HVF, Humphrey visual field
- mfVEP, multifocal visual evoked potentials
- OCT, optical coherence tomography
- PSD, pattern standard deviation
- RNFL, retinal nerve fibre layer
- SAP, static automated perimetry
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Published Online First 14 February 2007
Supported by National Eye Institute grants R01-EY-02115 and R01-EY-09076 and by the Steven and Shelley Einhorn Research Fund of the New York Glaucoma Research Institute, New York NY, USA.