Utility of the Modified Isolated-check Visual Evoked Potential Technique in Functional Glaucoma Assessment

Natasha Nayak Kolomeyer, Owen J. Drinkwater, Eleni Drivas, Amir Zakik, Vance Zemon, Paul A. Sidoti, James C. Tsai, Joseph F. Panarelli

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Precis: Cortical response to low contrast stimuli, as measured by isolated-check visual evoked potential (icVEP) technology, has the potential to provide functional assessment that may complement standard achromatic perimetry in assessing glaucomatous change. Purpose: To evaluate the utility of modified isolated-check visual evoked potential (icVEP) testing in detecting functional glaucomatous damage. Patients and Methods: Subjects who met pre-determined criteria of controls, glaucoma suspects, pre-perimetric glaucoma, or glaucoma were enrolled in this prospective cross-sectional study from a single tertiary care center. Glaucoma patients were further categorized as early, moderate, advanced, or severe based on Hodapp-Anderson-Parrish criteria. icVEP testing was performed with 10 2-second runs per qualified eye using the EvokeDx testing software. Multivariate statistics were used to calculate signal-to-noise ratios (SNR) and perform outlier analysis. Results: 140 eyes met criteria (mean±standard deviation; age of 63±14▒y, 49% male, logMAR visual acuity 0.11±0.089). There was no significant difference in age, gender, or logMAR visual acuity amongst the groups. Controls had a significantly higher SNR than all other groups (P<0.003), including patients with pre-perimetric glaucoma. Among those with glaucoma, the early glaucoma patients had significantly higher SNR than the moderate, advanced, or severe glaucoma cohorts (P<0.04). The optimal SNR cutoff for differentiating between glaucomatous and non-glaucomatous eyes was 0.95, both with (sensitivity 82%, specificity 76%) and without (sensitivity 82%, specificity 100%) glaucoma suspects included in analysis. Conclusions: icVEP technology has the potential to complement standard achromatic perimetry in functional assessment of glaucomatous defects.

Original languageEnglish
Article number0000143
JournalJournal of Glaucoma
StateAccepted/In press - 2019


  • electrophysiology
  • glaucoma
  • glaucomatous optic neuropathy
  • visual evoked potential


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