Abstract • Objective. —The purpose of this investigation was to determine whether blue-on-yellow (B/Y) perimetry is capable of predicting the onset and location of impending glaucomatous visual field loss in patients with ocular hypertension. Design. —A Humphrey Field Analyzer (Humphrey Instruments, San Leandro, Calif) was modified to perform B/Y perimetry to isolate and measure the sensitivity of short-wavelength—sensitive mechanisms. Participants were tested annually with standard white-on-white (W/W) and B/Y automated perimetry for a period of 5 years. Patients. —The study population consisted of 38 patients with ocular hypertension and 62 age-matched normal control subjects. Results. —Initially, all 76 ocular hypertensive eyes had normal W/W automated perimetry results, with 67 eyes having normal and nine eyes having abnormal B/Y test results. Five years later, five of the nine ocular hypertensive eyes with initial B/Y abnormal results developed glaucomatous visual field loss measured by standard W/W automated perimetry, while none of the 67 ocular hypertensive eyes with initially normal B/Y results developed abnormal W/W perimetry results. Conclusions. —Blue-on-yellow perimetry deficits are an early indicator of glaucomatous damage and are predictive of impending glaucomatous visual field loss for standard W/W automated perimetry. To our knowledge, this is the first prospective, long-term longitudinal study that demonstrates the ability to predict the onset of glaucomatous visual field loss in patients with ocular hypertension on the basis of psychophysical testing. References 1. Adams AJ, Heron G, Husted R. Clinical measures of central visual function in glaucoma and ocular hypertension . Arch Ophthalmol . 1987;105:782.Crossref 2. Adams AJ, Rodic R, Husted R, Stamper R. Spectral sensitivity and color discrimination changes in glaucoma and glaucoma-suspects . Invest Ophthalmol Vis Sci . 1982;23:516-524. 3. Sample PA, Weinreb RN, Boynton RM. Acquired dyschromatopsia in glaucoma . Surv Ophthalmol . 1986;31:54-64.Crossref 4. Drance SM, Lakowski R, Schulzer M, Douglas GR. Acquired color vision changes in glaucoma: use of 100-Hue Test and Pickford anomaloscope as predictors of glaucomatous field change . Arch Ophthalmol . 1981;99:829-831.Crossref 5. Heron G, Adams AJ, Husted R. Central visual fields for short wavelength sensitive pathways in glaucoma and ocular hypertension . Invest Ophthalmol Vis Sci . 1988;29:64-72. 6. Sample PA, Boynton R, Weinreb R. Isolating the color vision loss in primary open angle glaucoma . Am J Ophthalmol . 1988;106:686-691. 7. Sample PA, Weinreb RN. Color perimetry for assessment of primary open-angle glaucoma . Invest Ophthalmol Vis Sci . 1990;31:1869-1875. 8. Johnson CA, Adams AJ, Twelker JD, Quigg JM. Age related changes of the central visual field for short wavelength sensitive (SWS) pathways . J Opt Soc Am . 1988;5:2131-2139.Crossref 9. Johnson CA, Adams AJ, Lewis RA. Automated perimetry of short-wavelength sensitive mechanisms in glaucoma and ocular hypertension: preliminary findings . In: Heijl A, ed. Perimetry Update 1988/89 . Amsterdam, the Netherlands: Kugler & Ghedini; 1989:31-37. 10. Johnson CA, Adams AJ, Lewis RA. Patterns of early glaucomatous visual field loss for short wavelength sensitive pathways . Invest Ophthalmol Vis Sci . 1989;30( (suppl) ):56. Abstract. 11. Adams AJ, Johnson CA, Lewis RA. S cone pathway sensitivity loss in ocular hypertension and early glaucoma has nerve fiber bundle pattern . In: Drum B, Moreland J, Serra A, eds. Proceedings of the 10th Symposium of the International Research Group on Colour Vision Deficiencies . The Hague, the Netherlands: Kluwer Academic Publishers; 1991:535-542. 12. Johnson CA, Adams AJ, Casson EJ, Nelson-Quigg JM. Can short wavelength sensitivity losses predict the development of glaucomatous visual field defects? In: Noninvasive Assessment of the Visual System . Washington, DC: Optical Society of America Technical Digest Series; 1991;1:2216-2219. 13. Sample PA, Weinreb RN. Progressive color visual field loss in glaucoma . Invest Ophthalmol Vis Sci . 1992;33:2068-2071. 14. Hart WM, Silverman SE, Trick GL, Nesher R, Gordon MO. Glaucomatous visual field damage: luminance and color-contrast sensitivities . Invest Ophthalmol Vis Sci . 1990;31:359-367. 15. Van Norren D, Vos JJ. Spectral transmission of the human ocular media . Vision Res . 1974;14:1237-1244.Crossref 16. Johnson CA, Adams AJ, Lewis RA. Evidence for a neural basis of age-related visual field loss in normal observers . Invest Ophthalmol Vis Sci . 1989;30:2056-2064. 17. Johnson CA, Adams AJ, Casson EJ, Brandt JD. Progression of early glaucomatous visual field loss for blue-on-yellow and standard white-on-white automated perimetry . Arch Ophthalmol . 1993;111:651-656.Crossref
Archives of Ophthalmology – American Medical Association
Published: May 1, 1993
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