ELECTROPHYSIOLOGICALLY DETERMINED CONTRAST SENSITIVITY IN PATIENTS WITH OCULAR HYPERTENSION AND CHRONIC GLAUCOMA

Subjectively assessed contrast sensitivity has been found to be abnormal in many patients with glaucoma. We previously reported the use of onset-offset visual evoked potential measurements to determine contrast threshold objectively. We now studied 216 patients (79 with ocular hypertension and 137 with chronic simple glaucoma) with this technique. In comparison with an age-matched control group (68 subjects), mean contrast threshold was found to be significantly different in both patient groups, the degree of significance being greater in the patients with chronic simple glaucoma. Additionally, the slope of the CI-CII amplitude versus log contrast plot was shown to be depressed in the majority of affected eyes in patients with unilateral chronic simple glaucoma. This measure appears to give an indication of suprathreshold contrast processing and is related to the difference in luminance between pattern elements, rather than the quality of the border or "edge" between them. The data support not only an increase in contrast threshold (reduced sensitivity) in early glaucoma and some patients with ocular hypertension but also a suppression in suprathreshold function that is not readily measurable with standard psychophysical methods. The findings are consistent with recent theories concerning the effect of early chronic simple glaucoma on the function of Y-type units of the M (magnocellular)-type pathways.