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. 1999 Feb;83(2):199–205. doi: 10.1136/bjo.83.2.199

Temporal contrast sensitivity with peripheral and central stimulation in glaucoma diagnosis

I Velten 1, M Korth 1, F Horn 1, W Budde 1
PMCID: PMC1722936  PMID: 10396199

Abstract

AIMS—To evaluate temporal contrast sensitivity with full field, peripheral, and central stimulation and to determine the most sensitive corresponding retinal area for glaucoma damage.
METHODS—Temporal contrast sensitivity was determined either with a full field, a peripheral annular area from 30° to 90°, or a central area from 0° to 30° at a frequency of 37.1 Hz. 232 eyes of 232 subjects were included. They were classified into four groups: eyes with ocular hypertension (OHT, n = 54), "preperimetric" glaucomas (n = 73) with glaucomatous optic disc abnormalities but no visual field loss, "perimetric" glaucomas (n = 53) with visual field loss, and 52 normals.
RESULTS—In all four groups, temporal contrast senstitivity was almost equal with full field and peripheral, but significantly higher than with central stimulation (p <0.001). With regard to the diagnostic power of the three different stimulus areas, OHTs and glaucomas were found to be best discriminated from normals by peripheral stimulation.
CONCLUSIONS—According to these results, temporal contrast sensitivity seems to be determined by peripheral retinal areas. As the diagnostic power of the three different stimulus areas was best with the peripheral stimulation, this condition should be used for early glaucoma diagnosis.

 Keywords: temporal contrast sensitivity; full field flicker; glaucoma; ocular hypertension

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Figure 1  .

Figure 1  

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A full field bowl (58 cm in diameter) was used to produce a homogeneous white flickering light. The areas to be tested were either the full field, a peripheral annular area from 30° to 90°, or a central area from 0° to 30°. Those areas not used for stimulation were screened by black cardboard.

Figure 2  .

Figure 2  

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Box plots of temporal contrast sensitivity values determined with three different stimuli (full field, peripheral, and central flicker test) in four different subjects groups (OHT = ocular hypertensives). The temporal contrast sensitivity was almost equal with full field and peripheral, but significantly higher (p <0.001) than with central stimulation. The boxes include 50% of measured values (25% and 75% percentiles) and show the position of the median (horizontal line). Error bars indicate the 1.5-fold of the interquartile distance from the upper and lower box edges. The position of the medians (solid lines within the boxes) illustrates the markedly lower temporal contrast sensitivity with central compared with full field and peripheral stimulation. Additionally, it shows the decreasing temporal contrast sensitivity with increasing stage of glaucoma with all three stimulus areas.

Figure 3  .

Figure 3  

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Receiver operating characteristic (ROC) curves for determination of temporal contrast sensitivity in "perimetric" glaucomas with three different stimulus areas (full field, peripheral, and central stimulation). Although there is only little difference between the three stimulus areas, for specificities >90% peripheral stimulation offers highest sensitivities. The next sensitive test condition is the full field stimulus, followed by the central stimulus which is least sensitive.

Selected References

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