Blue-on-yellow perimetry can predict the development of glaucomatous visual field loss

Arch Ophthalmol. 1993 May;111(5):645-50. doi: 10.1001/archopht.1993.01090050079034.


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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Color Vision Defects / diagnosis*
  • Female
  • Glaucoma / diagnosis*
  • Glaucoma / physiopathology
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Ocular Hypertension / diagnosis
  • Prospective Studies
  • Psychophysics
  • Sensitivity and Specificity
  • Vision Disorders / diagnosis*
  • Vision Disorders / physiopathology
  • Visual Field Tests / methods*
  • Visual Fields*