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Purpose:To evaluate the diagnostic performance of the photopic negative response (PhNR) for the detection of primary open-angle glaucoma (POAG).Methods:Fifty-two normal subjects (52 eyes) and 173 POAG patients (173 eyes) were studied.The PhNR was elicited using a white stimuli on a white background.The mean deviation (MD) and pattern standard deviation (PSD) of the visual field were measured using standard automated perimetry (SAP).Spectral domain optical coherence tomography (SDOCT) was used to measure the mean thickness of the retinal nerve fiber layer (RNFL).Results:In the glaucoma group,as compared to the normal group,the amplitudes of a-waves,b-waves and PhNR were significantly smaller (P＜0.001),and the PhNR implicit time was significantly longer (P=0.004).The MD,PSD and mean thickness of the RNFL were significantly correlated with the amplitude of the PhNR (P＜0.001).The area under the receiver operating characteristic curve (AUCs) for the amplitudes of a-waves,b-waves and PhNR were 0.853,0.830 and 0.918,respectively.When the specificity was ≥95％,the sensitivities were 60.4％,54.2％ and 85.4％ respectively.Conclusion:The PhNR amplitude was reduced even when the loss in visual field sensitivity was mild,which suggests that PhNR might be a useful indicator of early glaucoma disease.
