Silent substitution stimulation of S-cone pathway and L- and M-cone pathway in glaucoma

Patrick Bessler*, Sascha Klee, Ulrich Kellner, Jens Haueisen

*Corresponding author for this work

Research output: Journal article (peer-reviewed)Journal article

15 Citations (Scopus)


PURPOSE. The study aimed for objective detection of primary open-angle glaucoma with selective color channel stimulation based on the silent substitution technique. In addition, an objective was analysis of the characteristics of individual color channels based on visual evoked potentials. METHODS. Visual evoked potentials were recorded in 141 subjects (39 patients with glaucoma, 71 healthy subjects, and 31 age-matched healthy subjects) with two scalp electrodes after cone-specific flash stimulation. Silent substitution stimulation was presented with a 30-in. liquid crystal display. Separate responses were obtained for short-, medium-, and long-wavelength- sensitive cones. Age-matched subgroups were used to compare patients with glaucoma and healthy subjects. RESULTS. The S-cone responses of age-matched healthy subjects had significantly different slopes for the first positive wave, compared with the responses of patients with moderate glaucoma. This difference was not observed in the L- and M-cone responses. Distinct changes in the S-cone response profiles were observed with increasing severity of glaucoma. Patients with severe glaucomatous damage were recognizable by the altered profiles of their visual evoked potentials. Healthy subjects showed significant differences between color channels. CONCLUSIONS. Glaucoma and its severity were objectively detected by using the silent substitution technique. The stimulation technique and signal analysis enabled assessment of the visual evoked potentials of individual color channels.

Original languageEnglish
Pages (from-to)319-326
Number of pages8
JournalInvestigative Ophthalmology and Visual Science
Issue number1
Publication statusPublished - Jan 2010
Externally publishedYes

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience


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