Psychophysical measurement of glaucomatous damage

Within the past twenty years, a number of new psychophysical test procedures have been adapted for use in perimetry and visual field testing. These procedures are designed to measure the functional properties of different types of retinal ganglion cell subpopulations. Although many of these new procedures exhibit better performance characteristics than standard automated perimetry, no single test procedure appears to be decidedly superior to all others. Comparison of multiple functions in patients with early glaucomatous damage suggests that visual function losses are not selective for specific retinal ganglion cell subpopulations in all patients. For evaluation of the efficacy of neuroprotective agents in glaucoma, one of the challenges facing the development of new psychophysical tests is to be able to distinguish visual function losses that are due to ganglion cell drop-out ("dead" cells) from those that are due to malfunctioning retinal nerve fibers ("sick" cells).