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Updated: Jun 8, 2026

Assessing Early Stage Open-Angle Glaucoma in Patients by Isolated-Check Visual Evoked Potential
Published on: May 25, 2020
Comparison of stereo disc photographs and alternation flicker using a novel matching technology for detecting
Nathan M Radcliffe1, Mitra Sehi, Ira B Wallace
1Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY, USA. nmr9003@med.cornell.edu
Background And Objective:
To compare agreement of automated alternation flicker and serial stereophotograph inspection for detection of progressive glaucoma.
Patients And Methods:
Serial photographs of patients with glaucoma with at least 36 months of follow-up and perimetry every 4 months were assessed by four graders using predefined criteria with both flicker and stereophotography. The main outcome measure was progressive neuroretinal rim deterioration as identified by each technique.
Results:
Forty eyes (20 patients) were included and 12 eyes progressed with perimetry. Using stereophotography, the overall agreement (kappa ± standard error) was 0.19 ± 0.06 for rim change, 0.78 ± 0.06 for disc hemorrhage, and -0.04 ± 0.06 for vessel movement. Using flicker, the overall agreement was similar for rim change (0.28 ± 0.06; P = .29), worse for disc hemorrhage (0.43 ± 0.06; P < .001), and better for vessel movement (0.22 ± 0.06; P = .002). The agreement between perimetric and disc progression was similar using stereophotography (0.10 ± 0.05) and flicker (0.19 ± 0.05; P = .20).
Conclusion:
Agreement between flicker and stereophotography was similar.

