Standardization of the Tübingen flicker test

In the Tübingen flicker test, the subjective brightness of a steady field is adjusted to that of a flickering test field at 50-0 Hz. This test has proven itself as a valuable and highly specific method in the diagnosis of optic neuritis (ON). This paper reports on the development of new judgement criteria and their standardization, based on a new cohort of 527 eyes, 138 of them with florid ON. After improving the conditions of examination and evaluation the optimal criteria for the definition of a pathological result were determined in an explorative manner that is described in detail. The criteria finally chosen are defined such that they preserve the high specificity (98%) of the test, while also retaining a high sensitivity (85.5%).