Perimetry, visual evoked potentials and visual evoked spectrum array in homonymous hemianopsia

Confrontation field examination, perimetry, visual evoked potentials (VEPs) to pattern hemi-field stimulation and visual evoked spectrum array to flash stimulation were compared in 50 patients with homonymous hemianopsia. Visual field could be examined by confrontation in all patients and demonstrated the field defect in 96% of cases. Goldmann perimetry could only be performed in 60% of patients, but always quantitatively defined the margins of the defect. VEPs could only be tested in 77% of patients and demonstrated an abnormality in 79% of cases. VEPs were absent to stimulation of the affected hemifield in every case of homonymous field defects with macular splitting. Visual evoked spectrum array could be tested in 95% of patients and revealed abnormalities in 67% of cases. The relative value of each test is discussed.