Dual-directional optokinetic nystagmus elicited by the intermittent display of gratings in primary open-angle glaucoma and normal eyes.

PURPOSE To compare optokinetic nystagmus (OKN) responses to the intermittent display of stimuli between normal subjects and patients with primary open-angle glaucoma (POAG). METHODS Optokinetic nystagmus (OKN) was recorded in 9 glaucomatous patients and 7 normal subjects. The computer-generated stimuli displayed sinusoidal luminance gratings (16 cd/m(2) mean luminance, 0.5 cyc/deg) with a pi/2 phase shift between successive stimulus gratings. These stimulus gratings were separated by an interstimulus interval (ISI), during which a homogeneous luminance field of 16 cd/m(2) was presented. The ISI duration and the luminance contrast were set at different values. RESULTS For normal subjects, dual-directional alternating OKN could be evoked in the ISI range from 33 to 100 ms. The dual-directional alternating OKN was defined as that OKN slow phase alternatively tracked in the direction of pi/2 shift (forward OKN) and against the pi/2 shift (reverse OKN). By contrast, for most glaucomatous eyes, nearly no reverse OKN could be evoked at any ISI value. CONCLUSIONS The lack of reverse OKN in POAG patients in the present experiments is a meaningful finding. The occurrence of reverse OKN during a certain range of ISI duration could be related to the biphasic characteristics of the temporal impulse response in normal subjects, whereas, the lack of reverse OKN might suggest the plausible damage of magnocellular cells in POAG.