Abstract

Purpose: To determine the effect of glaucomatous damage on latency and amplitude of the multifocal visual evoked potential (MF-VEP), to compare latencies of conventional pattern visual evoked potential (C-VEP) and multifocal visual evoked potential and to compare diagnostic performance of MF-VEP and standard automated perimetry (SAP).

Participants: Thirty-five glaucomatous patients (70 eyes) and twenty- five normal controls (50 eyes) were enrolled in this study.

Methods: Monocular MF-VEP were recorded from glaucoma group and control group. Both eyes of (60) individuals were evaluated. Subjects ranged in age from 30 to 60 years in control and from 32 to 65years in glaucoma group. C- VEP and MF-VEP were obtained by using (Roland consult, Brandenburg, Germany) with four - electrode array. SAP visual field (Humphrey Field Analyzer, 640 Carl Zeiss, Co, Sanleandro, Calif) were obtained within days from VEP.

Results: Fifty-five eyes in glaucoma group had Humphrey field defect, of which 50 eyes (90%), Humphrey field defects were correlated with MF-VEP amplitude. Topographic location was well correlated with Humphrey field. Mean amplitude was significantly reduced in glaucoma eyes.

In 15 glaucoma patients with no scotoma by definition in the fellow eye, 13 had abnormal multifocal perimetry. In 55 glaucoma eyes with abnormal Humphrey visual field one had normal multifocal perimetry. Of 140 hemi field (35 glaucoma patients x two eyes x two hemi field), 110 hemi field showed significant clusters on HVF and 134 hemi field showed significant cluster on the MF-VEP. The amplitude of MF-VEP was correlated with Humphrey MD (r = 0,7, P = 0,000).

Conclusion: MF-VEP can assess the visual field and identify glaucomatous visual field defect. It may have the potential for identifying defects earlier than conventional perimetry. MF-VEP showed more abnormalities than SAP. However, although there were abnormalities detected by the MF- VEP that were missed by SAP, the reverse was true.

Keywords: Multifocal Visual Evoked Potential (MF-VEP); Conventional Pattern Visual Evoked Potential (C-VEP); Standard Automated Perimetry (SAP)

References

1. Fortune B., et al. “Structural and functional abnormalities of retinal ganglion cells measured in vivo at the onset of optic nerve head surface change in experimental glaucoma”. Investigative Ophthalmology and Visual Science 53 (2012): 3939-3950.
2. Medeiros FA., et al. “Retinal ganglion cell count estimates associated with early development of visual field defects in glaucoma”. Ophthalmology 120 (2013): 736-744.
3. Subramanian SK., et al. “Low luminance/eye closed and monochromaticstimulation variability of visual evoked potential latency”. Annals of Indian Academy of Neurology 16.4 (2013): 641-648.
4. Odom JV., et al. “ISCEV standard for clinical visual evoked potentials (2016 update)”. Documenta Ophthalmologica 133 (2016): 1-9.
5. Graham SL., et al. “The diagnostic significance of the multifocal pattern visual evoked potential in glaucoma”. Current Opinion in Ophthalmology 10 (1999): 140-146.
6. Kothari R., et al. “Influence of visual angle on pattern reversal visual evoked potentials”. Oman Journal of Ophthalmology 7 (2014): 120-125.
7. Hood DC and Zhang X. “Multifocal ERG and VEP responses and visual fields: Comparing disease- related changes”. Documenta Ophthalmologica , 100 (2000): 115-137.
8. Graham SL., et al. “Objective perimetry in glaucoma, astrymmetry analysis to identify early deficits”. The Journal of Glaucoma 9 (2000): 10-19.
9. Hood DC., et al. “An interocular comparsian of the multifocal VEP: a possible technique for detecting local damage to the optic nerve”. Investigative Ophthalmology and Visual Science 41 (2000): 1580.
10. Hood Dc., et al. “Visual field defects and multifocal visual evoked potentials: evidence of a linear relationship”. Archives of Ophthalmology , 12 (2002): 3-15.
11. Hood Dc., et al. “Detecting glaucomatous damage with multifocal visual evoked potentials: how can a monocular test work?” The Journal of Glaucoma 12 (2003): 3-15.
12. Goldberg I., et al. “Multifocal objective perimetry in detection of glaucomatous field loss”. American Journal of Ophthalmology 133 (2002): 29-39.
13. Anderson DR and Patella VM. “Automated, Static perimetry”. 2nd edition. St louis: Mosby (1996).
14. Odom JV., et al. “Visual evoked potentials”. Documenta Ophthalmologica 108 (2004): 115-123.
15. Grippo TM., et al. “Comparison between Multifocal and convential VEP latency changes secondary to glaucomatous damage”. Investigative Ophthalmology and Visual Science 47 (2006): 5331-5336.
16. Klistoner A., et al. “Objective perimetry in glacame: recent advances with multifocal stimuli”. Survey of Ophthalmolog 2 (1999): 5199-5209.
17. Rodarte C., et al. “The effects of glaucoma on the latency of the multifocal visual evoked potential”. British Journal of Ophthalmology 90 (2006): 1132-1136.
18. Hood DC and Greenstien VC. “The multifocal VEP and ganglion cell damage. Applications and limitations for the study of glaucoma”. Progress in Retinal and Eye Research 22 (2003): 201-251.
19. Hood DC., et al. “Visual field defects and multifocal visual ecoked potentials: evidence for a linear relation ship”. Archives of Ophthalmology 120 (2002): 1672-1681.
20. Hood DC., et al. “Detecting early to mild glaucomatous damage: A comparsion of multifocal VEP and automated perimetry”. Investigative Ophthalmology and Visual Science 45 (2004): 492-498.
21. Thienprasiddhi P., et al. “Multifocal VEP responses in glaucoma patient with unilateral hemifild defects”. American Journal of Ophthalmology 136 (2003): 34-40.
22. Bengisson B. “Evaluation of VEP perimetry in normal subjects and glaucoma patients”. Acta Ophthalmologica Scandinavica 80 (2002): 620-626.
23. Hood Dc. “Comment on Bengisson paper”. International Glaucoma Review 4-3 (2003): 473-474.
24. Klistorner A and Gracam SL. “Objective perimetry in glaucoma”. Ophthalmology 107 (2000): 2283-2299.
25. Sood NN., et al. “Assesment of visual evoked response in chronic simple glaucoma”. Indian Journal of Ophthalmology 35 (1987): 274-277.
26. Accornero N., et al. “A new color VEP procedure discloses asymptomatic visual impairments in optic neuritis and glaucoma”. Neurology India 102 (2000): 258-263.
27. Price Mj., et al. “The pattern electroretinogram and visual evoked potential in glaucoma”. Gaede’s Archive for Clinical and Experimental Ophthalmology 226 (1988): 542-547.
28. Atkin A., et al. “Flicker threshold and pattern VEP latency in ocular hypertension and glaucoma”. Investigative Ophthalmology and Visual Science 24 (1983): 1524-1528.
29. Parisi V., et al. “Clinical ability of pattern electroretin ogram and visual evoked potentials in detecting visual dysfunction in ocular hypertension and glaucoma”. Ophthalmology 113 (2006): 216-228.
30. Aine CJ., et al. “Retinotopic organization of human visual cortex. departures from the classical model”. Cerebral Cortex 6 (1996): 354-361.
31. Bertuzzi F., et al. “Evaluation of retinal nerve fiber thickness measurements for glaucoma detection: GDx ECC versus spectral-domain optical coherence tomography”. Journal of Glaucoma 23 (2014): 232-239.

Citation

Citation: Mona Abdel Kader. “Multifocal Visual Evoked Potential in Glaucoma".Acta Scientific Ophthalmology 4.11 (2021): 53-63.

Copyright

Copyright: © 2021 Mona Abdel Kader. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.