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Jo YJ, Kim HK, Lee JS. The clinical efficacy of preoperative flash visual evoked potential (VEP) for mature cataracts without a response to pattern VEP. Graefes Arch Clin Exp Ophthalmol 2024; 262:2525-2532. [PMID: 38441681 DOI: 10.1007/s00417-024-06411-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 01/02/2024] [Accepted: 02/07/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND This study aims to assess the effectiveness of the preoperative flash visual evoked potential (VEP) test in predicting postoperative visual acuity for monocular mature cataract cases when compared to the contralateral normal eye. METHODS The study included 60 patients, each with a monocular mature cataract diagnosis, who underwent preoperative flash VEP testing showing no pattern VEP response. Subsequently, phacoemulsification was performed. The relationship between the flash VEP test latency values (P1, N2, P2) and amplitude value (N2-P2), and the degree of visual acuity recovery 3 months post-cataract surgery, was evaluated using the LogMAR scale. Furthermore, a linear regression analysis was conducted to explore the connection between preoperative flash VEP components and postoperative visual acuity. RESULTS The average age of the patients was 65.4 ± 13.6 years, with a range of 43 to 87 years. The study included 36 males and 24 females. A significant disparity in visual acuity was observed between the preoperative and 3-month postoperative stages (p < 0.001). The preoperative flash VEP test for mature cataracts revealed significant delays in P1, N2, and P2 latency, as well as a reduction in N2-P2 amplitude potential when compared to the contralateral normal eye (p < 0.001). Notably, delayed P2 latency and reduced N2-P2 amplitude potential were particularly indicative of poor visual acuity prognosis after cataract surgery in the multiple regression analysis (p < 0.05). The N2-P2 amplitude potential was the important value that exhibited statistically significant results, with an area under the curve (AUC) of 80% sensitivity and 88% specificity, using a cutoff value of 6.07 μV. CONCLUSIONS In cases of monocular mature cataract, a reduction in N2-P2 amplitude potential compared to the contralateral normal eye emerged as the most reliable predictor of postoperative visual prognosis following cataract surgery.
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Affiliation(s)
- Yeon Ji Jo
- Department of Ophthalmology, Pusan National University College of Medicine & Medical Research Institute of Pusan National University Hospital, 179, Gudeok-ro, Seo-gu, Busan, 49241, Republic of Korea
| | - Hui Kyung Kim
- Department of Ophthalmology, Pusan National University College of Medicine & Medical Research Institute of Pusan National University Hospital, 179, Gudeok-ro, Seo-gu, Busan, 49241, Republic of Korea
| | - Jong Soo Lee
- Department of Ophthalmology, Pusan National University College of Medicine & Medical Research Institute of Pusan National University Hospital, 179, Gudeok-ro, Seo-gu, Busan, 49241, Republic of Korea.
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Yan W, He Q, Chen M, Zhang S, Chen T, Zhang L, Wang H. SSFVEP as a potential electrophysiological examination for evaluating visual function of fundus diseases with vitreous hemorrhages: a clinical study. Sci Rep 2024; 14:2378. [PMID: 38287026 PMCID: PMC10825178 DOI: 10.1038/s41598-023-47714-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 11/17/2023] [Indexed: 01/31/2024] Open
Abstract
To investigate the sensitivity and potential application of steady-state flash visual evoked potentials (SSFVEP) in assessing the visual function of fundus diseases with vitreous hemorrhage. 18 patients diagnosed with monocular vitreous hemorrhages in the fundus were examined the flash visual evoked potentials (FVEP) and SSFVEP in both eyes. The difference in the P2-wave amplitude of FVEP and the average amplitude of SSFVEP waveform between the diseased eyes and those without vitreous hemorrhage were statistically compared. There was no significant difference in the waveform of FVEP between both eyes. The amplitude of P2-wave from FVEP of the diseased eye was slightly lower than that without vitreous hemorrhage. However, the difference was not statistically significant (P = 0.111). The waveform of SSFVEP in the eye without vitreous hemorrhage showed a towering shape, while that of the diseased eye was flat. The average amplitude of SSFVEP in the diseased eye was statistically lower than that without vitreous hemorrhage (P = 0.036). The difference ratio of SSFVEP amplitude between both eyes was significantly greater than that of FVEP amplitude (P = 0.028). In some fundus diseases with vitreous hemorrhage, SSFVEP had a higher sensitivity than FVEP, providing a novel potential application for visual function assessment.
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Affiliation(s)
- Weiming Yan
- The Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, China
- The Third Hospital of Zhangzhou, Zhangzhou, China
- Fuzong Clinical Medical College of Fujian Medical University, Dongfang Hopsital Affiliated to Xiamen University, Fuzhou, China
| | - Qiurui He
- The Third Hospital of Zhangzhou, Zhangzhou, China
| | - Meizhu Chen
- Fuzong Clinical Medical College of Fujian Medical University, Dongfang Hopsital Affiliated to Xiamen University, Fuzhou, China
| | - Sheng Zhang
- Fuzong Clinical Medical College of Fujian Medical University, Dongfang Hopsital Affiliated to Xiamen University, Fuzhou, China
| | - Tao Chen
- Center of Clinical Aerospace Medicine, Air Force Military Medical University, Xi'an, China
| | - Lei Zhang
- The Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, China
| | - Haiyan Wang
- The Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, China.
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Elsaid MAM, Soliman S, Hashem O. Changes in the Parameters of Visual Evoked Potentials in Media Opacities. Clin Ophthalmol 2023; 17:3261-3270. [PMID: 37927575 PMCID: PMC10625330 DOI: 10.2147/opth.s423526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 10/10/2023] [Indexed: 11/07/2023] Open
Abstract
Purpose This study compared flash visual evoked potentials (VEPs) parameter differences between eyes with unilateral opaque media and their normal contralateral counterparts. Patients and Methods We included 178 patients with unilateral media opacity and normal contralateral eye in each patient. The diseased eyes had normal ultrasonographic findings and were candidates for keratoplasty or anterior segment reconstruction. The patients underwent electrophysiological testing by the flash VEPs recording with the use of 1.4Hz (transient) and 8Hz (flicker) frequencies. Results The medians of P2 implicit times were significantly higher in eyes with media opacity than in normal eyes, with median differences between both eyes of -6.7 ms. Furthermore, the median N2P2 amplitude was 9.70 µv with media opacity compared with 11.00 µv in the normal eyes, with a significant difference of 1.3 (p = 0.002). The flash VEPs median parameters recorded at a frequency of 8-Hz showed significant differences in medians of spectral plots of 0.6 µv between normal and abnormal eyes. The same for the signal-to-noise ratio, where the difference in medians was 3 dB. Analysis of the difference between both eyes (normal-abnormal) in each patient showed in P2 implicit time a difference range of -49 to 54.7 ms with a median difference of -3 ms. The difference in amplitudes of recorded N2P2 showed a median of 2.13 µv. There was a statistically significant but weak negative correlation between N2P2 amplitude (r spearman = -0.173, p = 0.021) and the grades of corneal opacity. Conclusion Preoperative flash VEPs recording is useful for evaluating visual function in patients with unilateral media opacity to determine the future benefits of keratoplasty or anterior segment reconstruction. There are no correlations between the flash VEP parameters or the difference between the 2 eyes and the grades of corneal opacity.
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Affiliation(s)
- Maryam A M Elsaid
- Department of Clinical Electrophysiology of Vision, Research Institute of Ophthalmology, Giza, Egypt
| | - Shady Soliman
- Department of Cornea and Refractive, Research Institute of Ophthalmology, Giza, Egypt
| | - Omar Hashem
- Department of Cornea and Refractive, Research Institute of Ophthalmology, Giza, Egypt
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Assessment of Human Visual Acuity Using Visual Evoked Potential: A Review. SENSORS 2020; 20:s20195542. [PMID: 32998208 PMCID: PMC7582995 DOI: 10.3390/s20195542] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/16/2020] [Accepted: 09/25/2020] [Indexed: 01/23/2023]
Abstract
Visual evoked potential (VEP) has been used as an alternative method to assess visual acuity objectively, especially in non-verbal infants and adults with low intellectual abilities or malingering. By sweeping the spatial frequency of visual stimuli and recording the corresponding VEP, VEP acuity can be defined by analyzing electroencephalography (EEG) signals. This paper presents a review on the VEP-based visual acuity assessment technique, including a brief overview of the technique, the effects of the parameters of visual stimuli, and signal acquisition and analysis of the VEP acuity test, and a summary of the current clinical applications of the technique. Finally, we discuss the current problems in this research domain and potential future work, which may enable this technique to be used more widely and quickly, deepening the VEP and even electrophysiology research on the detection and diagnosis of visual function.
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Predicting visual function after an ocular bee sting. Int Ophthalmol 2018; 39:1621-1626. [PMID: 30105490 DOI: 10.1007/s10792-018-0978-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 06/17/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE To report a case of toxic optic neuropathy caused by an ocular bee sting. METHODS Case report and literature review. RESULTS A 44-year-old female presented with no light perception vision 2 days after a corneal bee sting in her right eye. She was found to have diffuse cornea edema with overlying epithelial defect and a pinpoint penetrating laceration at 6 o'clock. There was an intense green color to the cornea. The pupil was fixed and dilated with an afferent pupillary defect. A small hyphema was seen, and a dense white cataract had formed. A diagnosis of toxic endophthalmitis with associated toxic optic neuropathy was made. The patient underwent pars plana vitrectomy and lensectomy with anterior chamber washout. She was also placed on systemic broad-spectrum antibiotics. She had noted clinical improvement over the course of her hospitalization and was discharged with light perception vision. A corneal opacity precluded viewing of the fundus. We utilized ganzfeld electroretinography and flash visual evoked potentials (2 and 10 Hz) to assess the visual function. Both tests were normal and predicted improvement following restorative surgery. She underwent a secondary lens implantation with penetrating keratoplasty 7 months later. This was followed by an epiretinal membrane peel 1 year after the bee sting. Her best corrected visual acuity improved to 20/80. CONCLUSION Toxic endophthalmitis and toxic optic neuropathy can be complications of ocular bee sting. We discuss the management of this rare occurrence and the role of electroretinographic testing and visual evoked potentials in predicting visual outcome.
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The Success of Cataract Surgery and the Preoperative Measurement of Retinal Function by Electrophysiological Techniques. J Ophthalmol 2015; 2015:401281. [PMID: 26576292 PMCID: PMC4631904 DOI: 10.1155/2015/401281] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 09/20/2015] [Indexed: 11/18/2022] Open
Abstract
Purpose. To study the effect of different electrophysiological methods to evaluate retinal function prior to cataract surgery. Methods. Cataract patients who had no significant other eye disease were chosen. VA, pattern visual evoked potential (PVEP), electroretinogram (ERG), and multifocal electroretinogram (mfERG) responses were measured from 150 cataract patients and 20 control subjects. Results. When the preoperative VA was more than 0.3 in cataract patients, the amplitude of PVEP was not significantly different between cataract and control subjects. The amplitude of central point mfERG was significantly lower in cataract patients compared with control group from HM to 0.8 of preoperative VA. The 95% confidence intervals (CIs) of the amplitudes of center point mfERG were calculated for a range of preoperative VA values. Most of the patients within 95% CI of the center point mfERG had a postoperative VA more than 0.5. Conclusions. The amplitude of central point mfERG in cataract patients was the most relevant parameter to the preoperative VA compared with PVEP and ERG. The 95% CI of the amplitude of central point mfERG for each level of VA could help to evaluate preoperative macular function which is used to predict the outcome of cataract surgery.
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Bertschinger DR, Janin YA, Dosso A. Comparison of adapted Vryghem macular function test and Lotmar-light interferometer in predicting visual acuity after cataract surgery. Acta Ophthalmol 2008; 86:307-13. [PMID: 17995978 DOI: 10.1111/j.1600-0420.2007.01043.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To assess the accuracy of a newly described macular function test (Vryghem macular function test) adapted to our examination equipment and to compare it to the Lotmar-light interferometer for the preoperative evaluation of cataract patients at the University Eye Clinic, Geneva, Switzerland. METHODS This prospective study included 71 consecutive patients (72 eyes) who were undergoing uneventful cataract surgery. Testing with the Lotmar-light interferometer and an adapted form of Vryghem macular function test (AVMFT) using a Birkhauser reading chart, a hyperaddition of +8 D and halogen illumination were performed to assess macular function and to predict postoperative visual acuity (VA). The duration of each test and the density and location of lens opacities were also noted. Best-corrected postoperative VA was compared to the predicted values of each test. RESULTS The positive predictive value was 94.2% for AVMFT compared to 92.2% for the Lotmar-light interferometer. The negative predictive value was 50% for AVMFT compared to 42.9% for the Lotmar-light interferometer. The sensitivity was 83.1% for AVMFT and 79.7% for the Lotmar-light interferometer. The specificity was 76.9% for AVMFT and 69.2% for the Lotmar-light interferometer. The correlation coefficient for AVMFT and preoperative Lotmar results (both in LogMAR) with postoperative best-corrected VA (poBCVA; LogMAR) were similar (0.74 and 0.77 respectively). CONCLUSION The results of this study suggest that AVMFT is as reliable as the Lotmar-light interferometer in predicting postoperative VA after uneventful cataract surgery. The correlation coefficients with postoperative VA were 0.74 and 0.77, respectively. Both tests showed a high positive (94.2% and 92.2%, respectively) but a low negative (50.0% and 42.9%, respectively) predictive value.
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Givre SJ, Arezzo JC, Schroeder CE. Effects of wavelength on the timing and laminar distribution of illuminance-evoked activity in macaque V1. Vis Neurosci 1995; 12:229-39. [PMID: 7786845 DOI: 10.1017/s0952523800007914] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Responses to full-field colored flashes (red, blue, and green) were compared with those to illuminance-matched white flashes in area V1, optic radiations, and the lateral geniculate nucleus of two alert macaques. Laminar profiles of visual evoked potentials (VEPs), current source density, and multiunit activity were obtained using multicontact electrodes capable of sampling from all layers of cortex or lateral geniculate nucleus, simultaneously. In striate cortex, stimulation with colored flash enhanced transmembrane current flow dramatically in both layer 4c and the supragranular laminae. Stimulation with red evoked the largest enhancement in every electrode penetration. The mean peak amplitudes of current sinks evoked by red were 203% and 537% of those evoked by white light in layer 4c and the supragranular laminae, respectively. Color effects in V1 were preceded by an initial epoch of wavelength-insensitive activity. In layer 4c, the red effect reached significance, on average, at 47 ms, or approximately 24 ms after the onset of transmembrane current flow. In the supragranular layers, the red effect reached significance, on average, at 55 ms, or approximately 14 ms after the onset of current flow. Recordings from optic radiations in the white matter below V1 and from lateral geniculate nucleus showed no significant difference in the responses to color and illuminance-matched white light. Enhancement of supragranular current flow with color stimulation increased the contribution of these laminae to the generation of the surface VEP. Comparison of the surface VEP wave forms evoked by white and color stimuli may, therefore, help to differentiate the responses of the granular and supragranular laminae.
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Affiliation(s)
- S J Givre
- Department of Neuroscience, Rose F. Kennedy Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA
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Vadrevu VL, Cavender S, Odom JV. Use of 10-Hz flash visual evoked potentials in prediction of final visual acuity in diabetic eyes with vitreous hemorrhage. Doc Ophthalmol 1992; 79:371-82. [PMID: 1633747 DOI: 10.1007/bf00160950] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
In 44 diabetic eyes with vitreous hemorrhage, monocular steady-state visual evoked potentials were elicited through closed eyes by a 10-Hz flash. Visual evoked potentials were rated as normal or abnormal on the basis of amplitude and waveform. Abnormal visual evoked potentials were subdivided into mildly abnormal, markedly abnormal and nonrecordable categories. Patients with normal potentials were predicted to have visual acuities of 6/15 (20/50) or better. Patients with abnormal potentials were predicted to have visual acuities of 6/18 (20/60) or worse. Final visual acuities were the best visual acuities recorded in the 6 months after vitreous surgery (vitrectomy) or spontaneous clearing of the vitreous hemorrhage. The visual evoked potential categories and final acuities were compared with a 2 x 2 contingency table. The accuracy was 86%. The visual evoked potential categories and final acuities were associated at a statistically significant level.
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Affiliation(s)
- V L Vadrevu
- Department of Ophthalmology, West Virginia University Health Sciences Center, Morgantown 26506
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Cavender SA, Hobson RR, Chao GM, Weinstein GW, Odom JV. Comparison of preoperative 10-Hz visual evoked potentials to contrast sensitivity and visual acuity after cataract extraction. Doc Ophthalmol 1992; 81:181-8. [PMID: 1468348 DOI: 10.1007/bf00156007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2023]
Abstract
Cataract patients whose surgical outcomes were in question were referred for testing by visual evoked potentials, elicited through closed eyelids by a luminance stimulus (flash) that appeared 10 times per second. Visual evoked potentials were rated as normal (predicted acuity of 20/50 or better) or abnormal (predicted acuity of 20/60 or worse). Postoperative Arden and Optronix contrast sensitivities and visual acuities were determined in 37 patients who had no intraoperative or early postoperative complications. Arden grating scores of less than 100 were rated as normal. The optimal and cutoff spatial frequency values were determined for the Optronix scores. Optimal and cutoff values of greater or equal to 1 c/deg and 12 c/deg, respectively, were rated as normal. Visual acuities were considered normal at 20/50 or better. Preoperative visual evoked potentials were quantitatively compared to the postoperative contrast sensitivities and visual acuities by 2 x 2 contingency tables. The accuracy of prediction was 79% for the visual acuities, 62% for the Optronix optimal values, 70% for the Optronix cutoff values and 62% for the Arden gratings.
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Affiliation(s)
- S A Cavender
- Department of Ophthalmology, West Virginia University Health Sciences Center, Morgantown 26506
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Odom JV, Chao GM, Weinstein GW. Preoperative prediction of postoperative visual acuity in patients with cataracts: a quantitative review. Doc Ophthalmol 1988; 70:5-17. [PMID: 3229294 DOI: 10.1007/bf00154731] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Many tests of visual function have been proposed as means of preoperatively evaluating cataract patients' surgical outcomes. It is impractical to compare all of these tests simultaneously on the same group of patients. Quantitative reviews apply quantitative methods to comparisons across studies. We compared the results of 52 reports in which cataract patients' postoperative acuity was predicted by means of visually evoked potential, laser interferometry, or projection tests (potential acuity meters-pinhole). The results of each study were summarized in a 2 x 2 contingency table. Summary statistics were compared by means of analysis of variance and post hoc tests. Despite difficulties in metaanalysis, we found the visually evoked potential a better predictor with dense opacities. We recommend standardization in a quest for more precise predictions of postoperative visual acuity.
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Affiliation(s)
- J V Odom
- Department of Ophthalmology, West Virginia University, Morgantown 26506
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