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Crux K, Huchzermeyer C, Kremers J, Horn FK. Objective detection of visual field defects with multifrequency VEPs. Doc Ophthalmol 2024; 148:15-24. [PMID: 37749441 PMCID: PMC10879258 DOI: 10.1007/s10633-023-09949-4] [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: 10/24/2022] [Accepted: 08/25/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE To correlate multifrequency pattern reversal VEPs in quadrants (QmfrVEPs) with perimetric field losses for objective detection of visual field losses. METHODS QmfrVEP measurements were performed using four LED-based checkerboard stimulators to stimulate the four quadrants of the visual field. QmfrVEPs were measured monocularly in 5 normal subjects and in 5 glaucoma patients who showed losses in conventional Octopus perimetry. The pattern reversal frequency varied slightly between the stimulators: (11.92, 12.00, 12.08 and 12.16 reversals/sec). The responses to the different stimuli were identified by discrete Fourier analysis. VEPs were recorded using different electrode configurations, and the recording with the highest signal-to-noise ratio (SNR) was used for further analysis. RESULTS QmfrVEP responses from the different quadrants can be reliably measured and separated using the 0.08 reversals/sec interstimulus reversal frequency differences. The signal-to-noise ratio in the four quadrants was significantly correlated with the equivalent visual field losses obtained with perimetry (Spearman rank correlation: P < 0.001). In the five glaucoma patients, the SNR was reduced in 15 out of the 16 quadrants with a perimetric defect, in comparison to the results in quadrants of healthy subjects. This confirms the sensitivity of the procedure. CONCLUSION QmfrVEP responses can be measured reliably. This pilot study suggests that high SNR values exclude visual field defects and that focal defects can be identified in glaucoma patients. TRIAL REGISTRATION www. CLINICALTRIALS gov . NCT00494923.
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Affiliation(s)
- Katja Crux
- Department of Ophthalmology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Cord Huchzermeyer
- Department of Ophthalmology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Jan Kremers
- Department of Ophthalmology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Folkert K Horn
- Department of Ophthalmology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany.
- Department of Ophthalmology, University Eye Hospital, Friedrich-Alexander University Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen, Germany.
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Haugen OH, Andréasson S, Ersland L, Craven AR, Hugdahl K. Cerebral Functional Magnetic Resonance Imaging and Multifocal Visual Evoked Potentials in a Patient with Unexplained Impairment of Visual Function: A Case Report. Case Rep Ophthalmol 2018; 9:269-278. [PMID: 29928222 PMCID: PMC6006601 DOI: 10.1159/000488930] [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: 08/31/2017] [Accepted: 04/03/2018] [Indexed: 11/19/2022] Open
Abstract
We present a case of a young female with a slowly progressing visual impairment who was examined with multifocal visual evoked potentials and functional magnetic resonance imaging (fMRI) for underlying neuronal abnormality. The fMRI examination consisted of presenting black-and-white checkerboard stimuli, and her activation patterns were compared to the patterns from 4 normal-sighted subjects. The results showed clear differences in neuronal activation between the patient and the controls in the occipital and parietal lobes. Although we have shown neuronal correlates in a case of unexplained visual loss, it is still an open question as to whether this has an organic or functional cause, which should be the subject for future research.
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Affiliation(s)
- Olav H Haugen
- Department of Ophthalmology, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Sten Andréasson
- Department of Ophthalmology, University of Lund, Lund, Sweden
| | - Lars Ersland
- Department of Clinical Engineering, Haukeland University Hospital, Bergen, Norway
| | - Alexander R Craven
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Kenneth Hugdahl
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.,Department of Radiology, Haukeland University Hospital, Bergen, Norway
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Malmqvist L, De Santiago L, Fraser C, Klistorner A, Hamann S. Exploring the methods of data analysis in multifocal visual evoked potentials. Doc Ophthalmol 2016; 133:41-8. [DOI: 10.1007/s10633-016-9546-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 06/09/2016] [Indexed: 11/24/2022]
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de Santiago L, Klistorner A, Ortiz M, Fernández-Rodríguez A, Rodríguez Ascariz J, Barea R, Miguel-Jiménez J, Boquete L. Software for analysing multifocal visual evoked potential signal latency progression. Comput Biol Med 2015; 59:134-141. [DOI: 10.1016/j.compbiomed.2015.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 02/05/2015] [Accepted: 02/07/2015] [Indexed: 10/24/2022]
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Fernández A, de Santiago L, Blanco R, Pérez-Rico C, Rodríguez-Ascariz JM, Barea R, Miguel-Jiménez JM, García-Luque JR, Ortiz del Castillo M, Sánchez-Morla EM, Boquete L. Filtering multifocal VEP signals using Prony's method. Comput Biol Med 2014; 56:13-9. [PMID: 25464344 DOI: 10.1016/j.compbiomed.2014.10.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 10/21/2014] [Accepted: 10/25/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND This paper describes use of Prony's method as a filter applied to multifocal visual-evoked-potential (mfVEP) signals. Prony's method can be viewed as an extension of Fourier analysis that allows a signal to be decomposed into a linear combination of functions with different amplitudes, damping factors, frequencies and phase angles. METHOD By selecting Prony method parameters, a frequency filter has been developed which improves signal-to-noise ratio (SNR). Three different criteria were applied to data recorded from control subjects to produce three separate datasets: unfiltered raw data, data filtered using the traditional method (fast Fourier transform: FFT), and data filtered using Prony's method. RESULTS Filtering using Prony's method improved the signals' original SNR by 44.52%, while the FFT filter improved the SNR by 33.56%. The extent to which signal can be separated from noise was analysed using receiver-operating-characteristic (ROC) curves. The area under the curve (AUC) was greater in the signals filtered using Prony's method than in the original signals or in those filtered using the FFT. CONCLUSION filtering using Prony's method improves the quality of mfVEP signal pre-processing when compared with the original signals, or with those filtered using the FFT.
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Affiliation(s)
- A Fernández
- Department of Electronics, University of Alcalá, Plaza de S. Diego, s/n, 28801 Alcalá de Henares, Spain
| | - L de Santiago
- Department of Electronics, University of Alcalá, Plaza de S. Diego, s/n, 28801 Alcalá de Henares, Spain.
| | - R Blanco
- Department of Surgery, University of Alcalá, Plaza de S. Diego, s/n, 28801 Alcalá de Henares, Spain
| | - C Pérez-Rico
- Department of Surgery, University of Alcalá, Plaza de S. Diego, s/n, 28801 Alcalá de Henares, Spain
| | - J M Rodríguez-Ascariz
- Department of Electronics, University of Alcalá, Plaza de S. Diego, s/n, 28801 Alcalá de Henares, Spain
| | - R Barea
- Department of Electronics, University of Alcalá, Plaza de S. Diego, s/n, 28801 Alcalá de Henares, Spain
| | - J M Miguel-Jiménez
- Department of Electronics, University of Alcalá, Plaza de S. Diego, s/n, 28801 Alcalá de Henares, Spain
| | - J R García-Luque
- Department of Electronics, University of Alcalá, Plaza de S. Diego, s/n, 28801 Alcalá de Henares, Spain
| | - M Ortiz del Castillo
- Department of Electronics, University of Alcalá, Plaza de S. Diego, s/n, 28801 Alcalá de Henares, Spain
| | - E M Sánchez-Morla
- Department of Psychiatry, University Hospital of Guadalajara, Guadalajara, Spain
| | - L Boquete
- Department of Electronics, University of Alcalá, Plaza de S. Diego, s/n, 28801 Alcalá de Henares, Spain
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Lövestam-Adrian M, Gränse L, Andersson G, Andreasson S. Multifocal Visual Evoked Potentials (mfVEP) in Diabetic Patients with and without Polyneuropathy. Open Ophthalmol J 2012. [PMID: 23198007 PMCID: PMC3504721 DOI: 10.2174/1874364101206010098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
UNLABELLED Previously not shown this study support that mfVEP is an indicator of optic nerve neuropathy in diabetic patients and there could be a correlation between the optic nerve dysfunction and diabetic poly neuropathy. The early optic nerve involvement might explain some of the visual complain in this group of diabetic patients. PURPOSE To investigate the function of the visual pathway measured by mfVEP (multifocal Visual Evoked Potentials) in patients with diabetic retinopathy and neurophysiologically verified polyneuropathy SUBJECTS AND METHODS Thirty-two diabetic patients with the same degree of diabetic retinopathy were classified with neurography regarding polyneuropathy and further examined with mfVEP. The mfVEPs of eighteen patients with polyneuropathy were compared to those of fourteen diabetic patients without polyneuropathy and to those of ten nondiabetic subjects. RESULTS Diabetic duration, and the number of patients who had undergone panretinal photocoagulation for proliferative diabetic retinopathy were similar in the two patient groups, 29±13 vs 25±7 years, p=0.3. Both groups of patients with diabetic retinopathy had significantly lower amplitudes in the mfVEP than the healthy subjects. In addition the mfVEP amplitudes, which reflect selected areas of the visual function, were significantly reduced in the lower nasal quadrant in patients with neuropathy compared to patients without neuropathy. CONCLUSION The results indicate that mfVEP could be an indicator of optic nerve neuropathy in patients with diabetic retinopathy. The early optic nerve involvement might explain some of the visual complaints in this group of diabetic patients.
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Báez Martín MM, del Carmen Pérez Téllez Y, Chacón LMM, Díaz BE, Trápaga-Quincoses O, Maeso IG, Bender JE, Galvizu R, García ME, Abreu IC, Rodríguez GS. Innovative evaluation of visual field defects in epileptic patients after standard anterior temporal lobectomy, using partial field visual evoked potentials. Epilepsy Res 2010; 90:68-74. [PMID: 20427151 DOI: 10.1016/j.eplepsyres.2010.03.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Revised: 03/10/2010] [Accepted: 03/12/2010] [Indexed: 01/16/2023]
Abstract
The purpose of this paper is to obtain an electrophysiological evaluation of visual field defects consecutive to the direct lesion of optic radiations in drug-resistant epileptic patients after a standard electrocorticographically adjusted lobectomy, and to correlate it with conventional perimetric results, and with the volume of resected tissue during surgical treatment. Twenty-four patients with temporal lobe epilepsy defined through long term EEG-video, ictal and interictal SPECT, as well as Magnetic Resonance Imaging were studied. Visual evoked potentials (VEPs) with partial and total visual field stimulation were carried out before and after 6, 12 and 24 months surgical treatment. A control group was also studied. No differences between patients and control subjects were observed during the evaluation of the full-field VEPs. However, there were statistical differences between groups in the half-field VEP recordings and in the VEP recordings of contralateral to resected side superior quadrant (CSQ) before lobectomy and 6 months later (Mann-Whitney's U-test, p<0.05). Significant associations were found between VEP abnormalities and perimetric results in CSQ. A close relationship between perimetry, VEPs and volume of the resected tissue in hippocampus, parahippocampus, medial and lower temporal giri was also found. Visual field defects consecutive to standard temporal lobe resection in epileptic patients could be objectively evaluated by partial stimulation VEPs corresponding to the size of resected tissue.
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Gränse L. Alterations in multifocal visual evoked potentials during the acute phase of Leber's hereditary optic neuropathy. ACTA OPHTHALMOLOGICA SCANDINAVICA 2006; 84:549-51. [PMID: 16879580 DOI: 10.1111/j.1600-0420.2006.00646.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE This report aimed to investigate alterations in multifocal visual evoked potentials (mfVEPs) during the acute stage of Leber's hereditary optic neuropathy (LHON). METHODS A 27-year-old woman with a point mutation at nucleotide 11778 in the mitochondrial DNA was examined during the acute phase of LHON, which is generally investigated only rarely because of its rapid progress. She was examined repeatedly, with testing of best corrected visual acuity, pupil function, Goldmann perimetry, ophthalmoscopy and frequent assessment of mfVEPs. RESULTS Multifocal VEPs, which reveal topographical information about different parts of the visual pathways, demonstrated reduced responses in all parts of the central visual field. The mean amplitude (summarized amplitude of the first two components) in the mfVEPs in the previously described sector C, which has been identified as a hallmark of other optic nerve disorders, was evaluated. This amplitude demonstrated a correlation with the progression of the disease during the acute period of LHON, which also correlated with the VA, pupil function and Goldmann perimetry. CONCLUSIONS These alterations in the components of mfVEPs reflect the reduction in the function of the visual pathways in different parts of the central field; the drop in amplitude in a localized area (sector C), not previously described, demonstrates the acute course of this disorder. Multifocal VEPs may be of further interest in evaluating the pathogenesis of this disorder and of clinical value in representing an objective method for monitoring the course of this disease.
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Affiliation(s)
- Lotta Gränse
- Department of Ophthalmology, University Hospital of Lund, Lund, Sweden.
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Andréasson S. Developments in molecular genetics and electrophysiology in inherited retinal disorders. ACTA ACUST UNITED AC 2006; 84:161-8. [PMID: 16637830 DOI: 10.1111/j.1600-0420.2006.00657.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Retinitis pigmentosa is said to be the most frequent reason for severe visual handicap among young people in Scandinavia today. Developments in the fields of electrophysiology and molecular genetics have increased our understanding of the pathophysiology of these disorders and have also improved our clinical competence, leading to a better understanding of the patient's visual handicap and his or her prognosis. This represents the first step towards fulfilling our plan for the future, which is ultimately to cure blindness caused by the different forms of hereditary retinal degeneration. This review is based on 20 years of research at the Department of Ophthalmology in Lund.
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Affiliation(s)
- Sten Andréasson
- Department of Ophthalmology, University Hospital of Lund, Lund, Sweden.
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