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Visual-evoked cortical potentials in dissociated vertical deviation.

A A Zubcov1, M G Fendick, I Gottlob

  • 1Wills Eye Hospital, Philadelphia, PA 19107.

American Journal of Ophthalmology
|December 15, 1991
PubMed
Summary
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This study found no evidence of optic nerve fiber misrouting in patients with dissociated vertical deviation. Pattern appearance visual evoked potentials are the most reliable method for detecting lateralization in albinism, with reliability increasing with age.

Area of Science:

  • Neuroscience
  • Ophthalmology
  • Genetics

Background:

  • Chiasmatic misrouting of temporal optic-nerve fibers is observed in ocular albinism.
  • It remains debated whether this misrouting also occurs in dissociated vertical deviation (DVD).

Purpose of the Study:

  • To investigate the presence of chiasmatic misrouting in individuals with dissociated vertical deviation.
  • To compare the efficacy of different visual evoked cortical potential (VEP) stimulation techniques in detecting lateralization.

Main Methods:

  • Monocular full-field visual evoked cortical potentials (VEPs) were recorded using pattern appearance, pattern reversal, and diffuse-flash stimulation.
  • Subjects included albino individuals, normal individuals, and individuals with dissociated vertical deviation.

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Main Results:

  • Pattern appearance VEPs were most reliable for detecting lateralization in adult albino patients; diffuse-flash VEPs were reliable in children.
  • Lateralization was not evident in patients with dissociated vertical deviation across all tested VEP stimulation modes.
  • VEP reliability for lateralization increased with age up to approximately 15 years.

Conclusions:

  • Dissociated vertical deviation does not appear to involve chiasmatic misrouting of temporal optic-nerve fibers.
  • Pattern appearance VEPs are the preferred method for assessing lateralization, with age-dependent reliability.
  • Pattern reversal VEPs were unreliable for detecting lateralization, particularly in patients with horizontal nystagmus.