Pattern visual evoked potentials in the assessment of objective visual acuity in amblyopic children

The aim of this study was to determine the value of pattern visual evoked potentials (PVEP) to five consecutive check size patterns in the assessment of visual acuity (VA) in children. One hundred unilateral amblyopic (study group) and 90 healthy children with best-corrected visual acuity (BCVA) of 1.0 (control group) were planned to be included. PVEP responses to five consecutive check sizes (2 degrees , 1 degrees , 30', 15', and 7') which are assumed to correspond to VAs of 0.1, 0.2, 0.4, 0.7 and 1.0 Snellen lines were recorded in both groups. Eighty-five children in the study group (85.0%) and 74 children in the control group (82.2%) who cooperated well with PVEP testing were included. Normal values for latency, amplitude, and normalized interocular amplitude/latency difference in each check size were defined in the control group. PVEP-estimated VA (PVEP-VA) in the amblyopic eye was defined by the normal PVEP responses to the smallest check size associated with normal interocular difference from the non-amblyopic eye, and was considered predictive if it is within +/-1 Snellen line (1 decimal) discrepancy with BCVA in that eye. Mean age was 9.7 +/- 1.9 and 9.9 +/- 2.2 years in the study and the control groups, respectively. LogMAR (logarithm of minimum angle of resolution) Snellen acuity was well correlated with the logMAR PVEP-VA (r = 0.525, P < 0.001) in the study group. The Snellen line discrepancy between BCVA and PVEP-VA was within +/-1 Snellen line in 57.6% of the eyes. PVEP to five consecutive check sizes may predict objective VA in amblyopic children.