Pattern visual evoked potentials in the assessment of objective visual acuity in amblyopic children
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Published on: May 25, 2020
Fatih C Gundogan1, Fatih M Mutlu, H Ibrahim Altinsoy
1Department of Ophthalmology, Gulhane Military Medical Academy, Göz Hastaliklari A.D, 06010, Etlik, Ankara, Turkey. fgundogan@yahoo.com
Insights
Pattern visual evoked potentials (PVEP) can predict objective visual acuity (VA) in amblyopic children. This method shows a correlation between PVEP-estimated VA and best-corrected visual acuity, offering a valuable assessment tool.
Area of Science:
- Ophthalmology
- Neuroscience
- Pediatrics
Background:
- Assessing visual acuity (VA) in children, especially those with amblyopia, presents challenges.
- Pattern visual evoked potentials (PVEP) offer a potential objective method for VA assessment.
Purpose of the Study:
- To evaluate the efficacy of PVEP using five distinct check sizes in determining VA in pediatric amblyopic patients.
- To establish normal PVEP parameters and assess the predictive value of PVEP-estimated VA (PVEP-VA) against best-corrected visual acuity (BCVA).
Main Methods:
- PVEP responses were recorded in 100 amblyopic and 90 healthy children using five consecutive check sizes (2°, 1°, 30', 15', 7').
- Normal PVEP values (latency, amplitude, interocular differences) were defined in the control group.
- PVEP-VA was determined based on normal responses and interocular differences, with predictive accuracy assessed against BCVA.
Main Results:
- A significant correlation was found between logarithm of the minimum angle of resolution (LogMAR) Snellen acuity and LogMAR PVEP-VA in the amblyopic group (r = 0.525, P < 0.001).
- The discrepancy between BCVA and PVEP-VA was within +/-1 Snellen line in 57.6% of amblyopic eyes.
- PVEP testing demonstrated good cooperation rates (85% in the study group, 82.2% in the control group).
Conclusions:
- PVEP testing with multiple check sizes shows promise as an objective method for predicting visual acuity in amblyopic children.
- PVEP-VA can be a valuable adjunct to traditional VA measurements, particularly in pediatric populations where cooperation is a concern.
Abstract:
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.
