Related Experiment Video
Updated: May 4, 2026
Binocular Dynamic Visual Acuity in Eyeglass-Corrected Myopic Patients
Published on: March 29, 2022
Contributing factors to VEP grating acuity deficit and inter-ocular acuity difference in children with cerebral
Nívea Nunes Cavascan1, Solange Rios Salomão, Paula Yuri Sacai
1Departamento de Oftalmologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, Rua Botucatu 822, São Paulo, SP, 04023-062, Brazil, nivea.cavascan@unifesp.br.
Insights
In children with cerebral visual impairment (CVI), severe visual evoked potential (VEP) grating acuity deficit (GAD) was common, especially in older children and those on anti-seizure drugs. Strabismus and nystagmus also impacted acuity differences between eyes.
Area of Science:
- Ophthalmology
- Neuroscience
- Pediatrics
Background:
- Cerebral visual impairment (CVI) is a leading cause of bilateral visual impairment in children.
- Understanding factors contributing to visual acuity deficits is crucial for effective management.
Purpose of the Study:
- To investigate factors contributing to visual evoked potential (VEP) grating acuity deficit (GAD) and inter-ocular acuity difference (IAD) in children with CVI.
- To analyze the severity of VEP GAD and IAD in relation to age, medication, and ocular conditions.
Main Methods:
- Sweep-VEPs were used to measure VEP GAD and IAD in 115 children with CVI.
- VEP GAD deficits were categorized as mild, moderate, or severe.
- IAD was assessed, with a maximum acceptable difference of 0.10 log units.
Main Results:
- Over half of the children (52%) exhibited severe VEP GAD.
- Severe GAD was significantly associated with older age and anti-seizure drug therapy.
- While 83% had acceptable IAD, children with strabismus and nystagmus showed significantly larger IADs.
Conclusions:
- A significant proportion of children with CVI experience severe VEP GAD.
- Older age and anti-seizure medications are risk factors for greater VEP GAD.
- Strabismus and nystagmus are associated with increased inter-ocular acuity differences, informing clinical management strategies.
Purpose:
To investigate contributing factors to visual evoked potential (VEP) grating acuity deficit (GAD) and inter-ocular acuity difference (IAD) measured by sweep-VEPs in children with cerebral visual impairment (CVI).
Methods:
VEP GAD was calculated for the better acuity eye by subtracting acuity thresholds from mean normal VEP grating acuity according to norms from our own laboratory. Deficits were categorized as mild (0.17 ≤ deficit < 0.40 log units), moderate (0.40 ≤ deficit < 0.70 log units) or severe (deficit ≥0.70 log units). Maximum acceptable IAD was 0.10 log units.
Results:
A group of 115 children (66 males-57 %) with ages ranging from 1.2 to 166.5 months (median = 17.7) was examined. VEP GAD ranged from 0.17 to 1.28 log units (mean = 0.68 ± 0.27; median = 0.71), and it was mild in 23 (20 %) children, moderate in 32 (28 %) and severe in 60 (52 %). Severe deficit was significantly associated with older age and anti-seizure drug therapy. IAD ranged from 0 to 0.49 log units (mean = 0.06 ± 0.08; median = 0.04) and was acceptable in 96 (83 %) children. Children with strabismus and nystagmus had IAD significantly larger compared to children with orthoposition.
Conclusion:
In a large cohort of children with CVI, variable severity of VEP GAD was found, with more than half of the children with severe deficits. Older children and those under anti-seizure therapy were at higher risk for larger deficits. Strabismus and nystagmus provided larger IADs. These results should be taken into account on the clinical management of children with this leading cause of bilateral visual impairment.
More Related Videos
Related Concept Videos
01:22Photoreceptors and Visual Pathways
01:12Visual Agnosia