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Visual evoked potentials changes with surgery in primary congenital glaucoma: a pilot study

Mai AbdelNabi Mohamed ElBahwash1, Mahmoud Hassan Morsy1, Amira Saad Mahmoud Hegazy2

  • 1Ophthalmology Department, Faculty of Medicine, Alexandria University, 311 Horeya Avenue, Alexandria, Egypt.

International Ophthalmology
|February 26, 2021
PubMed

Insights

Intraocular pressure (IOP) elevation in primary congenital glaucoma (PCG) impacts optic nerve function. However, successful surgery to control IOP shows no permanent detrimental effect on optic nerve function, evidenced by improved visual evoked potential (VEP) parameters in children.

Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Neuroscience

Background:

  • Primary congenital glaucoma (PCG) is a severe form of glaucoma presenting in infancy.
  • Elevated intraocular pressure (IOP) in PCG can lead to optic nerve damage.
  • Visual evoked potentials (VEPs) are electrophysiological tests that assess the function of the visual pathway.

Purpose of the Study:

  • To evaluate flash visual evoked potential (VEP) findings in children with primary congenital glaucoma (PCG).
  • To compare VEP parameters before and after surgical control of intraocular pressure (IOP) in PCG patients.

Main Methods:

  • Children with PCG underwent flash VEP testing before and after surgery.
  • Intraocular pressure (IOP) was measured before and after surgical intervention.
  • VEP parameters, including implicit times and amplitudes of specific waves (N1-P1, N2-P2, P2), were analyzed.

Main Results:

  • A significant reduction in IOP was observed postoperatively (23.0 ± 6.7 mmHg to 8.3 ± 2.4 mmHg, p < 0.0001).
  • There were statistically insignificant changes in P2 implicit time, N1-P1 amplitude, and N2-P2 amplitude postoperatively.
  • The study included 11 eyes of 8 children, with a mean age of 3.5 months at presentation.

Conclusions:

  • Elevated IOP in PCG adversely affects optic nerve function.
  • Successful surgical control of IOP in PCG does not appear to cause permanent detrimental effects on optic nerve function in the short term.
  • Improvements in VEP parameters suggest a reversible impact of IOP on optic nerve function in PCG.
Abstract

Keywords:
ElectrophysiologyIntraocular pressureOptic nervePrimary congenital glaucomaVisual evoked potentials

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