What can visual electrophysiology tell about possible visual-field defects in paediatric patients

Area of Science:

• Ophthalmology
• Neuroscience
• Pediatrics

Background:

• Assessing visual-field (VF) defects in pediatric patients, particularly those under five or with developmental delays, presents significant clinical challenges.
• Traditional perimetry requires subjective patient input, limiting its utility in non-cooperative or pre-verbal children.
• Visual electrophysiological testing provides an objective, non-invasive method to evaluate visual pathway function.

Purpose of the Study:

• To review and summarize electrophysiological findings associated with common visual-field defects in pediatric patients.
• To highlight the utility of electroretinography (ERG) and visual-evoked potentials (VEP) in diagnosing VF defects when perimetry is not feasible.
• To present clinical cases illustrating the application of electrophysiological tests in complex pediatric cases.

Main Methods:

• Systematic review of published literature on electrophysiological findings in pediatric visual-field defects.
• Analysis of electroretinography (ERG) and visual-evoked potentials (VEP) patterns corresponding to specific VF defects.
• Inclusion of clinical case examples to demonstrate diagnostic application.

Main Results:

• Electrophysiological tests like ERG and VEP can objectively characterize the location and nature of visual dysfunction in children.
• Specific patterns of ERG and VEP abnormalities correlate with various VF defects, including generalized, peripheral, central, hemianopic, and altitudinal losses.
• These tests provide valuable functional evidence complementing other diagnostic modalities.

Conclusions:

• Visual electrophysiological testing is a crucial tool for diagnosing and excluding visual-field defects in challenging pediatric populations.
• ERG and VEP recordings offer objective insights into visual pathway integrity from early infancy.
• Integrating electrophysiological data aids in the comprehensive management of pediatric visual impairments.