Related Experiment Video
Updated: Jul 16, 2025
Assessing Early Stage Open-Angle Glaucoma in Patients by Isolated-Check Visual Evoked Potential
Published on: May 25, 2020
Reliability of intraoperative visual evoked potentials (iVEPs) in monitoring visual function during endoscopic
Pier Paolo Mattogno1, Quintino Giorgio D'Alessandris2, Mario Rigante3
1Institute of Neurosurgery, Fondazione Policlinico Gemelli IRCCS, Università Cattolica del Sacro Cuore - Roma, Largo A. Gemelli 8, 00168, Rome, Italy. pierpaolo.mattogno@policlinicogemelli.it.
Objective:
To refine a reliable and reproducible intraoperative visual evoked potentials (iVEPs) monitoring protocol during endoscopic transsphenoidal surgery. To assess the reliability of baseline iVEPs in predicting preoperative visual status and perioperative iVEP variation in predicting postoperative visual outcome.
Methods:
Sixty-four patients harboring tumors of the pituitary region were included. All patients underwent endoscopic endonasal approach (EEA) with iVEPs monitoring, using a totally intravenous anesthetic protocol. Ophthalmological evaluation included visual acuity and visual field studies.
Results:
Preoperatively, visual acuity was reduced in 86% and visual field in 76.5% of cases. Baseline iVEPs amplitude was significantly correlated with preoperative visual acuity and visual field (p = 0.001 and p = 0.0004, respectively), confirming the reliability of the neurophysiological/anesthetic protocol implemented. Importantly, perioperatively the variation in iVEPs amplitude was significantly correlated with the changes in visual acuity (p < 0.0001) and visual field (p = 0.0013). ROC analysis confirmed that iVEPs are an accurate predictor of perioperiative visual acuity improvement, with a 100% positive predictive value in patients with preoperative vision loss.
Conclusions:
iVEPs during EEA is highly reliable in describing preoperative visual function and can accurately predict postoperative vision improvement.
Significance:
iVEPs represent a promising resource for carrying out a more effective and safe endoscopic transsphenoidal surgery.
