ISCEV standard pattern reversal VEP development: paediatric reference limits from 649 healthy subjects.

Area of Science:

• Ophthalmology
• Neuroscience
• Pediatrics

Background:

• Visual evoked potentials (VEPs) are crucial for assessing visual pathway function.
• Standardized protocols, like the ISCEV standard for pattern reversal VEPs (prVEPs), are essential for reliable clinical interpretation.
• Establishing normative data across different age groups and centers is vital for accurate diagnosis.

Purpose of the Study:

• To determine the agreement of prVEPs across three European centers.
• To identify any influence of sex on prVEP measurements.
• To establish reference intervals for prVEPs from birth to adolescence.

Main Methods:

• PrVEPs were recorded from healthy infants and children (2 weeks to 16 years) across three centers.
• Data were analyzed using nonlinear quantile Bayesian regression to model amplitudes and peak times.
• Comparisons were made between centers and sexes, and a 'critical age' for P100 peak time stabilization was determined.

Main Results:

• Data from the three centers showed adequate comparability, with no clinically meaningful sex differences.
• P100 peak time stabilized by 27 and 34 weeks for large and small check sizes, respectively.
• Post-critical-age reference limits for P100 peak time were 87-115 ms (large checks) and 96-131 ms (small checks); amplitude ranges were 5-57 μV and 3.5-56 μV.

Conclusions:

• PrVEP reference data are combinable across centers within ISCEV Standard tolerances, highlighting the standard's clinical utility.
• The established reference data can be validated or adapted for use in other settings.
• Lack of minimum reporting guidelines hinders comparison with historical VEP data.