Can a Portable Flash Visual Evoked Potential (VEP) Device Identify Chiasmal Decussation Anomalies in Albinism?

Background: Visual evoked potentials (VEPs) are used to detect chiasmal misrouting associated with albinism. However, VEPs are only performed in specialist centres and typically have long waiting lists. The portable electrophysiology device RETeval^® shows promise as a clinical screening tool across a range of ophthalmic conditions. Here, we explore its utility in detecting chiasmal abnormalities associated with albinism. Methods: Flash VEPs were recorded on the RETeval^® and by standard ISCEV techniques for 27 patients with suspected albinism and 40 control patients as part of routine appointments. We retrospectively investigated the agreeability between the two methods. The amplitude/latency of the main component was measured for standard VEPs whilst a correlation value of interhemispheric difference was calculated for the RETeval^® data. Results: We demonstrate a significant difference between albinism patients and controls (p < 0.001) with respect to the interhemispheric difference identified by the RETeval^®. By applying a threshold of 0.001865 to the correlation value, the RETeval^® detected chiasmal misrouting in all 27 patients with albinism and had 97% agreeability to standard testing. Conclusions: This study shows the potential of using the RETeval^® as a clinical tool for the diagnosis of chiasmal anomalies in albinism. The RETeval^® has significant time/cost savings which could hasten diagnoses.