Spatial tuning loss of pattern reversal visual evoked response in optic nerve disease

We compared the pattern reversal visual evoked response (PVER) amplitude-check size functions from 25 eyes (25 normal subjects; visual acuities > or = 20/20) with those from 32 eyes (22 patients; visual acuities 20/15 to 20/50; mean, 20/25.5) with mild optic nerve disease to determine if spatial tuning loss of the PVER occurs in the presence of optic nerve dysfunction. The steady-state PVER was recorded with five check sizes (range, 160 to 10 minutes of arc). To analyze the PVER amplitude-check size function, we calculated the difference between the maximum and minimum PVER amplitudes and then calculated the area of spatial tuning (the area under the function). Values were significantly smaller in patients than in normal subjects (1.81 +/- 1.27 microV versus 5.73 +/- 3.27 microV; F = 41.24, p = 0.0001; 3.87 +/- 2.70 area units versus 12.57 +/- 7.60 area units; F = 38.62, p = 0.0001). There was no shift in the distribution of peak check sizes. Results suggest that a spatial tuning loss occurs in optic nerve disease. The shape of the function, including the area of spatial tuning, appears to be a sensitive indicator of early or mild optic nerve dysfunction.