Objective detection of visual field defects with multifrequency VEPs

Doc Ophthalmol. 2024 Feb;148(1):15-24. doi: 10.1007/s10633-023-09949-4. Epub 2023 Sep 26.

Abstract

Purpose: To correlate multifrequency pattern reversal VEPs in quadrants (QmfrVEPs) with perimetric field losses for objective detection of visual field losses.

Methods: QmfrVEP measurements were performed using four LED-based checkerboard stimulators to stimulate the four quadrants of the visual field. QmfrVEPs were measured monocularly in 5 normal subjects and in 5 glaucoma patients who showed losses in conventional Octopus perimetry. The pattern reversal frequency varied slightly between the stimulators: (11.92, 12.00, 12.08 and 12.16 reversals/sec). The responses to the different stimuli were identified by discrete Fourier analysis. VEPs were recorded using different electrode configurations, and the recording with the highest signal-to-noise ratio (SNR) was used for further analysis.

Results: QmfrVEP responses from the different quadrants can be reliably measured and separated using the 0.08 reversals/sec interstimulus reversal frequency differences. The signal-to-noise ratio in the four quadrants was significantly correlated with the equivalent visual field losses obtained with perimetry (Spearman rank correlation: P < 0.001). In the five glaucoma patients, the SNR was reduced in 15 out of the 16 quadrants with a perimetric defect, in comparison to the results in quadrants of healthy subjects. This confirms the sensitivity of the procedure.

Conclusion: QmfrVEP responses can be measured reliably. This pilot study suggests that high SNR values exclude visual field defects and that focal defects can be identified in glaucoma patients.

Trial registration: www.

Clinicaltrials: gov . NCT00494923.

Keywords: Objective visual field test; Pattern reversal; Quadrant multifrequency VEP; Signal-to-noise ratio; Steady state.

MeSH terms

  • Electroretinography
  • Evoked Potentials, Visual
  • Glaucoma* / diagnosis
  • Humans
  • Pilot Projects
  • Vision Disorders / diagnosis
  • Visual Field Tests* / methods
  • Visual Fields

Associated data

  • ClinicalTrials.gov/NCT00494923