Is the prolongation latency of visual evoked potentials a pathological sign in children with Down's syndrome without ocular abnormalities? Case-control study of children with Down's syndrome

BMJ Open Ophthalmol. 2023 Mar;8(1):e001074. doi: 10.1136/bmjophth-2022-001074.

Abstract

Objective: To evaluate retino-cortical function in children with Down's syndrome (DS) and no evident ocular abnormalities beyond mild refractive error, by recording visual evoked potentials (VEP) in response to pattern-reversal stimuli and comparing to those of age-matched healthy controls.

Methods and analysis: All the children with DS registered at Split-Dalmatia County who met inclusion criteria of no ocular abnormalities and with refraction error between -0.5 and +2.0 D, and their age-matched healthy controls were included in the study (n=36 children, N=72 eyes, for both groups, respectively, with the same age of 9±2 years). Transient VEP was recorded and the waves with a positive peak as a response to a pattern-reversal stimulus, were analysed. The peak P100 latency, defined as the time from the stimulus onset to the main positive peak, and peak to peak amplitudes were measured.

Results: While P100 wave amplitudes were comparable between two groups (p=0.804), P100 latencies were from 4.3 to 28.5 ms longer in children with DS (p<0.001). Interocular latency difference between a VEP dominant and an inferior eye was pronounced in healthy (1.2 ms (0.2-4.0), but was almost diminished in children with DS (0.3 ms (0.1-0.5), p<0.001).

Conclusion: Our study has demonstrated that VEP response is divergent in children with DS compared with their age-matched healthy controls, indicating possible structural or functional abnormalities of the visual cortex. As VEP results are helpful in the diagnosis and treatment planning of vision-related disorders, we should reconsider the use of common VEP diagnostic criteria in subpopulation of children with DS.

Keywords: Child health (paediatrics); Clinical Trial; Diagnostic tests/Investigation; Electrophysiology.

MeSH terms

  • Case-Control Studies
  • Child
  • Down Syndrome* / diagnosis
  • Evoked Potentials, Visual
  • Humans
  • Neurologic Examination
  • Refractive Errors*
  • Vision Disorders / diagnosis