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Dichoptic stimulation improves detection of glaucoma with multifocal visual evoked potentials.
Invest Ophthalmol Vis Sci. 2007 Oct; 48(10):4590-6.IO

Abstract

PURPOSE

To determine whether simultaneous binocular (dichoptic) stimulation for multifocal visual evoked potentials (mfVEP) detects glaucomatous defects and decreases intereye variability.

METHODS

Twenty-eight patients with glaucoma and 30 healthy subjects underwent mfVEP on monocular and dichoptic stimulation. Dichoptic stimulation was presented with the use of virtual reality goggles (recording time, 7 minutes). Monocular mfVEPs were recorded sequentially for each eye (recording time, 10 minutes).

RESULTS

Comparison of mean relative asymmetry coefficient (RAC; calculated as difference in amplitudes between eyes/sum of amplitudes of both eyes at each segment) on monocular and dichoptic mfVEP revealed significantly lower RAC on dichoptic (0.003 +/- 0.03) compared with monocular testing (-0.02 +/- 0.04; P = 0.002). In all 28 patients, dichoptic mfVEP identified defects with excellent topographic correspondence. Of 56 hemifields (28 eyes), 33 had Humphrey visual field (HFA) scotomas, all of which were detected by dichoptic mfVEP. Among 23 hemifields with normal HFA, two were abnormal on monocular and dichoptic mfVEP. Five hemifields (five patients) normal on HFA and monocular mfVEP were abnormal on dichoptic mfVEP. In all five patients, corresponding rim changes were observed on disc photographs. Mean RAC of glaucomatous eyes was significantly higher on dichoptic (0.283 +/- 0.18) compared with monocular (0.199 +/- 0.12) tests (P = 0.0006).

CONCLUSIONS

Dichoptic mfVEP not only detects HFA losses, it may identify early defects in areas unaffected on HFA and monocular mfVEP while reducing testing time by 30%. Asymmetry was tighter among healthy subjects but wider in patients with glaucoma on simultaneous binocular stimulation, which is potentially a new tool in the early detection of glaucoma.

Authors+Show Affiliations

Save Sight Institute, University of Sydney, Sydney, Australia. hemamalini_arvind@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17898282

Citation

Arvind, Hemamalini, et al. "Dichoptic Stimulation Improves Detection of Glaucoma With Multifocal Visual Evoked Potentials." Investigative Ophthalmology & Visual Science, vol. 48, no. 10, 2007, pp. 4590-6.
Arvind H, Klistorner A, Graham S, et al. Dichoptic stimulation improves detection of glaucoma with multifocal visual evoked potentials. Invest Ophthalmol Vis Sci. 2007;48(10):4590-6.
Arvind, H., Klistorner, A., Graham, S., Grigg, J., Goldberg, I., Klistorner, A., & Billson, F. A. (2007). Dichoptic stimulation improves detection of glaucoma with multifocal visual evoked potentials. Investigative Ophthalmology & Visual Science, 48(10), 4590-6.
Arvind H, et al. Dichoptic Stimulation Improves Detection of Glaucoma With Multifocal Visual Evoked Potentials. Invest Ophthalmol Vis Sci. 2007;48(10):4590-6. PubMed PMID: 17898282.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dichoptic stimulation improves detection of glaucoma with multifocal visual evoked potentials. AU - Arvind,Hemamalini, AU - Klistorner,Alexander, AU - Graham,Stuart, AU - Grigg,John, AU - Goldberg,Ivan, AU - Klistorner,Asya, AU - Billson,Frank A, PY - 2007/9/28/pubmed PY - 2007/11/2/medline PY - 2007/9/28/entrez SP - 4590 EP - 6 JF - Investigative ophthalmology & visual science JO - Invest Ophthalmol Vis Sci VL - 48 IS - 10 N2 - PURPOSE: To determine whether simultaneous binocular (dichoptic) stimulation for multifocal visual evoked potentials (mfVEP) detects glaucomatous defects and decreases intereye variability. METHODS: Twenty-eight patients with glaucoma and 30 healthy subjects underwent mfVEP on monocular and dichoptic stimulation. Dichoptic stimulation was presented with the use of virtual reality goggles (recording time, 7 minutes). Monocular mfVEPs were recorded sequentially for each eye (recording time, 10 minutes). RESULTS: Comparison of mean relative asymmetry coefficient (RAC; calculated as difference in amplitudes between eyes/sum of amplitudes of both eyes at each segment) on monocular and dichoptic mfVEP revealed significantly lower RAC on dichoptic (0.003 +/- 0.03) compared with monocular testing (-0.02 +/- 0.04; P = 0.002). In all 28 patients, dichoptic mfVEP identified defects with excellent topographic correspondence. Of 56 hemifields (28 eyes), 33 had Humphrey visual field (HFA) scotomas, all of which were detected by dichoptic mfVEP. Among 23 hemifields with normal HFA, two were abnormal on monocular and dichoptic mfVEP. Five hemifields (five patients) normal on HFA and monocular mfVEP were abnormal on dichoptic mfVEP. In all five patients, corresponding rim changes were observed on disc photographs. Mean RAC of glaucomatous eyes was significantly higher on dichoptic (0.283 +/- 0.18) compared with monocular (0.199 +/- 0.12) tests (P = 0.0006). CONCLUSIONS: Dichoptic mfVEP not only detects HFA losses, it may identify early defects in areas unaffected on HFA and monocular mfVEP while reducing testing time by 30%. Asymmetry was tighter among healthy subjects but wider in patients with glaucoma on simultaneous binocular stimulation, which is potentially a new tool in the early detection of glaucoma. SN - 0146-0404 UR - https://www.unboundmedicine.com/medline/citation/17898282/Dichoptic_stimulation_improves_detection_of_glaucoma_with_multifocal_visual_evoked_potentials_ L2 - https://iovs.arvojournals.org/article.aspx?doi=10.1167/iovs.07-0318 DB - PRIME DP - Unbound Medicine ER -