Document Detail


Repeatability of normal multifocal VEP: implications for detecting progression.
MedLine Citation:
PMID:  16633227     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To assess the repeatability of the multifocal visual evoked potential (mfVEP) and to compare it with the repeatability of standard automated perimetry (SAP) in the same group of 50 normal controls retested after 1 year. Our second aim was to assess the repeatability of false alarm rates determined previously for the mfVEP using various cluster criteria. METHODS: Fifty individuals with normal vision participated in this study (33 females and 17 males). The age range was 26.7 to 77.9 years and the group average age (+/- SD) was 51.4 (+/- 12.1) years. Pattern-reversal mfVEPs were obtained using a dartboard stimulus pattern in VERIS and two 8-minute runs per eye were averaged. The average number of days between the first and second mfVEP tests was 378 (+/- 58). SAP visual fields were obtained within 17.4 (+/- 20.3) days of the mfVEP using the SITA-standard threshold algorithm. Repeatability of mfVEPs and SAP total deviation values were evaluated by calculating point-wise limits of agreement (LOA). Specificity (1-false alarm rate) was evaluated for a range of cluster criteria, whereby the number and probability level of the points defining a cluster were varied. RESULTS: Point-wise LOA for the mfVEP signal-to-noise ratio (SNR) ranged from 2.0 to 4.3 dB, with an average of 2.9 dB across all 60 locations. For SAP, LOA ranged from 2.4 to 8.9 dB, with an average of 4.0 dB (excluding the points immediately above and below the blind spot). Clusters of abnormal points were not likely to repeat on either mfVEP or SAP. When an mfVEP abnormality was defined as the repeat presence (confirmation) of a 3-point (P < 0.05) cluster anywhere within a single hemifield, only 1 (of 200) monocular hemifield was deemed abnormal. Although the LOA of the mfVEP were similar throughout the field, the limited dynamic range of SNR at superior field locations will limit the ability to follow progression in "depth" at those locations. CONCLUSIONS: Repeatability of the mfVEP was slightly better than SAP visual fields in this group of controls with a 1-year retest interval. This suggests that progression in early stages should be more easily detectable by mfVEP. However, in certain field locations (eg, superior periphery), the relatively more narrow dynamic range of the SNR of the mfVEP may limit detection of progression to just 1 event. Confirmation of a 3-point cluster abnormality is highly suggestive of a true defect on the mfVEP.
Authors:
Brad Fortune; Shaban Demirel; Xian Zhang; Donald C Hood; Chris A Johnson
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of glaucoma     Volume:  15     ISSN:  1057-0829     ISO Abbreviation:  J. Glaucoma     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-04-24     Completed Date:  2006-06-05     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  9300903     Medline TA:  J Glaucoma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  131-41     Citation Subset:  IM    
Affiliation:
Discoveries in Sight, Devers Eye Institute, Legacy Health System, Portland, OR 97232, USA. bfortune@discoveriesinsight.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Diagnostic Techniques, Ophthalmological*
Disease Progression
Evoked Potentials, Visual*
False Positive Reactions
Female
Glaucoma / diagnosis*
Humans
Intraocular Pressure
Male
Middle Aged
Predictive Value of Tests
Reproducibility of Results
Sensitivity and Specificity
Vision Disorders / diagnosis
Visual Fields
Grant Support
ID/Acronym/Agency:
R01-EY02115/EY/NEI NIH HHS; R01-EY03424/EY/NEI NIH HHS

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