J Korean Ophthalmol Soc.  2010 Apr;51(4):532-541. 10.3341/jkos.2010.51.4.532.

Multifocal Visual Evoked Potential in Normal Subjects

• Kim HD
• Park SH
• Ohn YH

• KMID: 2213396
• DOI: http://doi.org/10.3341/jkos.2010.51.4.532

Abstract

PURPOSE
To introduce the clinical utility of multifocal visual evoked potential (mfVEP) and to assess the waveform from normal Korean subjects.
METHODS
mfVEP with 4 channel recording was performed using the RETIscan(R) system (Roland Consult, Wiesbaden, Germany) for 25 eyes of 25 normal subjects. Amplitudes and implicit times were obtained from ring-shaped 6 areas and 4 sectors. To investigate the false-positive ratio of the examination, stimuli were given with one-half of the CRT monitor completely covered and the results were compared.
RESULTS
Amplitudes of P1, N2 were larger in the central 10degrees area than other areas (p<0.001). Amplitudes were reduced and implicit times were prolonged on peripheral areas. P1 amplitudes were larger in the inferior field. Waves with large amplitudes by noise were recorded in 13.7% of covered areas.
CONCLUSIONS
mfVEP is useful tool to detect local optic nerve damage and rule out the non-organic cause of visual field defect. However, mfVEP results are difficult to interpret due to noise and poor patient cooperation. Standardization of mfVEP is necessary for its application.

Keyword

Amplitude; Area; Multifocal visual evoked potential; Implicit time; Sector

MeSH Terms

Evoked Potentials, Visual
Eye
Noise
Optic Nerve
Organothiophosphorus Compounds
Patient Compliance
Visual Fields
Organothiophosphorus Compounds

Figure

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  Figure 1. The schematic representation of multifocal visual evoked potential (mfVEP) stimulus.

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  Figure 2. The position of the four electrodes and the configuration of the four channel recording of mfVEP.

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  Figure 3. Schematic diagram of 6 areas (A) and 4 sectors (B) on visual field of mfVEP.

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  Figure 4. To investigate the false-positive ratio of the examination, stimuli were given with covering one-half of the CRT monitor completely to stimulate the temporal retina of the right eye.

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  Figure 5. P1 (A) and N2 (B) amplitudes and P1 (C) and N2 (D) implicit times from mfVEP on 6 areas of visual field. P1 and N2 amplitudes on area 1 and 2 (*) were significantly higher than on the other areas (p<0.001, p<0.001). Implicit times of P1 and N2 showed no significant differences among areas (p=0.217, p=0.101).

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  Figure 6. P1 (A) and N2 (B) amplitudes and P1 (C) and N2 (D) implicit times from mfVEP on 4 sectors of visual field. P1 amplitudes on the inferior field (*) were significantly higher than on the other sectors (p=0.007). But, other parameters showed no significant differences among sectors.

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  Figure 7. The best VEP responses and 3-D plots of mfVEP without covering (A) and with covering on one-half of the CRT monitor (B). The amplitudes on no stimulation area were significantly smaller than on stimulation area (p<0.001). But, waves with large amplitudes were recorded on covered area in spite of no stimulation (five red hexagons).

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  Figure 8. Characteristics of results of multifocal VEP from normal subject. Signals with larger amplitudes were showed in central 15˚ field. Inferior field showed larger amplitudes compared to superior field. Signals out of 30˚ had relatively low amplitudes.

Reference

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