Correlation of the Multifocal Visual Evoked Potential and Standard Automated Perimetry in Compressive Optic Neuropathies

Helen V. Danesh-Meyer, Stuart C. Carroll, Brent J. Gaskin, Angela Gao, Greg D. Gamble
2006 Investigative Ophthalmology and Visual Science  
PURPOSE. To evaluate the relationship between abnormalities detected by the multifocal visual-evoked potential (mfVEP) compared with those detected by static achromatic automated perimetry in patients with compressive optic neuropathy. METHODS. Fifteen patients of mean age 50.8 years, with known compressive optic neuropathy from chiasmal lesions, underwent monocular mfVEP and 24-2 SITA-standard Humphrey visual field (HVF; Carl Zeiss Meditec, Dublin CA) testing in each eye. Visual field spatial
more » ... greement and extent of involvement were analyzed by assigning a severity score to each quadrant, based on pattern deviation and amplitude deviation probability plots. RESULTS. HVF mean deviation (MD) was Ϫ6.54 Ϯ 7.43 dB (mean), and the mfVEP mean AccuMap Severity Index (ASI; ObjectiVision Pty. Ltd., Sydney, Australia) score was 81 Ϯ 74. MD and ASI correlated significantly (r ϭ Ϫ0.55, P ϭ 0.024). Although both mfVEP and HVF reported approximately the same proportion of visual fields as abnormal (70%, 21/30, and 87%, 26/30, respectively), 19% (5/26) with abnormal HVF were labeled normal or borderline by mfVEP. The agreement for field quadrants between instruments was 69% ( ϭ 0.33). mfVEP severity scores for quadrants and hemifields were higher than scores for HVF in the same eyes. The superotemporal quadrant showed the strongest correlation between techniques (r ϭ 0.73, P ϭ 0.002). CONCLUSIONS. In the first study to compare mfVEP to HVF in patients with compressive optic neuropathy, there was good qualitative and quantitative agreement between tests, though findings were in only modest agreement in some areas. The injury caused by compressive optic neuropathy may be usefully identified by mfVEP. Improved methods of analysis may increase the diagnostic utility of the method. (Invest Ophthalmol Vis Sci. Consecutive patients with pituitary tumors causing chiasmal compression were identified and recruited
doi:10.1167/iovs.05-1146 pmid:16565379 fatcat:bp3royjlfzg7zij4g5ptfv76yq