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Sherry L. Fawcett, Eileen E. Birch; Motion VEPs, Stereopsis, and Bifoveal Fusion in Children with Strabismus. Invest. Ophthalmol. Vis. Sci. 2000;41(2):411-416.
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purpose. The link between nasal-temporal motion asymmetries and anomalous
binocular sensory function in infantile esotropia (ET) has led to the
idea that visual evoked potential responses to horizontal motion (mVEP)
is an alternative measure of sensory binocularity to stereopsis. A
second hypothesis is that the mVEP response is a marker for bifoveal
fusion. The purpose of this study was to directly evaluate these two
hypotheses by examining the correspondence between the mVEP response
and both stereoacuity and bifoveal fusion in a cohort of strabismic
patients with variable binocular sensory function.
methods. Motion VEPs, random dot stereopsis, and bifoveal fusion were measured
in 94 children: 20 with infantile ET, 16 with infantile accommodative
ET, 22 with late-onset accommodative ET, 10 with intermittent infantile
strabismus, and 26 normal control participants.
results. Patients with infantile ET and infantile accommodative ET had high
concordance between mVEP responses and stereoacuity and mVEP responses
and bifoveal fusion. Asymmetric mVEP responses were highly concordant
with both no measurable stereopsis and an absence of fusional vergence.
Patients with late-onset accommodative ET and intermittent infantile
strabismus revealed discordance between the mVEP response and
stereoacuity and high concordance between the mVEP response and
bifoveal fusion. Asymmetric mVEP responses were highly concordant with
the absence of bifoveal fusion and the minimum-size prism to elicit
conclusions. The qualitative and quantitative relationship between the mVEP response
and fusional vergence suggests that the mVEP response is an objective
measure of bifoveal fusion. The availability of such a test will
facilitate studies of normal development of bifoveal fusion and
development of monofixation syndrome in
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