June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Clinical Utility of Short Duration Transient Visual Evoked Potential (SD-tVEP) Pathologic Indicators in Chronic Glaucoma
Author Affiliations & Notes
  • William Eric Sponsel
    Biomedical Engineering, University of Texas San Antonio, San Antonio, TX
    Visual Science, University of Incarnate Word, San Antonio, TX
  • Carolyn Majcher
    Visual Science, University of Incarnate Word, San Antonio, TX
  • Sylvia Linner Groth
    Ophthalmology, University of North Carolina, Chapel Hill, NC
  • Rick Trevino
    Visual Science, University of Incarnate Word, San Antonio, TX
  • Footnotes
    Commercial Relationships William Sponsel, Diopsys (R); Carolyn Majcher, None; Sylvia Groth, None; Rick Trevino, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 1033. doi:
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      William Eric Sponsel, Carolyn Majcher, Sylvia Linner Groth, Rick Trevino; Clinical Utility of Short Duration Transient Visual Evoked Potential (SD-tVEP) Pathologic Indicators in Chronic Glaucoma. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1033.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To assess rates of abnormal SD-tVEP amplitude and latency findings in adults with chronic glaucoma using the Diopsys Nova-LX P100/N75-referenced high (Hc) and low (Lc) contrast stimuli.

 
Methods
 

Clinical records of adults with chronic glaucoma undergoing SD-tVEP evaluation with the Diopsys Nova system between Aug 2013 and Apr 2014 were reviewed. In addition to demographic information, the amplitude and latency of the SD-tVEP under both Lc and Hc stimuli conditions were collected, as was whether the VEP findings were interpreted by the device as being normal or abnormal. The mean defect (MD) of the most recent Humphrey 30-2 visual field was used to stage the severity of the glaucoma as being mild (MD > -6dB), moderate (-6dB ≥ MD > -12dB) or severe (MD ≤ -12dB).

 
Results
 

Complete data were available for 98 glaucomatous eyes of 85 patients (49 eyes mild, 16 moderate, 33 severe). The mean age was 68.2±1.3 yrs. Mean amplitudes were reported as normal in >85% of eyes. The Lc rate of amplitude abnormality was mild: 8.6%; moderate: 5.0%; severe: 7.9% (R2 = 0.008, P = 0.94). The Hc amplitude abnormality rate was mild: 5.7%; moderate: 0.0%; severe: 21.1% (R2 = 0.584, P = 0.45). Lc and Hc latency abnormality rates both showed strong associations with perimetric staging, but Hc latency deficits were far more common (P = 0.02). The Lc rate of latency abnormality was mild: 12.2%; moderate: 18.8%; severe: 33.3% (R2 = 0.991, P = 0.06). The Hc latency abnormality rate was mild: 18.4%; moderate: 31.3%; severe: 57.6% (R2 = 0.994, P = 0.05).

 
Conclusions
 

Using the Diopsys NOVA-LX integrated analysis software, rates of significant SD-tVEP latency abnormality increased with glaucoma severity, with Hc deficits being significantly more common than Lc defects. This Hc>Lc latency defect preponderance arose at all stages, afflicting a majority of eyes with severe glaucoma. SD-tVEP latency thus appears to have far greater clinical relevance to glaucoma than amplitude, for which there was no observed relationship with disease severity.  

 
Association of proportion of glaucomatous eyes demonstrating high contrast SD-tVEP latency deficit in relation to the Humphrey 30-2 mean deviation visual field pathologic category (mild <6dB, moderate 6-12 dB, and severe >12dB).
 
Association of proportion of glaucomatous eyes demonstrating high contrast SD-tVEP latency deficit in relation to the Humphrey 30-2 mean deviation visual field pathologic category (mild <6dB, moderate 6-12 dB, and severe >12dB).

 
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