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T.R. Hedges, E.B. Yang, L. Vuong, L. Semela, J.G. Odel, D.C. Hood; Multifocal VEP in Unilateral Compressive Optic Neuropathy . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4764.
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Purpose:To evaluate the effects of unilateral compressive optic neuropathy on the amplitude and latency of multifocal visual evoked potentials (mfVEP). Methods:Automated static perimetry (SAP) and mfVEP recordings were obtained from 6 patients with meningiomas affecting one optic nerve, diagnosed with MRI. Visual acuity ranged from 20/20 to 20/80 in the affected eyes and from 20/15 to 20/60 (5 patients between 20/15 to 20/25) in the unaffected eye. Using VERIS software (EDI), monocular mfVEPs were obtained from each eye using a pattern–reversal dartboard array, 44.5 deg in diameter, and containing 60 sectors. Recording electrodes were placed at the inion (I) and I+4 cm, and at two lateral locations up 1 cm and over 4 cm from I. Monocular and interocular amplitude [1,2] and latency  analyses were performed and compared to a normative group of 100 individuals . Results:All patients showed defects on SAP. The MD (mean deviation) ranged from –6.5 to –20.6 dB. The mfVEP amplitude changes agreed with the visual field results with regard to topography and severity of deviation from normal. Regions in the affected eyes with measurable responses tended to show an increase in latency. For the 6 patients, 40 to 85% (interocular analysis) and 20 to 60% (monocular analysis) of these regions had significant delays in the affected eye. The average delay of the recordable responses from the affected eye ranged from 7.6 to 17.0 ms (interocular analysis) and 7.9 to 13.8 ms (monocular analysis) for the six patients. Conclusions:Compressive optic neuropathy decreases the amplitude and increases the latency of the mfVEP. Even regions of the field with relatively mild visual field loss showed significant delays. The changes in latency were close to those seen in optic neuritis/MS , but considerably larger than those seen in other diseases of the ganglion cell/optic nerve such as ION and glaucoma. The mfVEP offers a way to monitor the post–treatment outcomes in patients with compressive optic neuropathy. 1. Hood et al (2002) AO. 2.Hood and Greenstein (2003) Prog Ret Eye Res. 3. Hood et al (in press) DOOP, 4. Fortune et al (in press) DOOP 5. Hood, Zhang & Odel (2000) IOVS.
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