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Klaus Rohrschneider; Usefulness of flash-VEP in childhood visual impairment. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4674.
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The management of visually impaired infants is difficult, especially concerning visual function and prognosis. We therefore retrospectively evaluated the results and the prognostic value of flash visual evoked potentials (VEP) in children with severe visual impairment or blindness.
105 infants with severe visual impairment or functional blindness were examined and mostly followed for further development. VEP recording was performed unilaterally and bilaterally using the standard ISVEC recommended electrode set-up with the medetec LED goggles and a medetec synergy system. We correlated VEP results with visual function and further visual outcome.
In 15 of 45 patients with normal VEP only pupillary light reaction was detected, however 7 were less than 1 year of age. In contrast only 4 out of 55 children with missing VEP had reliable visual function, two of them measureable visual acuity. During follow-up extinguished VEP changed to normal examinations when visual function markedly improved in 8 patients. During follow-up, kids with initially maintained VEP mostly showed positive visual development.
Although flash-VEP has only limited value in differentiation of severe visual impairment and blindness, it may be useful for counseling those patients concerning further visual prognosis. For confirmation of blindness with the VEP it is necessary to have more than one exam with absent VEP because developmental changes may lead to normal results. Due to missing maturation of the optic nerve examination during the first year of life may be of limited value. However, abnormal VEP does not necessarily demonstrate poor prognosis, even in the first years of life.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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