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Yianni Yiannakou, Lynnette Hoai Nguyen, Paul Namkoong, Keshav Narain; Normalization of Visual Evoked Potential with Treatment of Selective Trabeculoplasty Laser. Invest. Ophthalmol. Vis. Sci. 2018;59(9):6093. doi: https://doi.org/.
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Visual evoked potentials (VEPs) are used to measure the integrity of the visual pathways from the retina via the optic nerves to the occipital cortex. In clinical practice, the prolongation of high contrast VEP latency allows an objective measure of early glaucomatous progression before subjective visual field loss occurs1. We performed a retrospective, observational clinical analysis to determine if treatment with 360-degree Selective Laser Trabeculoplasty (SLT) can stabilize glaucomatous progression in patients by normalizing optic nerve high contrast latencies, per VEPs.
We analyzed 121 eyes of 80 patients with open-angle-glaucoma (OAG) who received 360-degree SLT treatment following prolonged high contrast latency per VEP, over the course of 3 years. The laser was applied to the patient’s trabecular meshwork (TM) of the affected eye(s) at various power levels of 0.6 -1.2mJ with respect to patient’s TM pigmentation. Patients were reevaluated 6 months status-post SLT with repeat VEP to determine response of high contrast latency in the treated eye(s). South Bay Retina, Inc. Ophthalmology Clinic permitted use of anonymous clinical data.
Of the 121 eyes treated, 62% (75 eyes) experienced a normalization of VEP at least 6 months status-post SLT treatment, while 38% (46 eyes) did not.
VEP is a valuable objective measure for early-diagnosis and prognosis of OAG. We believe that normalization of high contrast VEP latency is an early indicator of optic nerve response to therapy. With SLT treatment, such progression of OAG-induced, early optic nerve dysfunction may be reversible before visual field loss occurs. Future studies may further investigate SLT as an effective replacement therapy in lieu of topical IOP lowering medications with an added benefit of reversing early glaucomatous changes.1 Ruchi Kothari, Pradeep Bokariya, Smita Singh, and Ramji Singh, “Significance of Visual Evoked Potentials in the Assessment of Visual Field Defects in Primary Open-Angle Glaucoma: A Review,” Neuroscience Journal, vol. 2013, Article ID 418320, 6 pages, 2013. doi:10.1155/2013/418320
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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