Comparing isolated-check visual evoked potential, pattern visual evoked potential, and standard automated perimetry in dysthyroid optic neuropathy eyes

Abstract

Objective To determine the diagnostic ability of isolated-check visual evoked potential (icVEP), pattern visual evoked potential (pVEP), and standard automated perimetry (SAP) between dysthyroid optic neuropathy (DON) and thyroid-associated ophthalmopathy (TAO) without DON (non-DON). Methods This is a case-control study, 49 bilateral patients (26 DON and 23 non-DON) were included. icVEP, pVEP, and SAP were conducted in all the subjects, icVEP parameters compared were signal-to-noise ratios (SNRs) under 8, 16, and 32% depth of modulation (DOM). pVEP parameters compared were amplitude and latency. SAP parameters were mean deviation (MD) and pattern standard deviation (PSD). The area under the receiver operating characteristic (ROC) curve (AUC), net reclassification index (NRI), integrated discrimination index (IDI), and decision curve analysis (DCA) were applied for analysis. Results In icVEP, values of SNR in DON were significantly smaller than non-DON (p < 0.05). In pVEP, P100 latent time in DON was significantly larger than non-DON (p = 0.0026). In SAP, value of PSD in DON was larger than non-DON (p = 0.0006), and value of MD in DON was smaller (p = 0.0007). AUC, NRI, and IDI among the three tests were not significantly different. DCA showed that SNR of icVEP under 8% DOM was the farthest from the two extreme curves. Conclusions icVEP, pVEP, and SAP have equal diagnostic capabilities to discern between DON and non-DON. In addition, icVEP may represent a significant ancillary diagnostic approach to DON detection, with more clinical benefit.

Preliminary Diffusion‐Tensor Imaging Evidence for Trans‐Synaptic Axonal Degeneration in Dysthyroid Optic Neuropathy Due to Thyroid‐Associated Ophthalmopathy

“…39 However, pVEP (the delayed P100 latent time and/or reduced P100 amplitude) reflects the absolute value of cortical potentials evoked by patterned stimuli, which are prone to fluctuations and are affected by the interference of external noise. 40 Thus, the DTI parameters, which reflect structural integrity, may be associated with, and even show changes prior to, corresponding functional abnormalities of VEPs.…”

“…Interestingly, the FA and MD of almost all segments of the visual pathway were related to the amplitude and latency of the VEPs, which are signals obtained from electroencephalographic activities 38 that can reflect the functional integrity of the visual pathway 39 . However, pVEP (the delayed P100 latent time and/or reduced P100 amplitude) reflects the absolute value of cortical potentials evoked by patterned stimuli, which are prone to fluctuations and are affected by the interference of external noise 40 . Thus, the DTI parameters, which reflect structural integrity, may be associated with, and even show changes prior to, corresponding functional abnormalities of VEPs.…”

SSFVEP as a potential electrophysiological examination for evaluating visual function of fundus diseases with vitreous hemorrhages: a clinical study

“…Conventional PVEP and FVEP can be used for visual function evaluation, which can reflect the light sensitivity of the entire retinal optic nerve, including coarse incoming fibers from the peripheral retinal area and fine incoming fibers from the macula. The application of PVEP and FVEP in various studies, including optic nerve diseases, has been widely reported 14 , 15 . Furthermore, when accompanied by opacities in the ocular media, the role and significance of FVEP in the diagnosis and evaluation of visual function can be further demonstrated 16 , 17 .…”

Diagnostic Capability of Isolated-Check Visual Evoked Potential for Early to Moderate Primary Open-Angle Glaucoma

“…Recently, isolated-check VEPs (icVEPs), a new visual electrophysiology technology, have been reported to be able to detect glaucomatous visual damage early and quickly [ 7 ]. In recent years, this technique has been applied to detect optic nerve damage of glaucoma [ 8 , 9 , 10 , 11 , 12 , 13 ] and other diseases such as traumatic optic neuropathy [ 14 ] and dysthyroid optic neuropathy [ 15 , 16 ]. The specificity and sensitivity values in detecting glaucomatous optic nerve defects are 84.6–100% and 53.1–83%, respectively [ 7 , 8 , 9 , 10 , 11 ].…”