BackgroundThe purpose of this study is to validate the use of visual evoked potential (VEP) to objectively quantify visual acuity in normal and amblyopic patients, and determine if it is possible to predict visual acuity in disability assessment to register visual pathway lesions.MethodsA retrospective chart review was conducted of patients diagnosed with normal vision, unilateral amblyopia, optic neuritis, and visual disability who visited the university medical center for registration from March 2007 to October 2009. The study included 20 normal subjects (20 right eyes: 10 females, 10 males, ages 9–42 years), 18 unilateral amblyopic patients (18 amblyopic eyes, ages 19–36 years), 19 optic neuritis patients (19 eyes: ages 9–71 years), and 10 patients with visual disability having visual pathway lesions. Amplitude and latencies were analyzed and correlations with visual acuity (logMAR) were derived from 20 normal and 18 amblyopic subjects. Correlation of VEP amplitude and visual acuity (logMAR) of 19 optic neuritis patients confirmed relationships between visual acuity and amplitude. We calculated the objective visual acuity (logMAR) of 16 eyes from 10 patients to diagnose the presence or absence of visual disability using relations derived from 20 normal and 18 amblyopic eyes.ResultsLinear regression analyses between amplitude of pattern visual evoked potentials and visual acuity (logMAR) of 38 eyes from normal (right eyes) and amblyopic (amblyopic eyes) subjects were significant [y = −0.072x + 1.22, x: VEP amplitude, y: visual acuity (logMAR)]. There were no significant differences between visual acuity prediction values, which substituted amplitude values of 19 eyes with optic neuritis into function. We calculated the objective visual acuity of 16 eyes of 10 patients to diagnose the presence or absence of visual disability using relations of y = −0.072x + 1.22 (−0.072). This resulted in a prediction reference of visual acuity associated with malingering vs. real disability in a range >5.77 μV. The results could be useful, especially in cases of no obvious pale disc with trauma.ConclusionsVisual acuity quantification using absolute value of amplitude in pattern visual evoked potentials was useful in confirming subjective visual acuity for cutoff values >5.77 μV in disability evaluation to discriminate the malingering from real disability.
The number of patients with low vision is increasing as life expectancy increases. In addition, the interest and demand for low vision aids are also increasing with improved socioeconomic status and the development of mass media. Therefore, it is imperative to recognize the importance of low vision aids. We reviewed the clinical records of 118 patients who visited our low vision clinic more than twice. According to the data analyzed, optic nerve atrophy, retinal degeneration, diabetic retinopathy and age-related macular degeneration were the most common causes of low vision in these patients. The best corrected visual acuities without low vision aids were less than 0.3, but with the help of low vision aids, vision improved to more than 0.4 in 87% of the patients for near vision, and 56% for distant vision. The patients had complained that they could not read books, see a blackboard, recognize a person at a distance, and had other problems because of low vision. However, with the use of low vision aids their satisfaction with their vision rose to 70%. Hand magnifiers, high-powered spectacle lenses, and stand magnifiers were the low vision aids commonly used by people for near vision, while the Galilean telescope and Keplerian telescope were the most popular devices used for distant vision. In conclusion, low vision aids are very helpful devices to patients with low vision.
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