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.

Object. The sella turcica usually appears partially empty in MR images obtained from patients with chronic elevation of intracranial pressure. The authors measured the size of the sella turcica to determine if enlargement of the pituitary fossa explains the partially empty sella associated with pseudotumor cerebri. Methods. The medical records from 2005 to 2011 of a single neuro-ophthalmologist were searched to identify consecutive patients with pseudotumor cerebri. Age-matched control patients were selected from the same practice. The sella turcica and pituitary gland were measured on sagittal T1-weighted MR images. Results. Measurements were obtained for 48 patients with pseudotumor cerebri and 48 controls. The cross-sectional area of the sella was 38% greater in the patients with pseudotumor cerebri, with only a slight reduction in mean pituitary gland size. Conclusions. Chronic elevation of intracranial pressure is associated with bony enlargement of the sella turcica. Enlargement of the sella turcica contributes to its partially empty appearance.

<h4>PURPOSE</h4> <p>To investigate the factors influencing visual development in blepharophimosis-ptosis-epicanthus inversus syndrome.</p> <h4>MATERIALS AND METHODS</h4> <p>The study population comprised 20 patients with blepharophimosis-ptosis-epicanthus inversus syndrome who were referred for an oculoplastic opinion. The ocular examination included measurement of Snellen visual acuity, cycloplegic refraction, ocular movements and alignment, and the presence of amblyopia. Patients were treated with spectacle correction, occlusion therapy, strabismus surgery, and oculoplastic surgery if necessary. Minimum follow-up was 2 years.</p> <h4>RESULTS</h4> <p>Nine (45%) patients had amblyopia; 5 (25%) of these patients had unilateral amblyopia and 4 (20%) had bilateral amblyopia. Six (67%) patients with amblyopia had a significant coexisting strabismus. A significant strabismus was present in 11 (55%) patients; 6 (55%) of these patients had unilateral or bilateral amblyopia. Patients with strabismus were more likely to have amblyopia than those without. A total of 14 (70%) patients had refractive error; 6 (43%) of these patients had amblyopia.</p> <h4>CONCLUSIONS</h4> <p>Patients with blepharophimosis-ptosis-epicanthus inversus syndrome had a high rate of amblyopia, especially bilateral amblyopia. Patients with strabismus were more likely to have amblyopia than those without. Patients also had a high incidence of refractive errors.</p> <p><cite>J Pediatr Ophthalmol Strabismus</cite> 2006;43:285-288.</p> <h4>AUTHORS</h4> <p>The authors are from the Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.</p> <p>Originally submitted December 9, 2004.</p> <p>Accepted for publication July 6, 2005.</p> <p>Address reprint requests to Sei Yeul Oh, MD, Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul 135-710, Korea.</p>

BackgroundTo evaluate the effect of occlusion treatment for anisometropic amblyopia using multifocal visual evoked potentials (mfVEPs).MethodsThe patients for this study comprised 19 patients (mean age 6.05 ± 1.65 years) with anisometropic amblyopia underwent mfVEP analysis using the RETIscan® system before and after occlusion treatment. After dividing the area into six ring areas and four quadrants, we analyzed the amplitudes and latencies of the mfVEPs.ResultsThe amplitudes of ring 1 (central field) in amblyopic eyes after treatment were significantly higher than those in the other rings (p = 0.001). The mfVEP amplitudes in each of the six rings between amblyopic eyes and fellow eyes at diagnosis and after occlusion treatment showed no significant differences. In quadrant 1 the amplitudes of the amblyopic eyes and fellow eyes were significantly different at the time of diagnosis (p = 0.005), whereas after occlusion treatment there was no significant difference (p = 0.888). The amplitudes for each of the six rings at diagnosis and after occlusion treatment in amblyopic eyes versus fellow eyes showed no significant difference. There were also no differences in the amplitudes in each of the four quadrants at the time of diagnosis and after occlusion treatment in amblyopic eyes versus fellow eyes. No significant difference was found in the comparison of latency values in each of the six rings or in each of the four quadrants at diagnosis and after occlusion treatment in amblyopic eyes versus their fellow eyes.ConclusionsThe amplitudes of quadrant 1 in amblyopic eyes compared with those of the fellow eyes at diagnosis were increased after occlusion treatment. Changes of the difference between amblyopic eyes and fellow eyes in quadrant 1 after occlusion treatment could be a useful, objective method for monitoring improvement in visual acuity.Electronic supplementary materialThe online version of this article (10.1186/s12886-018-0877-0) contains supplementary material, which is available to authorized users.

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