Multifocal visual evoked potentials for quantifying optic nerve dysfunction in patients with optic disc drusen

Malmqvist, Lasse; Santiago, Luis de; Boquete, Luciano; Hamann, Steffen

doi:10.1111/aos.13347

Cited by 6 publications

(7 citation statements)

References 27 publications

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“…They reported significant reductions of mean overall amplitude (p < 0.001), inner ring amplitude (p < 0.001) and outer ring amplitude (p < 0.001) in ODD patients (n = 33) compared to controls (n = 22). A more robust correlation was seen for the outer ring measures, presumably due to less variability in these segments (Malmqvist et al 2017b). In this study, there was also a significant correlation between mfVEP amplitude, visual field MD (determined by automated perimetry) and OCT-measured RNFL thickness in ODD eyes.…”

Section: Electrophysiologysupporting

confidence: 56%

“…In contrast, multifocal VEP (mfVEP) testing allows simultaneous recording of local responses from many regions of the visual field with high spatial resolution, thus overcoming many of the limitations encountered with prior full-field VEP studies (Malmqvist et al 2016a). Given the prelaminar location of ODD, demyelination is a mechanism that does not likely account for the pathophysiology of this condition (Malmqvist et al 2017b). For this reason, mfVEP-measured latency delay may not be the best means of capturing deleterious effects of ODD.…”

Section: Electrophysiologymentioning

confidence: 99%

“…Given the prelaminar location of ODD, demyelination is a mechanism that does not likely account for the pathophysiology of this condition (Malmqvist et al 2017b). A more robust correlation was seen for the outer ring measures, presumably due to less variability in these segments (Malmqvist et al 2017b). Instead, Malmqvist and colleagues used mfVEP to measure amplitudes in ODD patients, with the rationale being that mechanical compression of the axons was the basis of optic nerve dysfunction.…”

Section: Electrophysiologymentioning

confidence: 99%

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Optic disc drusen: understanding an old problem from a new perspective

Hamann

Malmqvist

Costello

2018

Acta Ophthalmologica

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101

106

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Optic disc drusen (ODD) are acellular deposits located in the optic nerve head of up to 2.4% of the population. They may develop as by-products of impaired axonal metabolism in genetically predisposed individuals, in whom a narrow scleral canal is hypothesized to play a role. Although ODD are often considered as benign innocent bystanders, recognized as part of a routine ophthalmological examination, the vast majority of patients with ODD have visual field defects. Optic disc drusen (ODD)-associated complications with severe visual loss, most often due to anterior ischaemic optic neuropathy, are also known to occur. There are no treatments available to prevent or ameliorate the vision loss caused by ODD. In children, the ODD are usually uncalcified and buried within the optic nerve head tissue. In these cases, the condition can be difficult to diagnose, as it often resembles a papilloedema with optic nerve head swelling caused by raised intracranial pressure. During the teenage years, the ODD progressively become more calcified and probably also larger, which allow them to be visible on ophthalmoscopy. With the advent and proper utilization of high-resolution modalities of optical coherence tomography (OCT), it has now become possible to detect even the smallest and most deeply located ODD. This allows for ODD detection at a much earlier developmental stage than has previously been possible and enhances the possibilities of research in underlying mechanisms. A review of the literature on ODD was conducted using the PUBMED database. The review focuses on the current knowledge regarding pathogenesis, diagnostics, clinical disease-tracking methodologies, structure-function relationships and treatment strategies of ODD.

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Section: Electrophysiologysupporting

confidence: 56%

Section: Electrophysiologymentioning

confidence: 99%

Section: Electrophysiologymentioning

confidence: 99%

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Optic disc drusen: understanding an old problem from a new perspective

Hamann

Malmqvist

Costello

2018

Acta Ophthalmologica

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101

106

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“…In this study, we included mfVEP amplitude and latency as an objective measure of optic nerve function as previous studies have found significantly decreased amplitude and latency delays in patients with optic disc drusen when compared to control subjects. 37,38 Hence an association between ODD volume and mfVEP parameters was expected. Parameters of mfVEP were significantly correlated with RNFL and GCL thickness, but not with ODD volume.…”

Section: Discussionmentioning

confidence: 95%

Quantitatively Measured Anatomic Location and Volume of Optic Disc Drusen: An Enhanced Depth Imaging Optical Coherence Tomography Study

Malmqvist

Lindberg

Dahl

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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“…Clustering of mfVEP responses in various eccentric rings makes it possible to identify patients with multiple sclerosis (MS) [12,13]. Analysis of mfVEP responses in the inner (0.87°-5.67°) and outer rings (5.68°-24°) is proposed as a method for assessing optic nerve dysfunction in patients with optic disc drusen [14]. The best results achieved in implementing computer-aided diagnosis of multiple sclerosis are obtained by analysing the characteristics of the mfVEP responses when clustered by ring [15].…”

Section: Introductionmentioning

confidence: 99%

Identification of clusters in multifocal electrophysiology recordings to maximize discriminant capacity (patients vs. control subjects)

et al. 2019

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Purpose To propose a new method of identifying clusters in multifocal electrophysiology (multifocal electroretinogram: mfERG; multifocal visual-evoked potential: mfVEP) that conserve the maximum capacity to discriminate between patients and control subjects. Methods The theoretical framework proposed creates arbitrary N-size clusters of sectors. The capacity to discriminate between patients and control subjects is assessed by analysing the area under the receiver operator characteristic curve (AUC). As proof of concept, the method is validated using mfERG recordings taken from both eyes of control subjects (n = 6) and from patients with multiple sclerosis (n = 15). ResultsConsidering the amplitude of wave P1 as the analysis parameter, the maximum value of AUC = 0.7042 is obtained with N = 9 sectors. Taking into account the AUC of the amplitudes and latencies of waves N1 and P1, the maximum value of the AUC = 0.6917 with N = 8 clustered sectors. The greatest discriminant capacity is obtained by analysing the latency of wave P1: AUC = 0.8854 with a cluster of N = 12 sectors. Conclusion This paper demonstrates the effectiveness of a method able to determine the arbitrary clustering of multifocal responses that possesses the greatest capacity to discriminate between control subjects and patients when applied to the visual field of mfERG or mfVEP recordings. The method may prove helpful in diagnosing any disease that is

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Multifocal visual evoked potentials for quantifying optic nerve dysfunction in patients with optic disc drusen

Abstract: Decreased mfVEP amplitude in patients with ODD suggests a direct mechanical compression of the optic nerve axons. Our results suggest that mfVEP amplitude is applicable for the assessment of optic nerve dysfunction in patients with ODD.

Cited by 6 publications

References 27 publications

Optic disc drusen: understanding an old problem from a new perspective

Optic disc drusen: understanding an old problem from a new perspective

Quantitatively Measured Anatomic Location and Volume of Optic Disc Drusen: An Enhanced Depth Imaging Optical Coherence Tomography Study

Identification of clusters in multifocal electrophysiology recordings to maximize discriminant capacity (patients vs. control subjects)

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