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Kim, Park, and Ohn: Multifocal Visual Evoked Potential in Normal Subjects
Original Article

J Korean Ophthalmol Soc 2010;51(4):532-541.

Published online: 25 September 2010

DOI: https://doi.org/10.3341/jkos.2010.51.4.532

Multifocal Visual Evoked Potential in Normal Subjects

Hoon Dong Kim, MD1, Sang Hyouk Park, MD2, Young-Hoon Ohn, MD1,

1Department of Ophthalmology, Soonchunhyang University College of Medicine, Bucheon, Korea

2Department of Ophthalmology, Soonchunhyang University College of Medicine, Gumi, Korea

Address reprint requests to Young-Hoon Ohn, MD Department of Ophthalmology, Soonchunhyang University College of Medicine #1174 Jung-dong, Wonmi-gu, Bucheon 420-767, Korea Tel: 82-32-621-5425, Fax: 82-32-321-5435, E-mail: yhohn@schbc.ac.kr

Received 15 May 2009       Accepted 15 December 2009

Copyright © 2010 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To introduce the clinical utility of multifocal visual evoked potential (mfVEP) and to assess the waveform from normal Korean subjects.

Methods

mfVEP with 4 channel recording was performed using the RETIscan® system (Roland Consult, Wiesbaden, Germany) for 25 eyes of 25 normal subjects. Amplitudes and implicit times were obtained from ring-shaped 6 areas and 4 sectors. To investigate the false-positive ratio of the examination, stimuli were given with one-half of the CRT monitor completely covered and the results were compared.

Results

Amplitudes of P1, N2 were larger in the central 10°area than other areas (p＜0.001). Amplitudes were reduced and implicit times were prolonged on peripheral areas. P1 amplitudes were larger in the inferior field. Waves with large amplitudes by noise were recorded in 13.7% of covered areas.

Conclusions

mfVEP is useful tool to detect local optic nerve damage and rule out the non-organic cause of visual field defect. However, mfVEP results are difficult to interpret due to noise and poor patient cooperation. Standardization of mfVEP is necessary for its application.

Keywords: Amplitude, Area, Multifocal visual evoked potential, Implicit time, Sector

References

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Figure 1.
The schematic representation of multifocal visual evoked potential (mfVEP) stimulus.
jkos-51-532f1.tif
Figure 2.
The position of the four electrodes and the configuration of the four channel recording of mfVEP.
jkos-51-532f2.tif
Figure 3.
Schematic diagram of 6 areas (A) and 4 sectors (B) on visual field of mfVEP.
jkos-51-532f3.tif
Figure 4.
To investigate the false-positive ratio of the examination, stimuli were given with covering one-half of the CRT monitor completely to stimulate the temporal retina of the right eye.
jkos-51-532f4.tif
Figure 5.
P1 (A) and N2 (B) amplitudes and P1 (C) and N2 (D) implicit times from mfVEP on 6 areas of visual field. P1 and N2 amplitudes on area 1 and 2 (*) were significantly higher than on the other areas (p<0.001, p<0.001). Implicit times of P1 and N2 showed no significant differences among areas (p=0.217, p=0.101).
jkos-51-532f5.tif
Figure 6.
P1 (A) and N2 (B) amplitudes and P1 (C) and N2 (D) implicit times from mfVEP on 4 sectors of visual field. P1 amplitudes on the inferior field (*) were significantly higher than on the other sectors (p=0.007). But, other parameters showed no significant differences among sectors.
jkos-51-532f6.tif
Figure 7.
The best VEP responses and 3-D plots of mfVEP without covering (A) and with covering on one-half of the CRT monitor (B). The amplitudes on no stimulation area were significantly smaller than on stimulation area (p<0.001). But, waves with large amplitudes were recorded on covered area in spite of no stimulation (five red hexagons).
jkos-51-532f7.tif
Figure 8.
Characteristics of results of multifocal VEP from normal subject. Signals with larger amplitudes were showed in central 15˚ field. Inferior field showed larger amplitudes compared to superior field. Signals out of 30˚ had relatively low amplitudes.
jkos-51-532f8.tif
Table 1.
Mean amplitudes (μV) and implicit times (ms)of P1 and N2 of mfVEP on 6 areas
  Area 1 Area 2 Area 3 Area 4 Area 5 Area 6 p-value*
P1 amplitude 0.400±0.362 0.347±0.304 0.171±0.194 0.170±0.196 0.127±0.140 0.094±0.103 <0.001
N2 amplitude 0.565±0.614 0.471±0.519 0.242±0.322 0.233±0.253 0.150±0.178 0.141±0.159 <0.001
P1 implicit time 93.88±11.98 94.64±13.37 93.74±14.96 92.56±16.14 93.92±15.50 92.94±17.91 0.217
N2 implicit time 120.21±17.49 123.77±19.43 120.22±23.51 124.56±23.19 124.45±24.08 120.47±23.49 0.101

* tested by one-way ANOVA.

Table 2.
Mean amplitudes (μV) and implicit times (ms) of P1 and N2 of mfVEP on 4 sectors
  Inferotemporal Superotemporal Superonasal Inferonasal p-value*
P1 amplitude 0.200±0.215 0.169±0.193 0.160±0.207 0.226±0.241 <0.001
N2 amplitude 0.267±0.388 0.212±0.273 0.279±0.273 0.271±0.262 0.057
P1 implicit time 92.84±15.44 93.19±16.08 92.82±15.46 94.32±15.40 0.554
N2 implicit time 123.31±24.51 123.59±21.87 123.38±23.27 125.48±21.90 0.556

* tested by one-way ANOVA.

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