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Visual Evoked Potential and Pupillary Signs: A Comparison in Optic Nerve Disease

Visual Evoked Potential and Pupillary Signs: A Comparison in Optic Nerve Disease Abstract • We measured the pupil cycle time, the relative afferent pupillary defect, and the pattern-reversal visual evoked potential (VEP) in 41 patients with unilateral anterior ischemic optic neuropathy (AION) and 24 patients with unilateral optic neuritis. We speculated that the relative afferent pupillary defect would match the VEP amplitude and that the pupil cycle time would correspond to the VEP latency. We found a correlation between the relative afferent pupillary defect and VEP amplitude in patients with AION, but not in patients with optic neuritis. We also found that the pupil cycle time and VEP latency were weakly correlated, but only in patients with optic neuritis. In these two groups of patients with unilateral optic neuropathy, the most sensitive objective indicator of disease was the relative afferent pupillary defect. The least sensitive indicator was the pupil cycle time. References 1. Thompson HS, Corbett JJ, Cox TA: How to measure the relative afferent pupillary defect . Surv Ophthalmol 1981;26:39-42.Crossref 2. Fineberg E, Thompson HS: Quantitation of the afferent pupillary defect , in Smith JL (ed): Neuro-ophthalmology Focus 1980 . New York, Masson Publishing, 1979, pp 25-29. 3. Miller SD, Thompson HS: Edge-light pupil cycle time . Br J Ophthalmol 1978;62:495-500.Crossref 4. Miller SD, Thompson HS: Pupil cycle time in optic neuritis . Am J Ophthalmol 1978;85:635-642. 5. Kirkham TH, Coupland SG: Multiple regression analysis of diagnostic predictors in optic nerve disease . Can J Neurol Sci 1981;8:67-72. 6. Weinstein JM, Van Gilder JC, Thompson HS: Pupil cycle time in optic nerve compression . Am J Ophthalmol 1980;89:263-267. 7. Ellis CJK: The afferent pupillary defect in acute optic neuritis . J Neurol Neurosurg Psychiatry 1979;42:1008-1017.Crossref 8. Arden GB, Gucukoglu AG: Grating test of contrast sensitivity in patients with retrobulbar neuritis . Arch Ophthalmol 1978;96:1626-1629.Crossref 9. Bynke H, Rosen I, Sandberg-Wollheim M: Correlation of visual evoked potentials, ophthalmological and neurological findings after unilateral optic neuritis . Acta Ophthalmol 1980;58:673-687.Crossref 10. Garrick R, Walsh JC, McLeod JG: Electrophysiological and immunological studies in optic neuritis . Clin Exp Neurol 1977;14:125-132. 11. Zeese JA: Pattern visual evoked responses in multiple sclerosis . Arch Neurol 1977;34:314-316.Crossref 12. Matthews WB, Small DG, Small M, et al: Pattern reversal evoked visual potential in the diagnosis of multiple sclerosis . J Neurol Neurosurg Psychiatry 1977;40:1009-1014.Crossref 13. Lowitzsch K, Kuhnt U, Sakmann C, et al: Visual pattern evoked responses and blink reflexes in assessment of MS diagnosis . J Neurol 1976;213:17-32.Crossref 14. Glaser JS, Laflamme P: The visual evoked response: Methodology and application in optic nerve disease , in Thompson HS (ed): Topics in Neuro-ophthalmology . Baltimore, Williams & Wilkins Co, 1979, pp 199-218. 15. Wilson WB, Keyser RB: Comparison of the pattern and diffuse-light visual evoked responses in definite multiple sclerosis . Arch Neurol 1980;37:30-34.Crossref 16. Shahrokhi F, Chiappa KH, Young RR: Pattern shift visual evoked responses . Arch Neurol 1978;35:65-71.Crossref 17. Tackmann W, Strenge H, Barth R, et al: Diagnostic validity for different components of pattern shift visual evoked potentials in multiple sclerosis . Eur Neurol 1979;18:243-248.Crossref 18. Nilsson BY: Visual evoked responses in multiple sclerosis: Comparison of two methods for pattern reversal . J Neurol Neurosurg Psychiatry 1978;41:499-504.Crossref 19. Griffin JF, Wray SH: Acquired color vision defects in retro-bulbar neuritis . Am J Ophthalmol 1978;86:193-201. 20. Halliday AM, McDonald WI, Mushin J: Visual evoked potentials in patients with demyelinating disease , in Desmedt JE (ed): Visual Evoked Potentials in Man: New Developments . Oxford, England, Clarendon Press, 1977, pp 438-449. 21. Wildberger HGH, Van Lith GHM: Color vision and visually evoked response (VECP) in the recovery period of optic neuritis . Mod Probl Ophthalmol 1976;17:320-324. 22. Trojaborg W, Petersen E: Visual and somatosensory evoked cortical potentials in multiple sclerosis . H Neurol Neurosurg Psychiatry 1979;42:323-330.Crossref 23. Asselman P, Chadwick DW, Marsden CD: Visual evoked responses in the diagnosis and management of patients suspected of multiple sclerosis . Brain 1975;98:261-282.Crossref 24. Hennerici M, Wenzel D, Freund HJ: The comparison of small-size rectangle and checkerboard stimulation for the evaluation of delayed visual evoked responses in patients suspected of multiple sclerosis . Brain 1977;100:119-136.Crossref 25. Regan D, Milner BA, Heron JR: Delayed visual perception and delayed visual evoked potentials in the spinal form of multiple sclerosis and in retrobulbar neuritis . Brain 1976;99:43-66.Crossref 26. Matthews WB, Small DG: Serial recording of visual and somatosensory evoked potentials in multiple sclerosis . J Neurol Sci 1979;40:11-21.Crossref 27. Ellenberger C, Ziegler SB: Visual evoked potentials and quantitative perimetry in multiple sclerosis . Ann Neurol 1977;1:561-564.Crossref 28. Wilson WB: Visual-evoked response differentiation of ischemic optic neuritis from the optic neuritis of multiple sclerosis . Am J Ophthalmol 1978;86:530-535. 29. Cox TA, Thompson HS, Corbett JJ: Relative afferent pupillary defects in optic neuritis . Am J Ophthalmol 1981;92:685-690. 30. Ukai K, Higashi JT, Ishikawa S: Edge-light pupil oscillation of optic neuritis . Neuroophthalmology 1980;1:33-43. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Visual Evoked Potential and Pupillary Signs: A Comparison in Optic Nerve Disease

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References (32)

Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1982.01030040581004
Publisher site
See Article on Publisher Site

Abstract

Abstract • We measured the pupil cycle time, the relative afferent pupillary defect, and the pattern-reversal visual evoked potential (VEP) in 41 patients with unilateral anterior ischemic optic neuropathy (AION) and 24 patients with unilateral optic neuritis. We speculated that the relative afferent pupillary defect would match the VEP amplitude and that the pupil cycle time would correspond to the VEP latency. We found a correlation between the relative afferent pupillary defect and VEP amplitude in patients with AION, but not in patients with optic neuritis. We also found that the pupil cycle time and VEP latency were weakly correlated, but only in patients with optic neuritis. In these two groups of patients with unilateral optic neuropathy, the most sensitive objective indicator of disease was the relative afferent pupillary defect. The least sensitive indicator was the pupil cycle time. References 1. Thompson HS, Corbett JJ, Cox TA: How to measure the relative afferent pupillary defect . Surv Ophthalmol 1981;26:39-42.Crossref 2. Fineberg E, Thompson HS: Quantitation of the afferent pupillary defect , in Smith JL (ed): Neuro-ophthalmology Focus 1980 . New York, Masson Publishing, 1979, pp 25-29. 3. Miller SD, Thompson HS: Edge-light pupil cycle time . Br J Ophthalmol 1978;62:495-500.Crossref 4. Miller SD, Thompson HS: Pupil cycle time in optic neuritis . Am J Ophthalmol 1978;85:635-642. 5. Kirkham TH, Coupland SG: Multiple regression analysis of diagnostic predictors in optic nerve disease . Can J Neurol Sci 1981;8:67-72. 6. Weinstein JM, Van Gilder JC, Thompson HS: Pupil cycle time in optic nerve compression . Am J Ophthalmol 1980;89:263-267. 7. Ellis CJK: The afferent pupillary defect in acute optic neuritis . J Neurol Neurosurg Psychiatry 1979;42:1008-1017.Crossref 8. Arden GB, Gucukoglu AG: Grating test of contrast sensitivity in patients with retrobulbar neuritis . Arch Ophthalmol 1978;96:1626-1629.Crossref 9. Bynke H, Rosen I, Sandberg-Wollheim M: Correlation of visual evoked potentials, ophthalmological and neurological findings after unilateral optic neuritis . Acta Ophthalmol 1980;58:673-687.Crossref 10. Garrick R, Walsh JC, McLeod JG: Electrophysiological and immunological studies in optic neuritis . Clin Exp Neurol 1977;14:125-132. 11. Zeese JA: Pattern visual evoked responses in multiple sclerosis . Arch Neurol 1977;34:314-316.Crossref 12. Matthews WB, Small DG, Small M, et al: Pattern reversal evoked visual potential in the diagnosis of multiple sclerosis . J Neurol Neurosurg Psychiatry 1977;40:1009-1014.Crossref 13. Lowitzsch K, Kuhnt U, Sakmann C, et al: Visual pattern evoked responses and blink reflexes in assessment of MS diagnosis . J Neurol 1976;213:17-32.Crossref 14. Glaser JS, Laflamme P: The visual evoked response: Methodology and application in optic nerve disease , in Thompson HS (ed): Topics in Neuro-ophthalmology . Baltimore, Williams & Wilkins Co, 1979, pp 199-218. 15. Wilson WB, Keyser RB: Comparison of the pattern and diffuse-light visual evoked responses in definite multiple sclerosis . Arch Neurol 1980;37:30-34.Crossref 16. Shahrokhi F, Chiappa KH, Young RR: Pattern shift visual evoked responses . Arch Neurol 1978;35:65-71.Crossref 17. Tackmann W, Strenge H, Barth R, et al: Diagnostic validity for different components of pattern shift visual evoked potentials in multiple sclerosis . Eur Neurol 1979;18:243-248.Crossref 18. Nilsson BY: Visual evoked responses in multiple sclerosis: Comparison of two methods for pattern reversal . J Neurol Neurosurg Psychiatry 1978;41:499-504.Crossref 19. Griffin JF, Wray SH: Acquired color vision defects in retro-bulbar neuritis . Am J Ophthalmol 1978;86:193-201. 20. Halliday AM, McDonald WI, Mushin J: Visual evoked potentials in patients with demyelinating disease , in Desmedt JE (ed): Visual Evoked Potentials in Man: New Developments . Oxford, England, Clarendon Press, 1977, pp 438-449. 21. Wildberger HGH, Van Lith GHM: Color vision and visually evoked response (VECP) in the recovery period of optic neuritis . Mod Probl Ophthalmol 1976;17:320-324. 22. Trojaborg W, Petersen E: Visual and somatosensory evoked cortical potentials in multiple sclerosis . H Neurol Neurosurg Psychiatry 1979;42:323-330.Crossref 23. Asselman P, Chadwick DW, Marsden CD: Visual evoked responses in the diagnosis and management of patients suspected of multiple sclerosis . Brain 1975;98:261-282.Crossref 24. Hennerici M, Wenzel D, Freund HJ: The comparison of small-size rectangle and checkerboard stimulation for the evaluation of delayed visual evoked responses in patients suspected of multiple sclerosis . Brain 1977;100:119-136.Crossref 25. Regan D, Milner BA, Heron JR: Delayed visual perception and delayed visual evoked potentials in the spinal form of multiple sclerosis and in retrobulbar neuritis . Brain 1976;99:43-66.Crossref 26. Matthews WB, Small DG: Serial recording of visual and somatosensory evoked potentials in multiple sclerosis . J Neurol Sci 1979;40:11-21.Crossref 27. Ellenberger C, Ziegler SB: Visual evoked potentials and quantitative perimetry in multiple sclerosis . Ann Neurol 1977;1:561-564.Crossref 28. Wilson WB: Visual-evoked response differentiation of ischemic optic neuritis from the optic neuritis of multiple sclerosis . Am J Ophthalmol 1978;86:530-535. 29. Cox TA, Thompson HS, Corbett JJ: Relative afferent pupillary defects in optic neuritis . Am J Ophthalmol 1981;92:685-690. 30. Ukai K, Higashi JT, Ishikawa S: Edge-light pupil oscillation of optic neuritis . Neuroophthalmology 1980;1:33-43.

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Oct 1, 1982

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