Multifocal Visual Evoked Potentials in Unilateral Compressive Optic Neuropathy Secondary to Orbital Tumors

Abstract

Purpose

To evaluate the effects of unilateral compressive optic neuropathy secondary to orbital tumors and the removal of the tumors on amplitude and latency of multifocal visual evoked potentials (mfVEPs) and to compare these responses with visual field defects seen on static automated perimetry.

Methods

Static automated and mfVEP recordings were obtained from 14 patients with orbital tumors affecting one optic nerve. Monocular and interocular amplitude and latency analyses were performed.

Results

The change in the mfVEP amplitude agreed with visual field findings with regard to topography and severity of deviation from normal in 10 patients. For 4 patients with normal visual field, the changes in the mfVEP were of significance. The delay in recordable responses from affected eyes ranged from 2.56 to 18.28 ms (interocular analysis) and 0.1 to 21.86 ms (monocular analysis). Ten patients whose tumor was totally removed showed a recovery of the visual field and mfVEP to various degrees. Visual field of 6 patients showed within normal limits after total removal of the tumor, and the defects of mfVEP in 3 patients remained apparent, while the mfVEP of the other 3 patients showed a complete recovery.

Conclusions

Various orbital tumors can cause compressive optic neuropathy. Compressive optic neuropathy secondary to orbital tumors results in mfVEP amplitude reduction and latency prolongation. The changes in measures of mfVEP due to orbital tumors are consistent with the visual field changes in most patients. In some patients, the subjective visual field results and objective mfVEP are discordant. The objective changes of mfVEP may appear earlier than the defect of visual field, and thus it may be able to identify subtle defects that are undetectable with Humphrey perimetry. Postoperatively, recovery of the mfVEP may be later than that of visual field in some patients. The mfVEP changes may assist in both early diagnosis and follow-up of the compressive optic neuropathy secondary to orbital tumors.

Keywords

Compressive optic neuropathy Multifocal visual evoked potentials Orbital tumor

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References

Baseler

H.A.

, Sutter

E.E.

, Klein

S.A.

, Carney

The topography of visual evoked response properties across the visual field. Electroencephalogr Clin Neurophysiol 1994; 90: 65–81.

Betsuin

, Mashima

, Ohde

, Inoue

, Oguchi

Clinical application of the multifocal VEPs. Curr Eye Res 2001; 22: 54–63.

Hood

D.C.

, Odel

J.G.

, Winn

B.J.

The multifocal visual evoked potential. J Neuroophthalmol 2003; 23: 279–89.

Hood

D.C.

, Odel

J.G.

, Zhang

Tracking the recovery of local optic nerve function after optic neuritis: a multifocal VEP study. Invest Ophthalmol Vis Sci 2000; 41: 4032–8.

Klistorner

, Graham

S.L.

Objective perimetry in glaucoma. Ophthalmology 2000; 107: 2283–99.

Yang

E.B.

, Hood

D.C.

, Rodarte

, Zhang

, Odel

J.G.

, Behrens

M.M.

Improvement in conduction velocity after optic neuritis measured with the multifocal VEP. Invest Ophthalmol Vis Sci 2007; 48: 692–8.

Goldberg

, Graham

S.L.

, Klistorner

A.I.

Multifocal objective perimetry in the detection of glaucomatous field loss. Am J Ophthalmol 2002; 133: 29–39.

Laron

, Cheng

, Zhang

, Schiffman

J.S.

, Tang

R.A.

, Frishman

L.J.

Assessing visual pathway function in multiple sclerosis patients with multifocal visual evoked potentials. Mult Scler 2009; 15: 1431–41.

Jayaraman

, Ambika

, Gandhi

R.A.

, Bassi

S.R.

, Ravi

, Sen

Multifocal visual evoked potential recordings in compressive optic neuropathy secondary to pituitary adenoma. Doc Ophthalmol 2010; 121: 197–204.

10.

Klistorner

A.I.

, Graham

S.L.

, Grigg

, Balachandran

Objective perimetry using the multifocal visual evoked potential in central visual pathway lesions. Br J Ophthalmol 2005; 89: 739–44.

11.

Danesh-Meyer

H.V.

, Carroll

S.C.

, Gaskin

B.J.

, Gao

, Gamble

G.D.

Correlation of the multifocal visual evoked potential and standard automated perimetry in compressive optic neuropathies. Invest Ophthalmol Vis Sci 2006; 47: 1458–63.

12.

Hood

D.C.

, Greenstein

V.C.

Multifocal VEP and ganglion cell damage: applications and limitations for the study of glaucoma. Prog Retin Eye Res 2003; 22: 201–51.

13.

Baseler

H.A.

, Sutter

E.E.

, Klein

S.A.

, Carney

The topography of visual evoked response properties across the visual field. Electroencephalogr Clin Neurophysiol 1994; 90: 65–81.

14.

Hood

D.C.

, Zhang

, Greenstein

V.C.

An interocular comparison of the multifocal VEP: a possible technique for detecting local damage to the optic nerve. Invest Ophthalmol Vis Sci 2000; 41: 1580–7.

15.

Hood

D.C.

, Zhang

, Winn

B.J.

Detecting glaucomatous damage with the multifocal visual evoked potential: how can a monocular test work?

J Glaucoma 2003; 12: 3–15.

16.

Semela

, Yang

E.B.

, Hedges

T.R.

, Vuong

, Odel

J.G.

, Hood

D.C.

Multifocal visual-evoked potential in unilateral compressive optic neuropathy. Br J Ophthalmol 2007; 91: 445.

17.

Holder

G.E.

Electrophysiological assessment of optic nerve disease. Eye 2004; 18: 1133–43.

18.

Pakrou

, Casson

, Kaines

, Selva

Multifocal objective perimetry compared with Humphrey full-threshold perimetry in patients with optic neuritis. Clin Experiment Ophthalmol 2006; 34: 562–7.

19.

Holder

G.E.

, Gale

R.P.

, Acheson

J.F.

, Robson

A.G.

Electrodiagnostic assessment in optic nerve disease. Curr Opin Ophthalmol. 2009; 22: 3–10.

20.

Watanabe

, Shinoda

, Kimura

, Mashima

, Oguchi

, Ohde

Discordance between subjective perimetric visual fields and objective multifocal visual evoked potential-determined visual fields in patients with hemianopsia. Am J Ophthalmol 2007; 143: 295–304.

21.

Hood

D.C.

, Thienprasiddhi

, Greenstein

V.C.

Detecting early to mild glaucomatous damage: a comparison of the multifocal VEP and automated perimetry. Invest Ophthalmol Vis Sci 2004; 45: 492–8.