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Analysis of Intraoperative Visual Evoked Potentials for Inclusion of Unstable Electroretinograms

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Title: Analysis of Intraoperative Visual Evoked Potentials for Inclusion of Unstable Electroretinograms
Authors: Cochard, Eva Cécile, Bérard, Nadia, Schaller, Karl Lothard, Boex, Colette
Source: J Clin Neurophysiol
Journal of clinical neurophysiology, vol. 42, no. 5, pp. 444-450
Publisher Information: Ovid Technologies (Wolters Kluwer Health), 2024.
Publication Year: 2024
Subject Terms: Adult, Male, Meningioma / surgery, 616.8, Vision, Brain Neoplasms / surgery, Neuromonitoring, Intraoperative Neurophysiological Monitoring / methods, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Humans, Electroretinography/methods, Evoked Potentials, Visual/physiology, Female, Middle Aged, Aged, Intraoperative Neurophysiological Monitoring/methods, Visual Fields/physiology, Photic Stimulation/methods, Reproducibility of Results, Glioma/surgery, Glioma/physiopathology, Meningioma/surgery, Meningioma/physiopathology, Brain Neoplasms/surgery, Brain Neoplasms/physiopathology, Alarm criterion, ERG, VEP, Visual field, Glioma / physiopathology, Original Research, Evoked Potentials, Visual / physiology, Visual Fields / physiology, Photic Stimulation / methods, Glioma / surgery, Electroretinography / methods, Brain Neoplasms / physiopathology, Meningioma / physiopathology
Description: Purpose: The objectives of the study were to evaluate the validity of intraoperative flash visual evoked potentials (VEPs) when electroretinograms (ERGs) were unstable, to compare white versus red light-emitting diodes, and to assess the impact of luminance on ERG variability. Methods: Thirty patients were included (Inomed system; pre- and postoperative visual fields). Possible changes in visual fields were assessed with mean defects in perimetry. The receiver operating characteristic (ROC) curves of normalized VEPs and of normalized and corrected VEPs with ERGs were compared. Results: Thirty-two eyes could be analyzed in 20 patients (mainly gliomas and meningiomas): 2 had a severe defect in their visual field, and 6 had a mild defect. The receiver operating characteristic curve indicated (1) normalized and corrected VEPs with ERGs were more reliable than normalized VEPs only (P < 0.03) and (2) an alarm threshold of 80% of normalized and corrected VEPs. No significant difference in variability of ERGs was found with white or red light-emitting diodes with this system. Increased luminance improved stability of ERGs (P < 0.05). Conclusions: Normalization and correction of VEPs with ERGs improved the validity of VEPs and indicated a 20% decrease as alarm criterion. This normalization and correction with peripheral excitation could be generalized to improve the reliability of neuromonitoring.
Document Type: Article
Other literature type
File Description: application/pdf
Language: English
ISSN: 1537-1603
0736-0258
DOI: 10.1097/wnp.0000000000001129
Access URL: https://pubmed.ncbi.nlm.nih.gov/39509114
https://archive-ouverte.unige.ch/unige:186558
https://doi.org/10.1097/wnp.0000000000001129
http://nbn-resolving.org/urn/resolver.pl?urn=urn:nbn:ch:serval-BIB_5721F84151120
https://serval.unil.ch/resource/serval:BIB_5721F8415112.P001/REF.pdf
https://serval.unil.ch/notice/serval:BIB_5721F8415112
Rights: CC BY NC ND
URL: http://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
Accession Number: edsair.doi.dedup.....89ab04ad4f6c86153703da31c0ee8d24
Database: OpenAIRE
Description
Abstract:Purpose: The objectives of the study were to evaluate the validity of intraoperative flash visual evoked potentials (VEPs) when electroretinograms (ERGs) were unstable, to compare white versus red light-emitting diodes, and to assess the impact of luminance on ERG variability. Methods: Thirty patients were included (Inomed system; pre- and postoperative visual fields). Possible changes in visual fields were assessed with mean defects in perimetry. The receiver operating characteristic (ROC) curves of normalized VEPs and of normalized and corrected VEPs with ERGs were compared. Results: Thirty-two eyes could be analyzed in 20 patients (mainly gliomas and meningiomas): 2 had a severe defect in their visual field, and 6 had a mild defect. The receiver operating characteristic curve indicated (1) normalized and corrected VEPs with ERGs were more reliable than normalized VEPs only (P < 0.03) and (2) an alarm threshold of 80% of normalized and corrected VEPs. No significant difference in variability of ERGs was found with white or red light-emitting diodes with this system. Increased luminance improved stability of ERGs (P < 0.05). Conclusions: Normalization and correction of VEPs with ERGs improved the validity of VEPs and indicated a 20% decrease as alarm criterion. This normalization and correction with peripheral excitation could be generalized to improve the reliability of neuromonitoring.
ISSN:15371603
07360258
DOI:10.1097/wnp.0000000000001129