A Study of Some Temporal Properties of the Human Visual Evoked Potential, and Their Relation to Binocular Function

Detta är en avhandling från Institutionen för nervsystem och rörelseorgan

Sammanfattning: As disturbed binocular functions in small children may lead to severe amblyopia it is of interest to detect it as early as possible. Most tests for binocular functions, however, demand active cooperation and may be unreliable in children up to 4-5 years of age. This study therefore aims to employ visual evoked potentials (VEP) to enable the examiner to evaluate the binocular function in a subject without need of active cooperation from the subject.Initially we studied the relation of suprathreshold contrast to the latency of the transient pattern VEP (tpVEP). Although suprathreshold contrast independently influenced the tpVEP latency, interindividual variation was too large to suggest tpVEP as a possible method for objectively measuring contrast sensitivity in a subject.The tpVEP latency in normal and microstrabismic adult subjects was examined. It was significantly shorter with binocular viewing in normals, but not in the microstrabismic group.Contrast sensitivity and tpVEP latency was examined in adults, both with normal binocularity and with microstrabismus, using both luminance (black-and-white) contrast and colour contrast patterns. The tpVEP latency to colour contrast, like that to luminance contrast, is shorter in normal subjects who view the stimulus binocularly. Interindividual variation or overlap between the normal and microstrabismic groups did not improve with colour contrast.The most significant features of the tpVEP are amplitude and latency. Depending on stimulus conditions, the response may show variations in configuration, amplitude and, to a lesser degree, latency. To decrease the influence of such variations steady-state VEP (ssVEP) can be used. The stimulus is presented in a fast repetitive manner, yielding a VEP response shaped as a continuous curve. The frequency components of this curve can be analysed using Fast Fourier Analysis.Fast Fourier analysis of ssVEP in children aged 8-15 years with normal binocularity and with microstrabismus showed that the power of the second harmonic (the double frequency of stimulus frequency) of the response with binocular viewing was larger than with monocular viewing, both in normals and microstrabismic subjects. For higher stimulus frequencies, microstrabismic subjects showed a significantly lower power of the second harmonic compared with subjects with normal binocularity, when the stimulus was presented binocularly.Finally, Fast Fourier analysed ssVEP in pre-school children aged 4-5 years was studied. A normal group was compared with a group with microstrabismus and a group with significant amblyopia. Amblyopic subjects had significant interocular differences in the first harmonic. We confirmed the significant difference found between microstrabismic subjects and subjects with normal binocularity regarding the second harmonic’s power with higher temporal frequency binocular stimulation, although at a slightly lower frequency than for older children. A low power of the second harmonic in the ssVEP to a binocular stimulus with high temporal frequency is a strong indicator of disturbed binocular function.