title: Multifocal visual evoked potential recordings in compressive optic neuropathy secondary to pituitary adenoma.
abstract: To investigate the effect of pituitary adenoma compressing the optic chiasm on multifocal visual evoked potential (mfVEP) responses and to compare these responses with visual field defects seen on static automated perimetry (SAP). Eight eyes of four subjects (median age, 41.50 years; interquartile range, 33-51 years) who were diagnosed with pituitary adenoma on magnetic resonance imaging (MRI) and seen to have a bitemporal visual field defect on standard automated perimetry (SAP), and twelve age-matched normal subjects (median age, 47.00 years; interquartile range, 34.75-51.75 years) were subjected to multifocal visual evoked potential (mfVEP) testing. The monocular latencies and monocular amplitudes of each sector of cases were compared with the responses of normative database. The topography of the mfVEP response was compared with corresponding field defect as seen in total deviation threshold on SAP to allow a comparison with conventional subjective perimetry. The mfVEP amplitudes were reduced in the areas with visual field defect on SAP. In 6 out of 8 eyes, locations with preserved amplitudes and no visual defects showed prolonged latency. A prolonged median latency of 9.17 ms (interquartile range, 3.44-17.69 ms) in cases was seen when compared to the median latency of 1.67 ms (interquartile range, 0.94-4.17 ms) in age-matched controls with P value of 0.054. Chiasmal compression due to pituitary adenoma causes the reduction of amplitudes and prolongation of latencies of the mfVEP response. The mfVEP can be used to assess objectively the topography of the visual field in compressive optic neuropathy secondary to pituitary adenomas. It can be used in assessing the subjects whose visual field report is unreliable and prolonged median latency can be an early sign of the disease.
authors.affiliation: Elite School of Optometry, Unit of Medical Research Foundation, Sankara Nethralaya, 18, College Road, Chennai, 600006, India. manjujayaselvi87@gmail.com
authors.forename: Manju
authors.initials: M
authors.lastname: Jayaraman
authors.forename: S
authors.initials: S
authors.lastname: Ambika
authors.forename: Rashmin Anilkumar
authors.initials: RA
authors.lastname: Gandhi
authors.forename: Shikha Rajesh
authors.initials: SR
authors.lastname: Bassi
authors.forename: Priya
authors.initials: P
authors.lastname: Ravi
authors.forename: Parveen
authors.initials: P
authors.lastname: Sen
mesh_terms: D000236:Adenoma / Q000150:complications*; D000328:Adult; D001331:Automation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D009897:Optic Chiasm; D009901:Optic Nerve Diseases / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D010911:Pituitary Neoplasms / Q000150:complications*; D011930:Reaction Time; D058609:Visual Field Tests; D014794:Visual Fields
references.citation: Vision Res. 2005 Apr;45(9):1155-63
references.pmid: 15707924
references.citation: Neurologist. 2010 Jan;16(1):23-34
references.pmid: 20065793
references.citation: Ophthalmol Clin North Am. 2001 Mar;14(1):61-71, viii
references.pmid: 11370572
references.citation: Cancer. 2004 Aug 1;101(3):613-9
references.pmid: 15274075
references.citation: Invest Ophthalmol Vis Sci. 2000 May;41(6):1580-7
references.pmid: 10798679
references.citation: Am J Ophthalmol. 2007 Feb;143(2):295-304
references.pmid: 17184719
references.citation: Invest Ophthalmol Vis Sci. 2001 Dec;42(13):3341-8
references.pmid: 11726643
references.citation: Arch Ophthalmol. 2002 Dec;120(12):1672-81
references.pmid: 12470141
references.citation: Invest Ophthalmol Vis Sci. 1998 May;39(6):937-50
references.pmid: 9579473
references.citation: Ophthalmic Surg Lasers Imaging. 2007 May-Jun;38(3):250-3
references.pmid: 17552396
references.citation: Br J Ophthalmol. 2007 Apr;91(4):445-8
references.pmid: 17077118
references.citation: Invest Ophthalmol Vis Sci. 2004 Feb;45(2):492-8
references.pmid: 14744890
references.citation: Brain. 1976 Jun;99(2):357-74
references.pmid: 990902
references.citation: Curr Opin Neurol. 2009 Feb;22(1):3-10
references.pmid: 19155758
references.citation: Ophthalmol Clin North Am. 2004 Mar;17(1):89-105
references.pmid: 15102515
references.citation: J Neuroophthalmol. 2003 Dec;23(4):279-89
references.pmid: 14663311
references.citation: Arch Ophthalmol. 2005 Jun;123(6):729-39
references.pmid: 15955974
references.citation: Doc Ophthalmol. 2004 Mar;108(2):115-23
references.pmid: 15455794
references.citation: Doc Ophthalmol. 2004 Sep;109(2):189-99
references.pmid: 15881265
references.citation: J Glaucoma. 2006 Apr;15(2):110-6
references.pmid: 16633223
references.citation: Prog Retin Eye Res. 2003 Mar;22(2):201-51
references.pmid: 12604058
references.citation: Invest Ophthalmol Vis Sci. 2007 Mar;48(3):1173-80
references.pmid: 17325161
references.citation: Clin Exp Optom. 2005 Jul;88(4):253-7
references.pmid: 16083420
references.citation: J Glaucoma. 2003 Feb;12(1):3-15
references.pmid: 12567104
references.citation: Doc Ophthalmol. 2004 Jul;109(1):87-100
references.pmid: 15675203
references.citation: Am J Ophthalmol. 2002 Jan;133(1):29-39
references.pmid: 11755837
references.citation: Postgrad Med. 2009 Jul;121(4):103-14
references.pmid: 19641276
references.citation: Eye (Lond). 2004 Nov;18(11):1133-43
references.pmid: 15534599
references.citation: Doc Ophthalmol. 1988 Jul;69(3):271-81
references.pmid: 3168727
references.citation: Invest Ophthalmol Vis Sci. 2007 Feb;48(2):692-8
references.pmid: 17251467
references.citation: Ophthalmol Clin North Am. 2004 Mar;17(1):69-88
references.pmid: 15102514
references.citation: Top Magn Reson Imaging. 2005 Jul;16(4):277-88
references.pmid: 16785843
references.citation: Curr Eye Res. 2001 Jan;22(1):54-63
references.pmid: 11402379
references.citation: Clin Ophthalmol. 2007 Sep;1(3):233-46
references.pmid: 19668477
references.citation: Electroencephalogr Clin Neurophysiol. 1994 Jan;90(1):65-81
references.pmid: 7509275
references.citation: Doc Ophthalmol. 2000;100(2-3):115-37
references.pmid: 11142742
references.citation: Clin Exp Ophthalmol. 2006 Aug;34(6):562-7
references.pmid: 16925704
references.citation: Electroencephalogr Clin Neurophysiol. 1978 Aug;45(2):278-80
references.pmid: 78837
references.citation: Doc Ophthalmol. 2002 May;104(3):303-20
references.pmid: 12076018
references.citation: Invest Ophthalmol Vis Sci. 2006 Apr;47(4):1458-63
references.pmid: 16565379
references.citation: Doc Ophthalmol. 2002 May;104(3):287-302
references.pmid: 12076017
references.citation: Br J Ophthalmol. 2005 Jun;89(6):739-44
references.pmid: 15923511