title: Pattern-reversal visual evoked potentials as a diagnostic tool for ocular malingering.
abstract: To investigate the contributions of transient pattern-reversal visual evoked potentials in the diagnosis of ocular malingering at a Brazilian university hospital.
  Adult patients with suspected malingering in one or both eyes were referred for visual evoked potential testing. Data from patients' medical records were reviewed and analyzed retrospectively. Data analysis included the distance optotype visual acuity based on a ETDRS retro-illuminated chart and the transient pattern-reversal visual evoked potential parameters of latency (milliseconds) and amplitude (microvolts) for the P100 component, using checkerboards with visual subtenses of 15' and 60'. Motivations for malingering were noted.
  The 20 subjects included 11 (55%) women. Patient ages ranged from 21 to 61 years (mean= 45.05 ± 11.76 years; median= 49 years). In 8 patients (6 women), both eyes exhibited reduced visual acuity with normal pattern-reversal visually evoked potential parameters (pure malingerers). The remaining 12 patients (7 men) exhibited reduced vision in only 1 eye, with simulated reduced vision in the contralateral eye (exaggerators). Financial motivation was noted in 18 patients (9 men).
  Normal pattern-reversal visually evoked potential parameters with suspected ocular malingering were observed in a 20 patient cohort. This electrophysiological technique appeared to be useful as a measure of visual pathway integrity in this specific population.
authors.affiliation: Laboratório de Eletrofisiologia Visual Clínica, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors.forename: Tarciana de Souza
authors.initials: TS
authors.lastname: Soares
authors.affiliation: Laboratório de Eletrofisiologia Visual Clínica, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors.forename: Paula Yuri
authors.initials: PY
authors.lastname: Sacai
authors.affiliation: Laboratório de Eletrofisiologia Visual Clínica, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors.forename: Adriana
authors.initials: A
authors.lastname: Berezovsky
authors.affiliation: Laboratório de Eletrofisiologia Visual Clínica, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors.forename: Daniel Martins
authors.initials: DM
authors.lastname: Rocha
authors.affiliation: Laboratório de Eletrofisiologia Visual Clínica, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors.forename: Sung Eun Song
authors.initials: SE
authors.lastname: Watanabe
authors.affiliation: Laboratório de Eletrofisiologia Visual Clínica, Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors.forename: Solange Rios
authors.initials: SR
authors.lastname: Salomão
mesh_terms: D000328:Adult; D001766:Blindness / Q000175:diagnosis / Q000503:physiopathology; D001938:Brazil; D005074:Evoked Potentials, Visual / Q000502:physiology*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008306:Malingering / Q000175:diagnosis* / Q000503:physiopathology*; D008875:Middle Aged; D010775:Photic Stimulation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013997:Time Factors; D014786:Vision Disorders / Q000175:diagnosis* / Q000503:physiopathology*; D014792:Visual Acuity / Q000502:physiology; D014795:Visual Pathways / Q000503:physiopathology; D055815:Young Adult