Usefullness of VEP in children with optic neuritis.

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  • 視覚誘発電位検査が診断および経過観察に有効であった小児視神経炎の３症例

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Abstract

Purpose: We describe our experiences with clinical applications of visually evoked potential (VEP) in diagnosis and follow-up of three cases of optic neuritis in the Ophthalmic Department of Aichi Children's Health and Medical Center.<BR>Purpose: To report three cases of optic neuritis in children who were diagnosed and followed up effectively by the visual evoked potential (VEP) test.<BR>Case 1: A five-year-old girl was referred to our department due to bilateral visual impairment and inconclusive fundus examination results. The initial visual acuity was 0.01 (decimal) in both eyes. A significant decrease in amplitude revealed by the flash VEP test led to the diagnosis of bilateral optic neuritis. Subsequently, methylprednisolone pulse therapy was initiated. After gaining improved visual acuity, the patient has been followed up by several repeated VEP and visual acuity tests.<BR>Case 2: A ten-year-old girl suspected of optic neuritis in the right eye was referred to our clinic. The initial visual acuity was (0.03) OD and (1.2) OS. Although her visual acuity recovered to (1.0) OD after methylprednisolone pulse therapy, the electrophysiological findings by Pattern-VEP indicated a significant laterality (i.e. a decrease in amplitude and delay in latency) in the right eye. She has been followed up since then.<BR>Case 3: A ten-year-old girl suspected of optic neuritis in the right eye was referred to our clinic. The initial visual acuity was (0.03) OD and (1.2) OS. For the right eye, the Pattern-VEP examination showed a negative result indicating disappeared waveform and the diagnosis of optic neuritis was confirmed. After methylprednisolone pulse therapy, she showed excellent improvement in both visual acuity and Pattern-VEP testing and no further follow-up was necessary.<BR>Conclusion: Although diagnosis of optic neuritis can be made based on fundus and pupil findings, the VEP testing is clinically useful for objectively testing the visual function in young children with posterior optic neuritis. In addition, the VEP testing is also helpful during follow-up to detect any subtle visual impairment caused by neurological damage from optic neuritis.

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