Abstract
Cataract patients suspected of having disease which might interfere with good postoperative visual function were referred for evaluation. Monocular steady-state luminance visual evoked potentials (VEPs) were elicited with closed eyes at a stimulus rate of 10 flashes/sec. VEPs were rated as either normal or abnormal. Patients with normal VEPs were predicted to have an acuity of 6/15 (20/50) or better. Patients with abnormal VEPs were predicted to have acuities of 6/18 (20/60) or worse. Postoperative acuities were determined for all patients who underwent surgery and who had no intraoperative or early postoperative complications. The association of preoperative VEPs and observed postoperative acuities were quantitatively compared by a 2 × 2 contingency table for the 59 eyes which met these criteria. The chi-square was significant (p < 0.001). The overall accuracy of prediction was 76%. Accuracy was 80% for patients with a preoperative acuity of 6/60 (20/200) or better and 75% for those whose postoperative acuity was 6/120 (20/400) or worse. This difference was not statistically significant.
Similar content being viewed by others
References
Aspinall PA, Hill AR. Clinical inferences and decisions. I. Diagnosis and Bayes' theorem. Ophthalmic Physiol Opt 1983; 3: 295–304.
Aspinall PA, Hill AR. Clinical inferences and decisions. II. Decision trees, receiver operating curves and subjective probabilities. Ophthalmic Physiol Opt 1984a; 4: 31–38.
Aspinall PA, Hill AR. Clinical inferences and decisions. III. Utility assessment and the Bayesian decision model. Ophthalmic Physiol Opt 1984b; 4: 251–263.
Binder PS, Ayazuddin M, Hintze R. Visual prognosis for corneal transplantation based on preoperative visual evoked potential and electroretinogram. Ophthalmology 1982; 89: 661–667.
Emery JM, McIntyre DJ. Extracapsular Cataract Surgery. St. Louis: C.V. Mosby, 1983.
Enoch JM, Bedell HE, Kaufman HE. Interferometric visual acuity testing in anterior segment disease. Arch Ophthalmol 1979; 97: 1916–1919.
Farber ME, Odom JV, Hobson RR. Visual function behind vitreal opacities: VEP assessment. Invest Ophthalmol Vis Sci 1985; 26 (Suppl): 32.
Faulkner W. Laser interferometric prediction of postoperative visual acuity in patients with cataracts. Am J Ophthalmol 1983; 95: 625–636.
Fletcher RH, Fletcher SW, Wagner EH. Clinical epidemiology - The essentials. Baltimore: Williams & Wilkins, 1982.
Fricker SJ. Analysis of the visual evoked response by synchronous detector techniques. I. Patients with cataracts. Invest Ophthalmol 1971; 10: 340–347.
Fuller DG, Hutton WL. Presurgical evaluation of eyes with opaque media. New York: Grune & Stratton, 1982.
Guyton DL. Misleading predictions of postoperative visual acuity. Arch Ophthalmol 1986; 104: 189–190.
Green DG. Testing the vision of cataract patients by means of laser-generated interference fringes. Science 1970; 168: 1240–1242.
Green DG, Cohen MM. Laser interferometry in the evaluation of potential macular function in the presence of opacities in the ocular media. Trans Am acad Ophthalmol Otolaryngol 1971; 75: 629–637.
Hirose T, Miyake Y, Hara A. Evaluation of severe ocular trauma: Electroretinogram and visual evoked response. In Freeman HM, ed. Ocular Trauma. New York: Appleton-Century-Crofts, 1979.
Huber C. A clinical projection stimulator for sine-wave and pattern visual evoked response. Appliction to opacities of the ocular media and amblyopia. Doc Ophthalmol Proc Series 1977; 11: 39–47.
Huber C, Knus M. Preoperative evaluation of traumatic eye lesions with visual evoked cortical potentials in response to sine wave modulated light. Doc ophthalmol Proc Series 1978; 15: 211–219.
Hutton WL, Fullr DG. Factors influencing final visual results in severely injured eyes. Am J Ophthalmol 1984; 97: 715–722.
Maumenee AE. Laser interferometry in the evaluation of potential macular function in the presence of opacities in the ocular media. Green DG and Cohen MM, Discussion. Trans Am Acad Ophthalmol Otolaryngol 1971; 75: 629–637.
Minkowski JS, Palese M, Guyton DL. Potential acuity meter using a minute aerial pinhole aperture. Ophthalmology 1983; 90: 1360–1368.
Miris R, Missotten L. Evaluation of the macular function in cataractous eyes by means of the blue field entoptoscope. Bull Soc Belge Ophthalmol 1982; 201: 121–126.
Murphy GE. Limitations of blue field entoptoscopy in evaluating macular function. Ophthalmic Surg 1983; 14: 1033–1036.
Nakamura Z, Uesugi E. Preoperative evaluation of cataract patients with ERG and VEP. Jpn J Ophthalmol 1981; 25: 377–387.
Odom JV, Hobson RR, Coldren JT, Weinstein GW. Prediction of post-cataract extraction visual function: Use of 10 Hz flash VEPs. Invest Ophthalmol Vis Sci 1985; 26 (Suppl): 308.
Poirier RH. Personal communication. Cited in Knighton RW and Blankenship GW (1980) Electrophysiological evaluation of eyes with opaque media. Int Ophthalmol Clin 1978; 20 (1): 17.
Raju VK, Weinstein GW, Pillai L. Assessment of macular function in anterior segment surgery. India J Ophthalmol 1983; 31 (5): 42–44.
Regan D. Evoked potentials in psychology, sensory physiology and medicine. London: Chapman and Hall, 1972.
Rubin ML, Dawson WW. The transscleral VER: prediction of postoperative acuity. Invest Ophthalmol Vis Sci 1978; 17: 71–74.
Scherfig E, Edmund J, Tinning S, Krogh E. Prognostic parameters in pars plana vitrectomy. Acta Ophthalmol 1983; 61: 788–805.
Scherfig E, Tinning S, Edmund J, Trojaborg W. Visual evoked potential as a prognostic factor for vitrectomy in diabetic eyes. Acta Ophthalmol 1983b; 61: 778–787.
Scherfig E, Edmund J, Tinning S, Trojaborg W. Flash visual evoked potential as a prognostic factor for vitreous operations in diabetic eyes. Ophthalmology 1984; 91: 1475–1479.
Sinclair SH, Lobel M, Riva CE. Bluefield entoptic phenomenon in cataract patients. Arch Ophthalmol 1979; 97: 1092–1095.
Skalka HW. Blue field entoptoscopy and VER in preoperative cataract evaluation. Ophthalmic Surg 1981; 12: 642–645.
Thompson CRS, Harding GFA. The visual potential in patients with cataracts. Doc Ophthalmol Proc Series 1978; 15: 193–200.
Tinning S, Scherfig E, Edmund J, Trojaborg W. Visual evoked potentials (flash) in diabetes prior to vitrectomy. Fortschr Ophthalmol 1983; 80: 485–487.
Vrijland HR, van Lith GHM. The value of preoperative electro-ophthalmological examination before cataract extraction. Doc Ophthalmol 1983; 55: 153–156.
Weinstein GW. Clinical aspects of the visually evoked potentials. Trans Am Ophthalmol Soc 1977; 85: 627–673.
Author information
Authors and Affiliations
Additional information
Research supported by an unrestricted departmental grant from Research to Prevent Blindness, Inc.
Rights and permissions
About this article
Cite this article
Odom, J.V., Hobson, R., Coldren, J.T. et al. 10-Hz flash visual evoked potentials predict post-cataract extraction visual acuity. Doc Ophthalmol 66, 291–299 (1987). https://doi.org/10.1007/BF00213657
Issue Date:
DOI: https://doi.org/10.1007/BF00213657