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Characterising the orientation-specific pattern-onset visual evoked potentials in children with bilateral refractive amblyopia and non-amblyopic controls

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Abstract

Purpose

An orientation-specific visual evoked potential (osVEP) protocol was developed to probe meridional anisotropies in children with refractive amblyopia. The aim was to characterise the osVEP response in children with bilateral refractive amblyopia, evaluate the intra-session repeatability of the main osVEP components (C1, C2 and C3), coefficient of repeatability (CoR) of the response to gratings in different meridians and determine if refractive amblyopes have poorer repeatability as compared with non-amblyopic controls.

Methods

Children aged 4–7 years with newly diagnosed and untreated bilateral refractive amblyopia and non-amblyopic controls were recruited. Orientation-specific pattern-onset VEPs were recorded in response to an achromatic sinewave grating stimulus of 4 cycles per degree under monocular and binocular stimulation. The grating lines used for monocular stimulation were parallel with the subjects’ most positive and negative astigmatic meridians when considered in sphero-minus cylinder form (Meridians 1 and 2, respectively). In subjects without astigmatism, meridians 1 and 2 were designated horizontal and vertical gratings, respectively. Binocular stimuli were presented with grating lines parallel to meridians 45, 90, 135 and 180°. The repeatability of latencies of the main osVEP components (C1, C2 and C3) were investigated using two successive osVEPs recordings for each stimulus meridian and the CoR for each component’s latencies were assessed.

Results

Seven amblyopic children (Visual acuity (VA) ranging from 0.08 to 0.40 LogMAR in the less amblyopic eye and 0.26–0.52 LogMAR in the more amblyopic eye) and 7 non-amblyopic controls (VA ranging from 0.00 to 0.02 LogMAR in either eye), with a median age of 4.6 and 7.0 years, respectively, completed the study. C1 had the highest CoR for most conditions assessed. Ratio of CoRs C1:C2 was > 2 for all binocular meridians in controls and the 90 and 180 meridians in the amblyopes; C1:C3 was > 2 for the binocularly assessed 45, 90 and 135 meridians in the controls and the 90 and 180 meridians in the amblyopes; C2:C3 were all < 2 for all meridians assessed in both groups.

Conclusions

The osVEP waveforms are reliable and useful for future investigations into the meridional anisotropies in children with refractive amblyopia, particularly the C3 component. Component C1 had the poorest repeatability, which consequentially affected C2 amplitude estimation. Only C3 amplitude and latency could be consistently estimated as C2 and C3 latencies were similarly repeatable. Coefficients of repeatability of osVEP latencies did not appear to systematically differ between non-amblyopic and amblyopic children.

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Acknowledgements

The authors wish to thank Dr Ranjana Mathur for the collaboration with the Visual Electrophysiology Laboratory at Singapore National Eye Centre and all the colleagues at the Refraction Clinic in KK Women’s and Children’s Hospital for helping with the recruitment of the subjects.

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No funding was received for this research.

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Authors and Affiliations

  1. School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia

    Tiong Peng Yap, Catherine M. Suttle & Mei Ying Boon

  2. Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia

    Chi D. Luu

  3. Ophthalmology, Department of Surgery, The University of Melbourne, Parkville, VIC, Australia

    Chi D. Luu

  4. Division of Optometry and Visual Sciences, University of London, London, England, UK

    Catherine M. Suttle

  5. Paediatric Ophthalmology and Adult Strabismus Department, Singapore National Eye Centre (SNEC), Singapore, Singapore

    Audrey Chia

  6. Paediatric Ophthalmology and Strabismus Department, KK Women’s and Children’s Hospital (KKH), Singapore, Singapore

    Audrey Chia

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  1. Tiong Peng Yap
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  2. Chi D. Luu
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  3. Catherine M. Suttle
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Correspondence to Tiong Peng Yap.

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Conflict of interest

TP. Yap declares that he has no conflict of interest. C.D. Luu declares that he has no conflict of interest. C.M. Suttle declares that she has no conflict of interest. A. Chia declares that she has no conflict of interest. M.Y. Boon declares that she has no conflict of interest.

Ethical approval

The study adhered to the tenets of Helsinki and ethical approval was obtained from the Centralised Institutional Review Board (CIRB) (Registration number: R1083/98/2013) at SingHealth and ratified by the human research ethics committees at the University of New South Wales, Sydney, NSW, Australia (Approval number: 09364).

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Centralised Institutional Review Board at SingHealth, University of New South Wales, Sydney, NSW, Australia, and with the 1964 Helsinki Declaration and its later amendments.

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Yap, T.P., Luu, C.D., Suttle, C.M. et al. Characterising the orientation-specific pattern-onset visual evoked potentials in children with bilateral refractive amblyopia and non-amblyopic controls. Doc Ophthalmol 142, 197–211 (2021). https://doi.org/10.1007/s10633-020-09794-9

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