Analysis of Intraoperative Visual Evoked Potentials for Inclusion of Unstable Electroretinograms

Article Article scientifique Article Analysis of Intraoperative Visual Evoked Potentials for Inclusion of Unstable Electroretinograms eng 2024-11-07 2025-07 author Cochard Eva Cécile Department of Neurosurgery, “Hôpitaux Universitaires de Genève”, Genève, Switzerland; 931457 author Bérard Nadia Department of Neurosurgery, “Centre Hospitalier Universitaire Vaudois”, Lausanne, Switzerland. author Schaller Karl Lothard Department of Neurosurgery, “Hôpitaux Universitaires de Genève”, Genève, Switzerland; 658606 Département des neurosciences cliniques (OTONO) author Boex Colette 0000-0002-9374-4791 Department of Neurosurgery, “Hôpitaux Universitaires de Genève”, Genève, Switzerland; 28086 Département des neurosciences cliniques (OTONO) 444-450 10.1097/wnp.0000000000001129 39509114 0736-0258 PMC12203976 https://journals.lww.com/10.1097/WNP.0000000000001129 Purpose: The objectives of the study were to evaluate the validity of intraoperative flash visual evoked potentials (VEPs) when electroretinograms (ERGs) were unstable, to compare white versus red light-emitting diodes, and to assess the impact of luminance on ERG variability. Methods: Thirty patients were included (Inomed system; pre- and postoperative visual fields). Possible changes in visual fields were assessed with mean defects in perimetry. The receiver operating characteristic (ROC) curves of normalized VEPs and of normalized and corrected VEPs with ERGs were compared. Results: Thirty-two eyes could be analyzed in 20 patients (mainly gliomas and meningiomas): 2 had a severe defect in their visual field, and 6 had a mild defect. The receiver operating characteristic curve indicated (1) normalized and corrected VEPs with ERGs were more reliable than normalized VEPs only ( P < 0.03) and (2) an alarm threshold of 80% of normalized and corrected VEPs. No significant difference in variability of ERGs was found with white or red light-emitting diodes with this system. Increased luminance improved stability of ERGs ( P < 0.05). Conclusions: Normalization and correction of VEPs with ERGs improved the validity of VEPs and indicated a 20% decrease as alarm criterion. This normalization and correction with peripheral excitation could be generalized to improve the reliability of neuromonitoring. Alarm criterion ERG Neuromonitoring VEP Vision Visual field Adult Aged Brain Neoplasms / physiopathology Brain Neoplasms / surgery Electroretinography / methods Evoked Potentials, Visual / physiology Female Glioma / physiopathology Glioma / surgery Humans Intraoperative Neurophysiological Monitoring / methods Male Meningioma / physiopathology Meningioma / surgery Middle Aged Photic Stimulation / methods Reproducibility of Results Visual Fields / physiology Young Adult Dewey 616.8 61 Département des neurosciences cliniques 226 false 513 Groupe Schaller Karl Lothard (neurochirurgie) 851 Journal of clinical neurophysiology 42 5 6311395b-722a-47d3-913f-310f2f7ed7de Article (Published version) Public analysis_of_intraoperative_visual_e1.pdf 464905 application/pdf CC BY-NC-ND-4.0 61580cd5035d44dd24b2e973c51f6eb6e4ac24da28a5b9c5456d0e53a8815175 openAccess Faculté de médecine / Section de médecine clinique / Département des neurosciences cliniques

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Analysis of Intraoperative Visual Evoked Potentials for Inclusion of Unstable Electroretinograms	Journal of clinical neurophysiology			2025	31	183

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Cochard, Eva Cécile