Diagnostic power of visual evoked potentials in children

VEP (Visual Evoked Potential) is a non-invasive neurophysiological method that objectively evaluates the functionality of the visual system. This technique records the brain cortex's response to visual stimuli and is used to detect potential pathologies in the visual pathways. Dysfunction at any point in the visual pathways, which consist of the retina, optic nerve, and occipital cortex, can be identified through VEP measurements. In our thesis study, the diagnostic power of VEP testing in pediatric age groups for diseases affecting the visual pathways was evaluated. A retrospective analysis was conducted on 584 VEP records of pediatric patients, and data from 292 patients aged between 10 and 18 were included in the study. The age, gender, preliminary diagnosis, final diagnosis, pattern VEP findings, brain and orbital MRI findings affecting VEP, and serum 25OH vitamin D levels were obtained from the patients' medical records and documented. In our study, which evaluated visual functions in 584 eyes based on 292 VEP test results, abnormalities in VEP were detected in a total of 106 cases, including 86 patients with bilateral abnormalities. All patients with VEP abnormalities were shown to have a pathology affecting the visual pathways. The VEP test supported the diagnosis in %47 of the evaluated eyes and 36% of the patients. The most common presenting complaint among patients scheduled for VEP was visual impairment (%52). The proportion of patients with latency prolongation in demyelinating diseases was significantly higher compared to those with normal latency. However, ROC analysis results indicated that the 120 ms cut-off point for P100 latency in the literature demonstrated the best diagnostic performance in our MS patient group. Our study emphasizes the contribution of VEP, particularly in conditions such as optic neuritis, MS, and PTS, to diagnosis and patient management. It also highlights that combining this method with other diagnostic could improve diagnostic accuracy.