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Purpose: To assess visual function in children with papilledema using sweep visual evoked potentials (VEP) to determine whether vision function improved following treatment., Methods: Contrast sensitivity and grating acuity were prospectively measured by using sweep visual evoked potential testing in children with mild or moderate acute papilledema. A subset of children were tested longitudinally before and after treatment. Subject data was compared with that of age-matched controls using the Wilcoxon-Mann-Whitney test., Results: A total of 9 subjects (age range, 9-16 years) and 11 controls were included; 5 subjects were studied longitudinally. The control group's logMAR grating acuity (mean, 0.09; range, -0.13 to 0.36) was better than that of the papilledema group (mean, 0.36; range 0.15-0.59). Four patients showed recovery of contrast sensitivity following treatment of their raised intracranial pressure between first and last visit., Conclusions: In our study cohort, sweep VEP was able to detect early improvement in contrast sensitivity despite absence of apparent clinical change in disk edema in children undergoing treatment for raised intracranial pressure., (Copyright © 2016 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.)

Purpose: We evaluated the Mollon-Reffin Minimalist (M-R M) color vision test to determine how successfully young children can perform the task and to compare success rates with the American Optical Hardy Rand Rittler (HRR) test and a preferential-looking type test based on the F2 plates (the Pease-Allen color test [PACT])., Methods: Participants included 146 children (aged 3-10 years) and 32 older subjects (aged 11-39 years). The M-R M test uses 3 series of colored caps coinciding with protan, deutan, and tritan confusion axes, with 6 saturations along each axis. The observer must identify a single colored cap from gray caps of varying lightness. The PACT test consists of 2 cards with targets for detecting red-green and blue-yellow color deficiencies. The tester judges the location of the target on the basis of the child's looking and/or pointing responses. The HRR was performed according to standard instructions, although a more flexible scoring protocol was also used., Results: A significant difference in the children's performance between the "test" item of the 3 tasks emerged (Cochran Q test, P<.001): all children successfully completed the M-R M, 90% successfully completed the PACT, and 88% successfully completed the HRR. Few errors were made on the M-R M red-green series, even among children aged 3 to 4 years, although errors were made with the least saturated blue-yellow cap at all ages. Recommendations are made for the use of the M-R M with children., Conclusions: The M-R M test can be performed by young children and may prove to be especially useful for detecting and monitoring acquired color vision defects.

Purpose: We investigated whether disparity between visually evoked potential (VEP) acuity scores and Teller Acuity Card (TAC) scores varied according to presence of ocular or neurologic conditions., Methods: Charts from 175 children (mean age, 34.8 months; range, 3 to 158 months) referred for visual acuity testing were examined. All children had been tested with pattern-alternation VEP and TAC and had undergone a complete eye examination. VEP and TAC acuity scores were relative to age-expected acuity scores for each acuity test. The absence and degree of macular abnormality, retinal abnormality, optic nerve hypoplasia, optic nerve atrophy, cortical visual impairment, developmental delay, cerebral palsy, seizures, and nystagmus were noted. Analysis of variance models were used to determine whether differences between VEP and TAC scores varied according to the presence of specific deficits. Logistic regression analysis determined whether degree of specific deficits was associated with a greater chance of inconsistency between VEP and TAC scores (>0.3 log unit difference)., Results: Inconsistent scores were found in 48% of children. Developmental delay was associated with relatively poorer TAC than VEP score, and the chance of inconsistency increased with severity of developmental delay., Conclusions: Diagnosis-dependent variability exists between TAC and VEP scores. Therefore knowledge of the clinical picture is necessary in interpretation of VEP and TAC scores. It is not clear which test is more useful when a disparity exists, either from this or previous studies. When visual acuity is assessed longitudinally in a given child, then consistency in method for acuity assessment is important.

Purpose: We compared techniques for analyzing visually evoked potential (VEP) asymmetry in children with albinism to find one that could be used effectively and efficiently., Method: Subjects included 21 child volunteers, ages 10 months to 6 years (control group) and 21 children with albinism, ages 2 months to 6 years (albinism group). Five-channel flash VEP was performed on all subjects. Electrodes were positioned at Oz, O1, O2, O3, and O4 (10/20 system). Data were analyzed by use of techniques previously described. These included inspection of the VEP waveforms, measurement of hemispheric waveform parameters, calculation of an asymmetry index, and use of a bipolar derivation between left and right hemispheric responses (interhemispheric difference potential). In addition, we quantified the interhemispheric difference potential by use of Pearson's correlation coefficient. Measurements of sensitivity and specificity determined the success of the 5 analysis paradigms. The accuracy of each paradigm represented the ability to classify the data according to volunteer or albinism group and is derived from both sensitivity and specificity measures., Results: Measurement of hemispheric differences in VEP waveform parameters was the least sensitive measure method for detecting multichannel VEP asymmetry in albinism. Comparison of left and right eye interhemispheric difference potential increased accuracy to 67%. Nonquantitative inspection of waveform demonstrated an accuracy of 76%. The asymmetry index and Pearson's correlate measure yielded accuracy rates of 79% and 83%, respectively., Conclusion: The efficiency and capability of Pearson's correlate measure in quantifying interhemispheric difference potentials to detect albinotic misrouting makes this a useful and practical technique in a pediatric clinic.