Portable Diagnostic System for Age-Related Macular Degeneration Screening Using Visual Evoked Potentials.
Portable Diagnostic System for Age-Related Macular Degeneration Screening Using Visual Evoked Potentials.
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DOI：
10.2147/eb.s295745
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发表时间：
2021
期刊：
影响因子：
4.4
通讯作者：
Sridhar S
中科院分区：
文献类型：
--
作者：
Versek C;Banijamali SMA;Bex P;Lashkari K;Kamarthi S;Sridhar S
延迟暗适应视力恢复 (DAR) 是年龄相关性黄斑变性 (AMD) 的生物标志物，但其测量对患者和检查者来说都是负担。在这项研究中，我们开发了一种便携式、无线和用户友好的系统，该系统采用带有智能手机的耳机来提供受控的光漂白和单眼模式反转刺激，同时使用定制脑电图（EEG）电极和电子设备来客观地、单独地测量外围和中央视野的暗适应视觉诱发电位（DAVEP）。这是在一次舒适的 20 分钟会议中实现的，无需主题报告。对 12 名 AMD 患者、1 名退行性近视患者和 8 名未诊断出黄斑视力丧失的对照患者的双眼同时测量光漂白后长达 15 分钟的 DAVEP 反应。从刺激开始到暗视刺激的 200-500 ms 观察到强烈的正极性 DAVEP 反应，此前很少报道和分析。与对照组相比，AMD 患者的 DAVEP 反应幅度恢复明显延迟。我们开发了 DAVEP1 分数，这是 DAR 的一个简单指标，它可以正确分类 90% 的受试者眼睛，表明所有预先确诊的受试者中至少一只眼睛存在 AMD。我们开发了一种用户友好的便携式 VEP 系统和 DAVEP1 指标，显示出识别 AMD 患者 DAR 缺陷的巨大潜力。这项新技术可以帮助 AMD 的早期诊断。
Delayed Dark-Adapted vision Recovery (DAR) is a biomarker for Age-related Macular Degeneration (AMD), however its measurement is burdensome for patients and examiners. In this study, we developed a portable, wireless and user-friendly system that employs a headset with a smartphone to deliver controlled photo-bleach and monocular pattern reversal stimuli, while using custom electroencephalography (EEG) electrodes and electronics in order to measure Dark-Adapted Visual Evoked Potentials (DAVEP) objectively and separately at the peripheral and central visual field. This is achieved in one comfortable 20-minute session, without requiring subject reporting. DAVEP responses post photo-bleach for up to 15 minutes were measured concurrently from both eyes in 12 AMD-patients, 1 degenerative myopia patient, and 8 controls who had no diagnosed macular vision loss. Robust positive polarity DAVEP responses were observed at 200–500 ms from stimulus onset to scotopic stimuli that have been seldom reported and analyzed previously. The amplitude recovery of the DAVEP response was significantly delayed in AMD patients as compared to controls. We developed DAVEP1 scores, a simple metric for DAR, which classified 90% of subject eyes correctly, indicating the presence of AMD in at least one eye of all pre-confirmed subjects with this diagnosis. We developed a user-friendly, portable VEP system and DAVEP1 metric, which show a high potential to identify DAR-deficits in AMD-patients. This novel technology could aid in early diagnosis of AMD.