Documenta Ophthalmologica最新文献

{"title":"Characterization of functional and structural impairments in best vitelliform macular dystrophy using visual electrophysiology and optical coherence tomography in pediatric and adult patients.","authors":"Anna Polosa, Melissa Lu, Allison L Dorfman, Marisse Masis-Solano, Santiago Costantino, Cynthia X Qian","doi":"10.1007/s10633-025-10064-9","DOIUrl":"10.1007/s10633-025-10064-9","url":null,"abstract":"<p><strong>Purpose: </strong>To assess functional and anatomical impairments in pediatric patients and their affected adult family members with juvenile-onset Best vitelliform macular dystrophy (BVMD).</p><p><strong>Methods: </strong>Fifteen genetically confirmed BVMD patients (10 pediatric and 5 adults) underwent a comprehensive ophthalmic examination with multimodal imaging and electrophysiological testing. We quantified BVMD lesion volumes using sequential spectral-domain OCT (SD-OCT) scans, facilitating correlation with clinical parameters and electroretinogram (ERG) findings.</p><p><strong>Results: </strong>Children presented less advanced stages of BVMD than adults, had better visual acuity [Log MAR 0.13 ± 0.17] than adults [Log MAR 0.91 ± 0.52, p < 0.001], and displayed lower lesion volumes [0.93 ± 0.71 mm³] compared to adults [1.80 ± 0.79 mm³, p < 0.001]. Interestingly, in 3 eyes in Stage 3 disease (pseudohypopyon stage), despite a high lesion volume (1.74 ± 0.66 mm³), a good visual acuity was still observed (LogMAR of 0.00 in all 3 eyes). Multifocal ERG (mfERG) revealed macular dysfunction in all patients mostly pronounced in the 3 central rings [% of P1 reduction from control in Ring 1 in children and adults: 51% and 51%, Ring 2: 17% and 36% and Ring 3: 8% and 15%, respectively]. Furthermore, higher lesion volumes showed more affected mfERG responses. Full-field flash ERGs were normal in children, while reduced amplitudes and delayed responses were observed in some adults.</p><p><strong>Conclusion: </strong>While juvenile presentations of BVMD are less severe and more circumscribed, adult presentations demonstrate more widespread functional abnormalities in both amplitude and implicit times correlated with anatomical progression and clinical progression. Interestingly, mfERG responses in children with 20/20 vision also revealed functional impairment, correlating more strongly with the degree of vitelliform liquefaction on OCT than with visual acuity. Our findings suggest that mfERG may serve as an early, reliable indicator of functional defects in BVMD.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":"129-144"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145494914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monitoring outcomes of the first human whole eye allotransplant.","authors":"Vaidehi S Dedania, Alay R Shah, Sachin R Chinta, David L Tran, Scott E Brodie, Bruce E Gelb, Daniel J Ceradini, Eduardo D Rodriguez","doi":"10.1007/s10633-026-10083-0","DOIUrl":"10.1007/s10633-026-10083-0","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the first successful whole eye transplantation (WET) in a human, performed with concurrent partial face transplantation, and to characterize postoperative outcomes.</p><p><strong>Design: </strong>Case report.</p><p><strong>Participant: </strong>A 46-year-old male with severe facial and ocular deficits following high-voltage electrical injury, including left eye enucleation and extensive soft tissue and aesthetic deformities.</p><p><strong>Methods: </strong>Comprehensive preoperative evaluation, precise microsurgical techniques including vascular anastomosis and optic nerve coaptation, and serial postoperative assessments with optical coherence tomography (OCT), fluorescein angiography (FA), electroretinography (ERG), and visual evoked potentials (VEP).</p><p><strong>Main outcome measures: </strong>Sustained globe viability, vascular perfusion, retinal structural integrity, and electrophysiological function.</p><p><strong>Results: </strong>The transplanted globe demonstrated robust vascular perfusion and structural preservation over 12 months. Outer retinal function was maintained, as indicated by ERG, despite retinal nerve fiber layer loss and optic nerve transection. VEP confirmed absence of visual perception. The procedure achieved substantial aesthetic restoration.</p><p><strong>Conclusions: </strong>This study establishes the feasibility of WET in humans, with sustained globe viability and preserved outer retinal function. These findings serve as a critical step toward future exploration of ocular transplantation.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":"235-246"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anterior segment, static and dynamic pupillography changes in patients using different types of alpha-1 blockers.","authors":"Ramazan Birgul, Esat Kaan Akbay, Atilim Armağan Demirtaş, Hatice Daldal","doi":"10.1007/s10633-026-10094-x","DOIUrl":"https://doi.org/10.1007/s10633-026-10094-x","url":null,"abstract":"<p><strong>Aim: </strong>To investigate anterior segment and pupillary changes in patients with BPH (benign prostate hyperplasia) using different types of alpha-1 blockers.</p><p><strong>Materials and methods: </strong>The right eye of male patients using tamsulosin, siladosin, alfuzosin or doxazosin, and the right eye of male subjects in the control group were measured in the study. Anterior segment and pupillography measurements were performed using a Scheimpflug imaging technique of Sirius device. Central corneal thickness (CCT), corneal volume (CV), anterior chamber depth (ACD), anterior chamber angle (ACA), anterior chamber volume (ACV), scotopic, mesopic and photopic pupil sizes and dynamic pupil sizes at 0, 1, 2, 4, 6, 8 and 10 s (s) were measured.</p><p><strong>Results: </strong>Thirty-three patients using tamsulosin, 32 patients using siladosin, 31 patients using alfuzosin and 30 patients using doxazosin were compared with 34 patients in a control group. There was no statistically significant difference between the groups in age, CCT, CV, ACD, ACA, ACV, static pupillography under mesopic and photopic conditions. For three of the groups there was no statistically significant difference from the control group for either scotopic or dynamic pupillography, however pupil size was significantly smaller in the doxazosin group under both static and dynamic conditions.</p><p><strong>Conclusion: </strong>The alpha-1 blockers included in this study were those most commonly used in clinical practice. Our results showed that, as aspected, alpha-1 blockers do not change the anterior segment. Three of the groups showed no abnormal pupil behaviour, but the diameter was significantly smaller in the doxazosin group.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technical note: contour plot visualization of the light adapted electroretinogram using a generalized additive model.","authors":"Marek Brabec, Lynne Loh, Irene O Lee, Fernando Marmolejo-Ramos, David H Skuse, Dorothy A Thompson, Paul A Constable","doi":"10.1007/s10633-025-10078-3","DOIUrl":"10.1007/s10633-025-10078-3","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a new method to visualize the amplitude profile of light adapted ERGs as a series of contour plots in response to a Flash Strength series.</p><p><strong>Methods: </strong>Light adapted ERGs from a dataset of n = 88 Autism Spectrum Disorder (ASD) and n = 70 typically developing Control participants were used incorporating 10 flash strengths ranging from 12 to 446 Troland seconds (Td.s). The region chosen for analysis included the baseline, a-wave and ascending limb of the b-wave and included n = 1736 control and n = 1300 ASD waveforms. A Generalized Additive Model (GAM) with complexity penalized tensor product splines was applied to the waveform intervals.</p><p><strong>Results: </strong>Contour plots derived from the ASD and Control groups revealed a pattern of reduced amplitude in the ascending limb of the b-wave for the ASD group. Representative responses were derived from the GAM model for discrete Flash Strengths to exemplify the changing profile of the ERG waveform. A contour plot of the derived z-scores provided a qualitative evaluation of the differences in the mean amplitudes which was concentrated on the b-wave.</p><p><strong>Conclusions: </strong>The production of contour plots based on amplitude, time and Flash Strength with minimal a priori assumptions provide an additional approach to analyzing stimulus response data series and may support clinical applications. Additionally, the GAM-based methodology provides a tool for simultaneous investigation of the amplitude changes over time and Flash Strength which can be useful for theoretical purposes.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":"1-11"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12948813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145997487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A practical introduction to wavelet analysis in electroretinography.","authors":"Yousif J Shwetar, David S Lalush, Alice Y Zhang, J Jason McAnany, Brett G Jeffrey, Melissa A Haendel","doi":"10.1007/s10633-025-10070-x","DOIUrl":"10.1007/s10633-025-10070-x","url":null,"abstract":"<p><strong>Purpose: </strong>To provide a conceptual understanding of the continuous and discrete wavelet transforms (CWT, DWT) for clinical electroretinography (ERG) analysis, and how these methods uncover time-frequency features that complement traditional time-domain analysis.</p><p><strong>Methods: </strong>A technical overview without the use of mathematical formula describing the basics of CWT and DWT and implementation considerations. We also review an example of four standard ISCEV full-field ERG (ffERG) recordings from a healthy 32-year-old male.</p><p><strong>Results: </strong>Wavelet analysis uncovered time-frequency signatures absent in raw traces. In DA 0.01 cd s/m² DWT scalogram, energy localized in the 2-5 Hz range, with CWT scalograms corroborating these findings. In DA 3.0 cd s/m², a broader frequency response is seen across 10, 20 and 40 Hz center frequencies. A similar progression was found in the LA 3.0 cd s/m², with additional low energy indices at 80 and 160 Hz. For the LA 30 Hz flicker, all frequency and time-frequency profiles effectively replicated the 30 Hz response of the cone system.</p><p><strong>Conclusions: </strong>CWT and DWT provide complementary and objective insight into ERG responses. Open-source MATLAB toolkit and step-by-step tutorial provided herein lower technical barriers and enable use by the broader community.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":"23-31"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12948838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145762567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of visual evoked potential variability in eyes affected by optic neuritis and fellow eyes.","authors":"Marie Chutná, Jan Kremláček, Miroslav Kuba, Zuzana Kubová, Jana Szanyi, František Vít, Jana Langrová","doi":"10.1007/s10633-025-10061-y","DOIUrl":"10.1007/s10633-025-10061-y","url":null,"abstract":"<p><strong>Purpose: </strong>This study compared the variability of visual evoked potential (VEP) in response to stimulation of eyes affected by unilateral optic neuritis with that of fellow (non-affected) eyes.</p><p><strong>Methods: </strong>Pattern-reversal VEP (PVEP) and motion-onset VEP (MVEP) recordings from thirty-six subjects with unilateral optic neuritis at different intervals from disease onset were retrospectively evaluated, and differences in the following parameters were compared: signal‒to‒noise ratio (SRN), interquartile range of the response jitter (jitter IQR), and number of trials corresponding to the average response (corresponding N).</p><p><strong>Results: </strong>In the PVEP recordings, the P1 peak times of the fellow eyes were significantly shorter than those of the affected eyes (Cohen's d = -1.470, p < 0.001). P1 amplitudes were significantly greater in fellow eyes (d = 1.17, p < 0.001). Significant differences were found in the SNR (d = 0.782, p < 0.001), jitter IQR (d = -0.874, p < 0.001), and corresponding N (d = 0.700, p < 0.001). MVEP presented significantly shorter N2 peak times in fellow eyes than in affected eyes (d = 0.840, p < 0.01) and significantly greater amplitudes (d = 0.494, p = 0.002). There was a significant difference in the SNRs (d = 0.440, p = 0.01) and corresponding N values (d = 0.415, p = 0.01). There was no difference in the jitter IQR (d = 0.143, p = 0.230).</p><p><strong>Conclusions: </strong>The increased variability in eyes affected by optic neuritis compared with fellow eyes (in particular, in pattern-reversal VEP, which predominantly represents the activity of the macular-papillary fibers of the optic nerves) may represent important pathophysiologic features and may add valuable information to diagnostics via VEP examinations.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":"65-78"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12948876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145488117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rhegmatogenous retinal detachment in gyrate atrophy: a case report and review of literature.","authors":"Noel Fong, Yong Min Lee, Surbhi Agrawal, Shane Durkin, Franzco","doi":"10.1007/s10633-025-10073-8","DOIUrl":"10.1007/s10633-025-10073-8","url":null,"abstract":"<p><strong>Purpose: </strong>We present a rare case of a 25-year-old Polish male diagnosed with rhegmatogenous retinal detachment (RRD) on a background of gyrate atrophy (GA), successfully treated with pars plana vitrectomy (PPV) combined with cryotherapy and perfluoropropane (C3F8) gas tamponade.</p><p><strong>Methods: </strong>Regular ophthalmic examinations with optical coherence tomography were performed preoperatively and three months postoperatively.</p><p><strong>Results: </strong>The patient initially presented with acute loss of vision to counting fingers in the left eye secondary to a macula-off RRD. Intraoperatively, multiple circumferential skirts of vitreous bands and a peripheral break at 11 o'clock were identified. The break was treated with cryotherapy and C3F8 gas tamponade. The patient underwent left-sided cataract surgery six months following his vitrectomy and subsequently a YAG laser posterior capsulotomy. The retina remained attached at his 9-month follow up with a final best-corrected visual acuity of 6/9-1.</p><p><strong>Conclusions: </strong>PPV with cryotherapy and perfluoropropane tamponade can be an effective surgical approach in the management of RRD with underlying GA. Compared to previously reported cases, a favourable visual outcome was achieved in our case, likely attributed to the absence of other ophthalmic complications (such as proliferative vitreoretinopathy) and timely surgical intervention. Recognising atypical vitreous characteristics intraoperatively may refine surgical techniques and outcomes in similar cases. Future cases could consider an encircling scleral band for additional support, particularly in cases involving inferior retinal breaks.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":"79-84"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146029052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-altitude retinopathy with isolated ellipsoid zone loss: a case report.","authors":"Johnathan Abraham Bailey, Maximilian Daechul Kong, Baichun Hou, Abhdel Exinor, Caroline Bao, Stephen H Tsang","doi":"10.1007/s10633-025-10067-6","DOIUrl":"10.1007/s10633-025-10067-6","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a case of High-altitude retinopathy (HAR) and associated imaging and multimodal assessment.</p><p><strong>Methods: </strong>The patient was evaluated at Columbia University Irving Medical Center using a comprehensive multimodal imaging protocol that included color fundus photography, fundus autofluorescence (FAF), and spectral-domain optical coherence tomography (OCT). Functional assessments were conducted using full-field electroretinography (ERG), following the ISCEV standard protocols to ensure consistent and reproducible measurements of photoreceptor activity.</p><p><strong>Results: </strong>A 44-year-old woman with stable RP and previously remitted cystoid macular edema presented with acute bilateral blurry and distorted vision after climbing Mt. Kilimanjaro. OCT revealed new bilateral foveal EZ loss with preserved peripheral retina. OCT-A demonstrated intact retinal and choroidal perfusion, excluding ischemic injury. Dilated fundus examination (DFE) and autofluorescence were unchanged from baseline. Methazolamide was discontinued, and N-acetylcysteine (1800 mg BID) was initiated. At 3-month follow-up, visual acuity improved, and OCT showed partial EZ recovery, consistent with a metabolic or hypoxic insult.</p><p><strong>Conclusions: </strong>This case highlights a previously undescribed manifestation of HAR: isolated central photoreceptor damage without vascular involvement presenting as EZ line loss. The findings suggest that the high metabolic demand of foveal cones may predispose to hypoxia-induced injury, especially in patients with pre-existing retinal degeneration. Ophthalmologists should consider non-vascular mechanisms of high-altitude retinal injury, particularly in individuals with underlying retinal disease.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":"91-96"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145905872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fast ERG 15 Hz flicker protocol for assessing functional changes in the rod system.","authors":"Aleksandra Czarnek-Chudzik, Giulia Righetti, Ronja Jung, Melanie Kempf, Veronica Cuevas Villanueva, Katarzyna Nowomiejska, Robert Rejdak, Eberhart Zrenner, Katarina Stingl, Krunoslav Stingl","doi":"10.1007/s10633-025-10038-x","DOIUrl":"10.1007/s10633-025-10038-x","url":null,"abstract":"<p><strong>Purpose: </strong>To establish a clinically applicable dark-adapted 15 Hz flicker electroretinogram (ERG) for sensitive detection of functional changes in the fast and the slow retinal rod pathways.</p><p><strong>Methods: </strong>The study consisted of two parts. In the first part, the paradigm of the previously demonstrated \"null-effect\" of stimulus luminance on ERG-amplitudes for 15 Hz flicker stimuli with duration of 2.5 s was reexamined. In the second part an optimized faster protocol designed for routine clinical use was tested and compared with the results from the first part and data published in the past. The 15-Hz flicker ERG protocol included 12 steps with different intensities ranging from 0.00019 scot cd.s/m² to 0.05 scot cd.s/m² and was obtained from 15 normally sighted subjects. Stimulus flashes were presented in blue (448 nm) and white, alternating in each luminance step after 20 min of dark adaptation. A shorter version containing only 7 steps was selected with intensities ranging from 0.00031 scot cd.s/m² to 0.005 scot cd.s/m². Additionally, the stimulus paradigm included noise measurement to properly estimate the signal-to-noise ratio.</p><p><strong>Results: </strong>The results from the first protocol showed a U-shaped amplitude vs. luminance response curve at 15 Hz, consistent with previously published results. Using the new, shortened protocol, we also obtained similar results, but with a much shorter recording time. Based on the signal-to-noise ratio from these measurements a reliable measurement can be obtained in only 2.5 min which presents a considerable time reduction necessary to record a 15 Hz response curve in a clinical setup.</p><p><strong>Conclusion: </strong>The new protocol is suitable for integration into a daily clinical environment, offering short and well-balanced protocols to address complex retinal network interactions.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":"13-22"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12948902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of pulsed stimulation on objective and subjective visual acuity measurements in nystagmus.","authors":"Elisabeth V Quanz, Khaldoon O Al-Nosairy, Francie H Stolle, Juliane Kuske, Sven P Heinrich, Michael Bach, Michael B Hoffmann","doi":"10.1007/s10633-025-10060-z","DOIUrl":"10.1007/s10633-025-10060-z","url":null,"abstract":"<p><strong>Purpose: </strong>Quanz et al. (Sci Rep 14:16797, 2024) reported that participants with nystagmus had higher objective visual evoked potential visual acuity estimates (VA_VEP) by 0.12 logMAR relative compared to standard psychophysical VA (VA_{Psych_Stat}). The cause of this modest, but significant VA_VEP overestimation remains unclear. Here we investigated its association with the pattern-pulse stimulation mode applied for steady state VEP recording for VA_VEP estimation. Specifically, we tested whether psychophysical visual acuity to pulsed optotypes (VA_{Psych_Pulsed}) also exceeds standard optotype VA_{Psych_Stat}.</p><p><strong>Methods: </strong>Twelve participants with nystagmus were included in this analysis. VA_VEP was determined for pattern-pulse steady-state VEP stimulation (Quanz et al. in Sci Rep 14:16797, 2024) using EP2000, psychophysical VA was determined to stationary (VA_{Psych_Stat}) and to pulsed (VA_{Psych_Pulsed}) Landolt-C optotypes employing a modified version of the Freiburg Vision Test (FrACT). Pulsed stimulus timing was identical for VEP and VA (40 ms on and 93 ms off, i.e. at 7.5 Hz). In a separate measurement, fixation stability within the central 4° was determined using microperimetry (Nidek MP-1), and the eye with the stronger fixation instability was selected for the analysis (12 eyes). LogMAR differences were assessed with a paired t-test and the correlation of fixation stability and VA differences (ΔVA_Psych = VA_{Psych_Pulsed} - VA_{Psych_Stat}) was tested.</p><p><strong>Results: </strong>VA_{Psych_Stat} (0.43 ± 0.06 logMAR) and VA_{Psych_Pulsed} (0.45 ± 0.06 logMAR, P = 0.15) did not differ from each other, but from VA_VEP (0.26 ± 0.08 logMAR, P = 0.02 and P = 0.01, respectively). There was no correlation of ΔVA_Psych with fixation instability (r² = 0.002, P = 0.89).</p><p><strong>Conclusion: </strong>Pulsed stimulation appears not to be the reason for the VA_VEP overestimation in nystagmus. Further research should address whether differences in the spatial stimulus properties might be of relevance, as VA_Psych is tested with optotypes, VA_VEP with extended patterns.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":"85-90"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12948788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145437690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}