A Study of Visual Evoked Potential for Functional Assessment of Visual Pathway in Ophthalmologically Normal Diabetes Mellitus Patients

Document Type : Original Article


1 Department of Neurology, Nil Ratan Sircar Medical College and Hospital, West Bengal University of Health Sciences, Kolkata, West Bengal, India

2 Department of Internal Medicine, School of Medicine, University of Calcutta, Kolkata, India


Background and aim: Diabetic retinopathy(DR) is one of the most common complications of long-standing diabetes mellitus(DM). Early detection of this complication in the preclinical stages by Visual Evoked Potential (VEP) may help formulate management strategies to preserve Vision. With this background in mind, we conducted a cross-sectional study to measure the VEP of patients with DM.
Materials and methods: The study was conducted on 30 patients with diabetes mellitus(1 & 11) having no neurological or ophthalmological complications attending the diabetic clinic of RG Kar Medical College, Kolkata. Their PR-VEP(Pattern Reversal VEP) was measured in both eyes. Different VEP parameters(P100 & N75 waves) were compared with 30 age and sex-matched healthy controls and were statistically co-related with nerve conduction velocity, duration of diabetes, and Hb1Ac.
Results: The P100 & N75 wave peaks were significantly prolonged in diabetic patients compared to healthy non-diabetic control. Also, this prolongation was significant with the increasing duration of the disease.
Conclusion: Our study demonstrates that VEP prolongation in ophthalmologically normal DM patients may serve as an important screening tool to pick up visual dysfunction in the early stages.


Main Subjects

[1] Bhanu R, Shankar V, Kutty K, Annamalai N. Visual evoked potentials in non insulin dependent diabetes mellitus with-out retinopathy: A pilot study. Current Neurobiology 2012;3(1):55-59.
[2] Celesia GG, Brigell MG. Recommended standards for pattern electroretinograms and visual evoked potentials. The International Federation of Clinical Neurophysiology. Electroencephalography and clinical neurophysiology. Supplement. 1999;52:53-67.
[3] Chopra D, Gupta M, Manchanda KC, Sharma R S, Sidhu R S. A study of visual evoked potentials in patients of type 2 diabetes mellitus. Journal of Clinical& Diagnostic Research 2011; 5(3), 519-522.
[4] Dolu H, Ulas UH, Bolu E, Ozkardes A, Odabasi Z, Ozata M, et al. Evaluation of central neuropathy in type II diabetes mellitus by multimodal evoked potentials. Acta neurologica belgica. 2003;103(4):206-11.
[5] Gayathri V, Vijayalakshmi B, Chandrasekhar M. Electro physiological assessment of neuropathy in visual pathway of diabetes mellitus. Journal of diabetology. 2012;3(1):4.
[6] Green AJ. Visual evoked potentials, electroretinography, and other diagnostic approaches to the visual system. InAminoff's electrodiagnosis in clinical neurology 2012;477-503.
[7] Karlica D, Galetović D, Ivanisević M, Skrabić V, Znaor L, Jurišić D. Visual evoked potential can be used to detect a prediabetic form of diabetic retinopathy in patients with diabetes mellitus type I. Collegium antropologicum. 2010;34(2):525-9.
[8] Misra U. K., Kalita J. Visual Evoked Potentials. In Clinical Neurophysiology, U.K. Misra J. Kalita, 1st edition, B.I. Churchill Livingstone, New Delhi 1999; 249-266.
[9] Odom JV, Bach M, Brigell M, Holder GE, McCulloch DL, Tormene AP. ISCEV standard for clinical visual evoked potentials (2009 update). Documenta ophthalmologica. 2010;120(1):111-9. https://doi.org/10.1007/s10633-009-9195-4.
[10] Parisi V, Uccioli L, Parisi L, Colacino G, Manni G, Menzinger G, et al. Neural conduction in visual pathways in newly-diagnosed IDDM patients. Electroencephalography and Clinical Neurophysiology/Evoked Potentials Section. 1998;108(5):490-6. https://doi.org/10.1016/S0168-5597(98)00026-4.
[11] Di Russo F, Martínez A, Sereno MI, Pitzalis S, Hillyard SA. Cortical sources of the early components of the visual evoked potential. Human brain mapping. 2002;15(2):95-111. DOI10.1002/hbm.10010.
[12] Creel DJ. Visually evoked potentials. Handbook of clinical neurology. 2019;160:501-22. https://doi.org/10.1016/B978-0-444-64032-1.00034-5.