Portable Objective Diagnostics using Visual Evoked Potentials for Age-related Macular Degeneration

Abstract

AbstractDelayed Dark Adapted vision Recovery (DAR) is a biomarker for Age-related Macular Degeneration (AMD), however its measurement is burdensome for patients and examiners. We developed a portable, wireless, quick-setup system that employs a headset with a smartphone to deliver controlled photobleach and monocular pattern reversal stimuli, while using custom electroencephalography (EEG) electrodes and electronics in order to measure objective Dark Adapted Visual Evoked Potentials (DAVEP) at multiple locations of the visual field - all in one comfortable 20-minute session, without requiring subject reporting. DAVEP responses post photobleach (up to 15 minutes), were measured concurrently in both eyes of 13 patients with AMD and 8 others not diagnosed with AMD. New, unexpected features at high latencies were observed in the DAVEP responses to scotopic stimulus intensities. The amplitude recovery of the DAVEP response was significantly delayed in AMD patients compared with controls. We developed DAVEP1 scores, a simple metric for DAR, using it to successfully identify all 100% of AMD subjects and classify 90% of subject eyes correctly. Deficits in DAR in patients with AMD can be identified using this objective VEP based system and the DAVEP1 metric, a promising new objective biomarker for this disease that can be easily tested in a clinic.