The Multifocal Visual Evoked Potential (VEP): Applications and Limitations in Neuro-Ophthalmology

Background To review the multifocal visual evoked potential (mfVEP) technique and to illustrate its use in neuroophthalmology. Methods Monocular mfVEP recordings were obtained from both eyes. The display, 44.5° in diameter, contained 60 sectors. Each sector was a pattern-reversing checkerboard. Probability plots, analogous to the probability plot of the Humphrey Visual Field (HVF) Analyzer, were created and compared to 24-2 HVFs. Results Five applications of the mfVEP were identified. The mfVEP is valuable for ruling out functional causes, diagnosing and following patients with optic neuritis/MS, evaluating patients with unreliable or questionable HVFs, and following disease progression. Conclusion When combined with static visual fields, the mfVEP is an important tool for the neuro-ophthalmologist. However, in its current form, it is best recorded and interpreted by ophthalmologists and electrophysiologists experienced with the technique.