Evaluation of Agreement Between Sweep Visual Evoked Potential Testing and Subjective Visual Acuity

OBJECTIVES: The primary objective of this study was to evaluate the agreement of visual acuity (VA) obtained with the sweep visual evoked potential (sVEP) method with the VA obtained with the Snellen chart. The secondary objective was to examine the effect of age and gender on agreement. MATERIALS AND METHODS: Best corrected VAs of subjects were recorded with the Snellen chart, and sVEP testing was performed according to the recommendations of the International Society for Clinical Electrophysiology of Vision (ISCEV). Snellen VAs and sVEP measurements were analyzed using logMAR conversion for statistical analysis. Agreement was evaluated with Bland-Altman analysis. RESULTS: The study included 49 subjects with a mean age of 53.5±17.3 years (range: 19-75 years) and mean Snellen VA of 0.31±0.32 logMAR (range: 1.3-0.0 logMAR). In the Bland-Altman analysis, the mean differences between the VA and sVEP measurements (VA-sVEP) were significantly different and outside the limits of agreement (p=0.035). A significant proportional bias (p=0.0007) was found in the regression analysis performed between VA-sVEP and the mean VA. According to the Bland-Altman analysis of sex subgroups, there was a significant difference between VA and sVEP measurements in female subjects (p=0.006). The difference between VA and sVEP measurement increased significantly with older age (R(2): 0.306, p<0.001, β: 0.05 [0.03, 0.08]). CONCLUSION: In conclusion, sVEP measurements and VAs did not show statistical agreement. Cranial anatomy and endocrine differences of the subjects may affect their sVEP measurements. The difference between the methods varies according to VA level. Directly using sVEP results instead of VA would not be appropriate.