Portable device for VEP examination: continued development

Purpose Two years ago at the ISCEV meeting in Reims, we demonstrated a new portable device for examination of VEPs for which we received the Marmor Award for Clinical Innovation (initial award) In the meantime, we have tested practical use of the device and, on the basis of the results, some modifications were made Methods The main improvement represents introduction of an additional external visual stimulator The primary stimulator, based on a matrix of 32 LEDs built into the front of the device (distance from eyes is 7 5 cm), did not provide sufficiently high spatial frequency of pattern-reversal stimulation, and recorded VEPs had lower sensitivity in detection of the optic pathway pathologies (e g in optic neuritis, multiple sclerosis) The newly modified device can be connected and synchronized with a tablet generating standard pattern-reversal stimuli (check sizes 600 and 150 according to ISCEV standards) and any other stimuli, e g radial motion of a low contrast pattern for evaluation of motion-onset VEPs Results In 70 healthy subjects, it was verified that the parameters of VEPs recorded with the use of the new portable device did not differ significantly from parameters of VEPs acquired in standard laboratory conditions and that their intra- and inter-individual variability was comparable In 30 patients with optic neuritis (multiple sclerosis), the sensitivity of VEP examination with the use of the portable device did not differ from standard equipment, and moreover, its use enabled us to examine fully immobile patients even in their sitting or lying position (thanks to a special adjustable holder of the stimulating tablet) at their home environment In 15 schizophrenic patients, VEP examination was done during their visit in the psychiatric ambulance with the use of cognitive visual stimuli (confirming prolonged P300 latency in the majority of them) It was demonstrated that the device can be easily used even in poorly cooperative patients Conclusion We believe that the new version of the device is now ready for its diagnostic applications not only in neuroophthalmology but, owing to its mobility (all parts can be carried in one bag), also in other situations where functions of the visual pathway or CNS should be immediately verified We intended again to demonstrate the updated prototype live at the ISCEV 2020 meeting, but unfortunately due to the COVID-19 it is not possible this year A small production run of the device is now under construction and will be available to those who would like to help with further testing We are currently in search for a manufacturer of the device, the price of which should not exceed approximately $1,500 US