Has isolated check VEP finally come out of its infancy?

Excerpt

Human visual evoked potentials (VEP) have first been recorded and applied clinically initially using flash stimulation in the 1940s and 1950s [1]. It was not until the mid-1960s that advancement in microelectronics allowed the use of more sophisticated equipment to provide a patterned stimulation (reversing checkerboard pattern) to the central retina in order to evoke a pattern VEP for experimental [2] and clinical [3] purposes. The advantage of the pattern VEP is in its simple outline and better reproducibility compared to the flash VEP and better correlation with central visual function. At the same time, pattern-reversal VEP, the most used clinical type of VEP today, carries some disadvantages, like the necessity for refractive correction and stable monocular fixation during the whole period of stimulation, which at the rate of stimulation, recommended by the International Society for Clinical Electrophysiology of Vision (ISCEV) [4] of 2 reversals per second, would lead to a recording time of 50 s per stimulus check size (for averaging the responses generated by 100 reversals). Given the minimum use of two check sizes recommended by ISCEV, the nature of monocular stimulation, the pseudo motion illusion that reversing pattern creates, the recommendation for a repeated recording to demonstrate reproducibility and the requirement of a stable fixation of the center of the checkerboard pattern can lead to fatigue and relatively poor performance, which can complicate the clinical interpretation of the results. …