{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:52:43Z","timestamp":1790790763001,"version":"4.1.0"},"reference-count":19,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Preservation of visual function is important in surgery for suprasellar tumors. Visual evoked potentials (VEPs) are expected to play an important role in monitoring visual function during surgery. Given the lack of information in this field, the authors aimed to investigate the effects of optic nerve compression caused by suprasellar tumors to understand the possible usefulness of VEP monitoring using off-response (OFR) VEP.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Eleven healthy volunteers who underwent surgery for standard record confirmation and 32 patients with optic chiasm lesions who underwent surgery were examined. Preoperative, postoperative, and intraoperative VEPs were recorded. Propofol anesthesia was administered during intraoperative VEP monitoring. Patients who underwent surgery were monitored using the same stimulation method during surgery. Light stimulation was given from a luminant pad on the eyelids, and low-intensity stimulation with continuous 500-msec emission and 500 msec off was performed. The luminescence intensity of the stimulation was at a maximum of 8000 lx with three attenuation steps, each of which was recorded repeatedly.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>The OFR potentials and delay latencies decreased as stimulus intensity decreased. In the patient with temporal hemianopia, monocular stimulation produced the highest OFR in the contralateral occipital lobe of the stimulated eye. The authors recorded preoperative, intraoperative, and postoperative VEP in 32 patients and observed intraoperative changes in 23 patients. In the cases where VEP declined during intraoperative recording, it recovered when surgery was discontinued. Furthermore, 3 patients eventually achieved a higher VEP than that achieved at the beginning of the surgery, and rapid recovery was confirmed with visual field examination immediately after surgery. Of the 5 patients in whom VEP did not recover during surgery, 3 showed decreased visual field and acuity after surgery. In 15 cases, potential dropped temporarily but returned to the original potential, and their visual field recovered after surgery.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>OFR has a diagnostic element in the visual field, in which the maximal potential was recorded on the opposite side of the stimulus with monocular stimulation. Unambiguous determination required stimulation of different intensities in both eyes or 1 eye and multiple recording electrodes placed in the occiput. Monitoring the OFR provides real-time alerts, making it a valuable tool for visual function evaluation in suprasellar surgery.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.1.jns232118","type":"journal-article","created":{"date-parts":[[2024,4,13]],"date-time":"2024-04-13T01:29:14Z","timestamp":1712971754000},"page":"720-729","source":"Crossref","is-referenced-by-count":1,"title":["How should visual function monitoring be performed and interpreted in surgery for suprasellar tumors?"],"prefix":"10.3171","volume":"141","author":[{"given":"Atsushi","family":"Sato","sequence":"first","affiliation":[{"name":"Division of Neurosurgery, Ina Central Hospital, Ina, Nagano; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihiro","family":"Ogiwara","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Ina Central Hospital, Ina, Nagano; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuo","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Ina Central Hospital, Ina, Nagano; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","family":"Hongo","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Ina Central Hospital, Ina, Nagano; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuyoshi","family":"Horiuchi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"2","key":"b1","series-title":"J Neurosurg","first-page":"654","article-title":"Intraoperative monitoring with visual evoked potentials for brain surgeries","volume":"130","author":"Gutzwiller EM","year":"2018","unstructured":"Gutzwiller EM, Cabrilo I, Radovanovic I, Schaller K, Bo\u00ebx C. Intraoperative monitoring with visual evoked potentials for brain surgeries. J Neurosurg. 2018;130(2):654\u2013660."},{"issue":"8","key":"b2","series-title":"Neurol Med Chir (Tokyo)","first-page":"606","article-title":"Usefulness of intraoperative monitoring of visual evoked potentials in transsphenoidal surgery","volume":"54","author":"Kamio Y","year":"2014","unstructured":"Kamio Y, Sakai N, Sameshima T,  Usefulness of intraoperative monitoring of visual evoked potentials in transsphenoidal surgery. Neurol Med Chir (Tokyo). 2014;54(8):606\u2013611."},{"issue":"7","key":"b3","series-title":"Br J Ophthalmol","first-page":"454","article-title":"The asymmetrical visual evoked potential to pattern reversal in one half field and its significance for the analysis of visual field defects","volume":"61","author":"Blumhardt LD","year":"1977","unstructured":"Blumhardt LD, Barrett G, Halliday AM. The asymmetrical visual evoked potential to pattern reversal in one half field and its significance for the analysis of visual field defects. Br J Ophthalmol. 1977;61(7):454\u2013461."},{"issue":"4","key":"b4","series-title":"J Neurosurg","first-page":"888","article-title":"Interpretation of the causes of instability of flash visual evoked potentials in intraoperative monitoring and proposal of a recording method for reliable functional monitoring of visual evoked potentials using a light-emitting device","volume":"125","author":"Sato A","year":"2016","unstructured":"Sato A. Interpretation of the causes of instability of flash visual evoked potentials in intraoperative monitoring and proposal of a recording method for reliable functional monitoring of visual evoked potentials using a light-emitting device. J Neurosurg. 2016;125(4):888\u2013897."},{"key":"b5","series-title":"World Neurosurg","first-page":"e136","article-title":"The predictive role of intraoperative visual evoked potentials in visual improvement after endoscopic pituitary tumor resection in large and complex tumors: description and validation of a method","volume":"126","author":"Feng R","year":"2019","unstructured":"Feng R, Schwartz J, Loewenstern J,  The predictive role of intraoperative visual evoked potentials in visual improvement after endoscopic pituitary tumor resection in large and complex tumors: description and validation of a method. World Neurosurg. 2019;126:e136\u2013e143."},{"key":"b6","series-title":"Clin Neurol Neurosurg","first-page":"107149","article-title":"The clinical application of intraoperative visual evoked potential in recurrent craniopharyngiomas resected by extended endoscopic endonasal surgery","volume":"214","author":"Zhu H","year":"2022","unstructured":"Zhu H, Qiao N, Yang X,  The clinical application of intraoperative visual evoked potential in recurrent craniopharyngiomas resected by extended endoscopic endonasal surgery. Clin Neurol Neurosurg. 2022;214:107149."},{"issue":"5","key":"b7","series-title":"Neurosurgery","first-page":"709","article-title":"Are flash-evoked visual potentials useful for intraoperative monitoring of visual pathway function?","volume":"21","author":"Cedzich C","year":"1987","unstructured":"Cedzich C, Schramm J, Fahlbusch R. Are flash-evoked visual potentials useful for intraoperative monitoring of visual pathway function?. Neurosurgery. 1987;21(5):709\u2013715."},{"issue":"4","key":"b8","series-title":"Acta Neurochir (Wien)","first-page":"643","article-title":"Standard and limitation of intraoperative monitoring of the visual evoked potential","volume":"152","author":"Kodama K","year":"2010","unstructured":"Kodama K, Goto T, Sato A, Sakai K, Tanaka Y, Hongo K. Standard and limitation of intraoperative monitoring of the visual evoked potential. Acta Neurochir (Wien). 2010;152(4):643\u2013648."},{"issue":"4","key":"b9","series-title":"Can J Neurol Sci","first-page":"381","article-title":"The symptomatology of tumours of the anterior visual pathways","volume":"9","author":"McDonald WI","year":"1982","unstructured":"McDonald WI. The symptomatology of tumours of the anterior visual pathways. Can J Neurol Sci. 1982;9(4):381\u2013390."},{"issue":"6","key":"b10","series-title":"Oper Neurosurg (Hagerstown)","first-page":"516","article-title":"Comparison between conventional flash and off-response intraoperative visual evoked potential monitoring for endoscopic endonasal surgery","volume":"21","author":"Hardian RF","year":"2021","unstructured":"Hardian RF, Ogiwara T, Sato A,  Comparison between conventional flash and off-response intraoperative visual evoked potential monitoring for endoscopic endonasal surgery. Oper Neurosurg (Hagerstown). 2021;21(6):516\u2013522."},{"issue":"4","key":"b11","series-title":"Article in Japanese. No Shinkei Geka","first-page":"323","article-title":"A significant increase in intraoperative flash visual evoked potential amplitude during craniopharyngioma surgery-case report","volume":"43","author":"Kawaguchi T","year":"2015","unstructured":"Kawaguchi T, Ogawa Y, Fujiwara S, Tominaga T. A significant increase in intraoperative flash visual evoked potential amplitude during craniopharyngioma surgery-case report. Article in Japanese. No Shinkei Geka. 2015;43(4):323\u2013329."},{"issue":"11","key":"b12","series-title":"Acta Neurochir (Wien)","first-page":"2277","article-title":"Extended endoscopic endonasal resection of craniopharyngioma using intraoperative visual evoked potential monitoring: technical note","volume":"161","author":"Miyagishima T","year":"2019","unstructured":"Miyagishima T, Tosaka M, Yamaguchi R,  Extended endoscopic endonasal resection of craniopharyngioma using intraoperative visual evoked potential monitoring: technical note. Acta Neurochir (Wien). 2019;161(11):2277\u20132284."},{"issue":"10","key":"b13","series-title":"J Neurol Neurosurg Psychiatry","first-page":"890","article-title":"Visual evoked potential monitoring of optic nerve function during surgery","volume":"53","author":"Harding GF","year":"1990","unstructured":"Harding GF, Bland JD, Smith VH. Visual evoked potential monitoring of optic nerve function during surgery. J Neurol Neurosurg Psychiatry. 1990;53(10):890\u2013895."},{"issue":"1","key":"b14","series-title":"BMC Neurol","first-page":"287","article-title":"Intraoperative monitoring of visual evoked potentials in patients undergoing transsphenoidal surgery for pituitary adenoma: a systematic review","volume":"21","author":"Jashek-Ahmed F","year":"2021","unstructured":"Jashek-Ahmed F, Cabrilo I, Bal J,  Intraoperative monitoring of visual evoked potentials in patients undergoing transsphenoidal surgery for pituitary adenoma: a systematic review. BMC Neurol. 2021;21(1):287."},{"issue":"3","key":"b15","series-title":"Article in Japanese. No Shinkei Geka","first-page":"415","article-title":"Intraoperative Visual Evoked Potential","volume":"51","author":"Kawamata T","year":"2023","unstructured":"Kawamata T. Intraoperative Visual Evoked Potential. Article in Japanese. No Shinkei Geka. 2023;51(3):415\u2013424."},{"issue":"2","key":"b16","series-title":"J Neurosurg","first-page":"273","article-title":"Intraoperative monitoring of visual evoked potential: introduction of a clinically useful method","volume":"112","author":"Sasaki T","year":"2010","unstructured":"Sasaki T, Itakura T, Suzuki K,  Intraoperative monitoring of visual evoked potential: introduction of a clinically useful method. J Neurosurg. 2010;112(2):273\u2013284."},{"issue":"2","key":"b17","series-title":"Brain","first-page":"357","article-title":"The pattern-evoked potential in compression of the anterior visual pathways","volume":"99","author":"Halliday AM","year":"1976","unstructured":"Halliday AM, Halliday E, Kriss A, McDonald WI, Mushin J. The pattern-evoked potential in compression of the anterior visual pathways. Brain. 1976;99(2):357\u2013374."},{"issue":"6","key":"b18","series-title":"J AAPOS","first-page":"366","article-title":"Visual recovery after a year of craniopharyngioma-related amaurosis: report of a nine-year-old child and a review of pathophysiologic mechanisms","volume":"3","author":"Stark KL","year":"1999","unstructured":"Stark KL, Kaufman B, Lee BC, Primack J, Tychsen L. Visual recovery after a year of craniopharyngioma-related amaurosis: report of a nine-year-old child and a review of pathophysiologic mechanisms. J AAPOS. 1999;3(6):366\u2013371."},{"issue":"1","key":"b19","series-title":"Neurosurg Rev","first-page":"46","article-title":"Evolution of flash visual evoked potentials to monitor visual pathway integrity during tumor resection: illustrative cases and literature review","volume":"46","author":"Olmsted ZT","year":"2023","unstructured":"Olmsted ZT, Silverstein JW, Einstein EH,  Evolution of flash visual evoked potentials to monitor visual pathway integrity during tumor resection: illustrative cases and literature review. Neurosurg Rev. 2023;46(1):46."}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/141\/3\/article-p720.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/141\/3\/article-p720.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/141\/3\/article-p720.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T11:42:53Z","timestamp":1732621373000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/141\/3\/article-p720.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,1]]},"references-count":19,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2024.1.jns232118","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,1]]}}}