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Light Induced Visual-response (LIV)

Introduction:

Light Induced Visual-response (LIV) measures the electrical responses of cells within the eye upon stimulation by a light source. Various stimuli can be used to target different cells within the visual pathway to gain objective information regarding their function, thus allowing clinicians to detect even subtle changes in cell health and viability. But what is the real value of LIV?

With objective, functional data, Light Induced Visual-response allows for tailored treatment and more precise disease management.


Functional Response Guided TreatmentLight Induced Visual-response

As eye care stands on the precipice of potentially paradigm shifting treatments for common diseases like diabetic retinopathy (DR), measuring effectiveness is crucial. For the past decade-plus, laser treatment has been the preferred option for patients with DR that does not affect the macula. However, the recent approval of anti-VEGF therapy for any stage of DR (regardless of macular involvement) is poised to change the approach.

For practical purposes, deciding who to treat, when to treat and whether to stop or continue therapy with anti-VEGF agents will require information about treatment effectiveness. While OCT is one way to approach these questions, it only provides information about posterior pole (rather than retinal) structure. To maximize the efficacy of treatment of diabetic retinopathy, what clinicians really need is objective information about retinal function—precisely the kind of results that LIV testing can deliver – data to guide treatment of diabetic retinopathy patients with or without edema.

Tracking treatment efficacy is not limited to DR. The functional information LIV testing provides is beneficial for patient management in a number of different diseases, including CRVO,  glaucoma, and toxic retinopathies.1-4

Testing Features

All Diopsys® LIV tests have some important things in common.

1 They are all objective measurements of function (albeit at different parts of the visual pathway).

2 Testing is non-invasive, and uses sensors that are attached to the patients’ skin.

3 All testing platforms have a small physical footprint to fit into any practice.

4 Streamlined testing protocols and reports use documented references ranges for color-coding.


Conclusion:

Light Induced Visual-response (LIV) testing is a powerful tool for eye care specialists and is applicable across a broad range of eye disease, including diabetic retinopathy, glaucoma, optic neuritis, retinal toxicities, CRVO, and uveitis.1-6 There are applications in anterior segment eye care as well—for instance, evaluating the retina in the presence of a dense cataract that would otherwise limit the potential to perform imaging.7

More broadly, LIV tests allow you to objectively evaluate retinal and visual pathway health now and over time for early detection, tailored treatment and more precise disease management.


1. Holm K, et al. Peripheral retinal function assessed with 30-Hz flicker seems to improve after treatment with Lucentis in patients with diabetic macular oedema. Doc Ophthalmol. 2015;131:43-51. 2. Yasuda S, et al. Flicker electroretinograms before and after intravitreal ranibizumab injection in eyes with central retinal vein occlusion. Acta Ophthalmol. 2015;93:e465-8. 3. Banitt MR, et al. Progressive Loss of Retinal Ganglion Cell Function Precedes Structural Loss by Several Years in Glaucoma Suspects. Invest. Ophthalmol. Vis. Sci. 2013;54(3):2346-2352. 4. Dettoraki M, Moschos MM. The Role of Multifocal Electroretinography in the Assessment of Drug-Induced Retinopathy: A Review of the Literature. Ophthalmic Res 2016;56:169–177. 5. Naismith et al. Optical coherence tomography Is less sensitive than visual evoked potentials in optic neuritis. Neurology. 2009 Jul 7;73(1):46-52. 6. Moschos MM, et al. Electrophysiological examination in uveitis: a review of the literature. Clin Ophthalmol. 2014;8:199-214. 7. Ratanapakorn T, et al. Effect of cataract on electroretinographic response. J Med Assoc Thai. 2010 Oct;93(10):1196-9.

Topics: Visual Electrophysiology

Modern Visual Electrophysiology

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As the world leader in modern visual electrophysiology, Diopsys, Inc. has done more than any other company to advance the use of ERG and VEP in the eye care practice. Read through our blog to gain valuable insights into the benefits and integration of this valuable technology.

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