The quantitative effect of blue lenses on pediatric photoparoxysmal response

Jolanta Strzelecka, Tymon Skadorwa and Sergiusz Jóźwiak. The quantitative effect of blue lenses on pediatric photoparoxysmal response – an electroencephalographic cohort study. Seizure: European Journal of Epilepsy, in press.

Highlights

• Blue tinted lenses (Z1) reduce pediatric photoparoxysmal response (PPR) amplitude by 66%.

• Using Z1 lenses does not result in a complete PPR disappearance.

• There is no difference in PPR reduction between brain hemispheres and age groups.

• The improvement is slightly higher in children without epilepsy.

Abstract                                       

Purpose

To determine and quantify the effect of blue lenses (Z1) on photosensitivity (PS) suppression in patients aged 5-18 years with and without epilepsy. 

Methods

The retrospective cohort study was carried out in 100 pediatric patients aged 5-18 years with grade 4 PS assessed with EEG for medical indications. All EEG procedures were carried out and recordings assessed by two independent researchers. The study cohort was divided into groups with and without the diagnosis of epilepsy. The overall effect of the Z1 lenses on photoparoxysmal response (PPR) was determined by directly comparing the maximum discharge values in each patient without and with Z1 lenses in a within-subject design yielding the index of overall improvement (IOI). The differences in PS suppression by brain region and side were assessed by an additional between-subject comparison of age groups (below and above 14 years). Then, overall findings were compared with the PPR change criteria developed in 2006 by Capovilla (PPR disappearance, persistence, or attenuation) which warranted another subset analysis. Finally, in a between-subject design, we assessed whether the presence of epilepsy affects the intensity of PPR in children with PS, compared to non-epilepsy children. 

Results

The IOI in the entire cohort was 66.1±2.5% ( P <0.001). There were no significant differences in IOI between the left and right hemispheres, between the age groups, and between the epilepsy and non-epilepsy groups, despite some qualitative variation. With reference to literature findings, whereas median IOI were comparable in PPR disappearance and attenuation subsets, they differed significantly from the median IOI in the PPR persistence subset. 

Conclusion

Using Z1 lenses results in neither a complete PPR disappearance, nor a complete lack of effect. However, the correlation between the quantified PS suppression and the Z1 filter may be expected to become a valuable piece of information for both clinicians and manufacturers.