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. With objective, functional data, Light Induced Visual-response (LIV) allows for tailored treatment and more precise disease management. Original publication: http://info.diopsys.com/blog/light-induced-visual-response-liv

1. diopsys.com © Diopsys, Inc. 2018. All Rights Reserved.
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Alberto González García, MD, Chief Medical Officer, Diopsys
WHAT IS
LIGHT INDUCED VISUAL-RESPONSE (LIV)™?
Functional Response Guided Treatment
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?
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
With objective, functional data, Light Induced
Visual-response allows for tailored treatment
and more precise disease management.

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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.
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.
OBJECTIVE CLARITY. FUNCTIONAL INSIGHTS. ILLUMINATING RESULTS.
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.