Objective Assessment of Microperimetry Exam Using EEG Signals

PurposeTo evaluate the feasibility of detecting single-trial cortical responses to individual microperimetry (MP) stimuli using electroencephalography (EEG) under non-ideal synchronization conditions, and to explore EEG-based stimulus registration independent of patient responses. MethodsThis proof-of-concept study acquired EEG data from two healthy participants (12 trials) during MP testing using low- and high-intensity single-flash stimuli. Occipital EEG signals were recorded with an 8-channel portable system, band-pass filtered (4-49 Hz), normalized, and segmented into 600-ms epochs time-locked to MP stimuli using offline synchronization, resulting in an estimated temporal uncertainty of [~]250 ms. A bidirectional long short-term memory (BiLSTM) deep learning model classified stimulus-present versus stimulus-absent EEG segments. Performance was assessed using accuracy, sensitivity, specificity, and F1-score, with emphasis on feasibility rather than generalizability. ResultsAcross trials, EEG-based classification performance exceeded chance levels. For high-intensity stimuli, detection accuracy approached 80%, while low-intensity stimuli demonstrated greater inter-trial variability. Occipital electrode configurations consistently outperformed parietal or combined montages, consistent with visual cortex neuroanatomy. Despite the absence of hardware-level synchronization and single-trial analysis, detectable neural signatures of isolated MP flashes were observed. ConclusionThese findings demonstrate the feasibility of detecting single-flash MP stimuli from occipital EEG using deep learning, even under constrained acquisition conditions. While not intended for immediate clinical deployment, this work motivates future studies incorporating precise synchronization, optimized stimulus designs, and larger cohorts to evaluate EEG-augmented microperimetry as a potential objective adjunct to subjective functional testing. HighlightsO_LIEEG detects single-flash microperimetry stimuli without hardware-level synchronization C_LIO_LIOccipital EEG channels enable stimulus detection independent of patient responses C_LIO_LIBiLSTM deep learning decodes non-repetitive, long-duration microperimetry flashes C_LIO_LIDetection accuracy approaches 80% for high-intensity microperimetry stimuli C_LI