Pattern-reversal electroretinograms for the diagnosis and management of disorders of the anterior visual pathway

Abstract

Eletroretinograma de padrão reverso no diagnóstico e acompanhamento das afecções da via óptica anterior KENZO ABSTRACTThe pattern electroretinogram is an electrophysiological test that assesses the function of inner retinal layers, particularly the ganglion cells layer of retina, using a reversing checkerboard or grating pattern that produces no change in average luminance over time. The normal pattern electroretinogram is composed of a proeminent positive component (P50) and a large later negative component (N95). Since structural damage that compromises the retinal ganglion cell layer can lead to pattern electroretinogram changes, particularly in the N95 amplitude, the test can be useful in the treatment of a number of anterior visual pathway diseases. In this article, we review the methods for recording pattern electroretinogram and its usefulness in the diagnosis and management of diseases including inflammatory, hereditary, ischemic and compressive lesions of the anterior visual pathway. Keywords

Electrophysiological examination in uveitis: a review of the literature

“…The first, a small negative component, is N35, which is followed by a prominent positive component, P50, and finally a large negative component – N95 35. PERG is used primarily for the evaluation of the function of inner retinal layers and especially the ganglion cells layers of the retina 20,35. It is useful in detecting macular and inner retinal lesions that do not affect the flash ERG.…”

“…Furthermore, in the presence of an abnormal VEP recording, PERG can be used in order to determine if the abnormality is caused by macular or optic nerve dysfunction. In optic nerve dysfunctions, it is useful for quantification of neural loss 35. PERG is a significant testing method in glaucoma, and it can be also used as a predictor of the progression of ocular hypertension to glaucoma 22.…”

“…PERG is a significant testing method in glaucoma, and it can be also used as a predictor of the progression of ocular hypertension to glaucoma 22. Moreover, PERG is used for the diagnosis and management of several diseases, especially demyelinating optic neuropathies,22 toxic lesions of the anterior visual pathway, Leber’s hereditary optic neuropathy, dominant optic atrophy, multiple sclerosis, nonarteritic anterior ischemic optic neuropathy, and compressive diseases of the optic chiasm 35…”

Eletrorretinograma de padrão reverso (PERG) de campo total na esclerose múltipla e na neuromielite óptica e PERG multifocal na atrofia em banda do nervo óptico: correlação com os achados da tomografia de coerência óptica e da perimetria c

“…A seguir apresentaremos um artigo de revisão da literatura que aborda os principais aspectos a respeito da utilização do eletrorretinograma de padrão reverso no diagnóstico e avaliação das doenças que acometem a via óptica anterior (110) . Todos os pacientes foram submetidos ao exame oftalmológico completo incluindo: medida da acuidade visual corrigida, exame refracional dinâmico, pesquisa das reações pupilares, exame ocular externo, exame da motilidade ocular extrínseca, biomicroscopia do segmento anterior, medida da pressão intraocular com tonômetro de aplanação de Goldman e exame fundoscópico utilizando lente de 78 dioptrias.…”