Electrophysiological examination in uveitis: a review of the literature

Abstract

PurposeUveitis is the inflammation of the uveal tract, which usually also affects the retina and vitreous humor. The electrophysiological examination is an objective ocular examination that includes the electroretinogram, visual evoked potentials, the electrooculogram, the multifocal electroretinogram, and multifocal visual evoked potentials. Our aim is to review the literature of the use of the electrophysiological examination in cases of uveitis.MethodsWe performed a systematic search of the literature of published papers until October 2012 using the PubMed search engine. The key terms that were used were “uveitis”, “electrophysiological examination”, “electroretinogram”, “visual evoked potentials”, “electrooculogram”, “multifocal electroretinogram”, and “multifocal visual evoked potentials” in multiple combinations. To the best of our knowledge, this is the first review concerning the assessment of electrophysiology in uveitis.ResultsOur search of the literature demonstrated that the electrophysiological examination, mainly by means of electroretinogram, multifocal electroretinogram, and visual evoked potentials, is performed in several cases of uveitis for many purposes, including diagnosis and monitoring of disease progression and treatment efficacy. The electrophysiological examination is more useful in patients with multiple evanescent white dot syndrome, acute posterior multifocal placoid pigment epitheliopathy, birdshot chorioretinopathy, Vogt–Koyanagi–Harada disease, Adamantiades–Behçet disease, ocular syphilis, and Fuchs heterochromic cyclitis.ConclusionThis review summarizes the use of the electrophysiological examination in uveitic patients and underlines its value as a useful tool in the objective assessment and the monitoring of the disease.

Melatonin as a Therapeutic Resource for Inflammatory Visual Diseases

“…The term uveitis describes different forms of ocular inflammation affecting the uveal tract (iris, ciliary body, and choroid), and adjacent ocular structures (retina, vitreous, and optic nerve) [ 4 ]. Being the fourth most frequent cause of blindness in the active population from developed countries, uveitis is a major cause of severe visual diminishment [ 70 - 72 ]. Uveitis comprises a wide range of clinical presentations, with different patterns, extent, etiologies, and tissue involved.…”

“…Uveitis comprises a wide range of clinical presentations, with different patterns, extent, etiologies, and tissue involved. Panuveitis, which is associated with the worst clinical prognosis, is a generalized inflammation affecting not only the whole uveal tract, but also the vitreous humor and the retina [ 4 , 72 ]. Uveal inflammation can appear as an acute disease, with a sudden onset, as a chronic long lasting inflammatory process, or a recurrent relapsing ailment.…”

“…Uveal inflammation can appear as an acute disease, with a sudden onset, as a chronic long lasting inflammatory process, or a recurrent relapsing ailment. The most important uveitic complications are cataract, vitreous opacities, cystoid macular edema, secondary glaucoma, band keratopathy, dragged disk vessels, retinal detachment, retinoschisis, and “retinitis pigmentosa-like” changes [ 4 , 72 ]. Classical consequences of uveitis include eye hyperemia and pain, photophobia, blurred vision, floaters, and low visual acuity.…”

“…The etiology of uveitis is wide, including general affections with secondary eye involvement, to primary ophthalmic disorders, such as ocular infections. However, in many cases, the specific cause is not recognized, thus uveitis is considered idiopathic [ 4 , 72 , 73 ]. In order to diagnose uveitis, a complete ophthalmologic examination is carried on, including visual acuity test, slit-lamp examination, intraocular pressure (IOP) measurement, and indirect fundus ophthalmoscopy [ 4 , 72 ].…”

Visual Electrodiagnostic Testing in Birdshot Chorioretinopathy

“…It is generally believed that visual electrophysiological testing could detect early changes and could be used to track the disease progression in uveitis and other retinal inflammatory diseases [ 15 , 16 ]. However, a more comprehensive look at the value and findings of such tests in BSCR is still lacking.…”