Electroretinogram (Erg) and Visual Evoked Response (Ver) Studies in Patients With Optic Disc Drusen

Mustonen, Eila; Sulg, I; Kallanranta, T.

doi:10.1111/j.1755-3768.1980.tb08295.x

Cited by 11 publications

(9 citation statements)

References 34 publications

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“…Moreover, while visual field loss due to ONHD has been described previously,11 it more frequently involves the lower nasal quadrant12 and visual acuity is well preserved;13 both are not the case in this patient. Finally, ERG of patients with ONHD has been shown to be normal 14. Taken together, the authors believe that ONHD was not the correct diagnosis in this patient.…”

Section: Discussionmentioning

confidence: 70%

Bilateral presumed astrocytic hamartomas in a patient with retinitis pigmentosa

Kinori

Moroz²,

Rotenstreich³

et al. 2011

OPTH

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Retinal astrocytic hamartomas are benign intraocular tumors classically associated with phacomatoses. Their appearance in isolation is rare. An association between astrocytic hamartomas and retinitis pigmentosa (RP) has been described previously, but controversy still exists regarding the precise nature of these lesions in RP patients. The authors present a case report of a 24-year-old male with RP and multiple bilateral lesions clinically consistent with retinal astrocytic hamartomas. Optical coherence tomography revealed multiple bilateral hyper-reflective intraretinal masses, loss of retinal architecture, intralesional calcifications, and prominent optical posterior shadowing. Comprehensive systemic evaluation was negative for phacomatoses. However, given that a biopsy was not performed, the diagnosis of optic nerve head drusen could not be excluded.

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Section: Discussionmentioning

confidence: 70%

Bilateral presumed astrocytic hamartomas in a patient with retinitis pigmentosa

Kinori

Moroz²,

Rotenstreich³

et al. 2011

OPTH

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“…Various ancillary tests, including B-scan ultrasonography, 55; 105; 151; 168 fundus autofluorescence, 95; 140; 145 orbital computed tomography (CT) scan, 12; 131; 162 fluorescein angiography (FA), 24; 159; 177 scanning laser ophthalmoscopy, 75; 103; 187 electrophysiology, 17; 18; 23; 142; 186 and more recently optical coherence tomography (OCT), 31; 88; 112; 125; 215 have been used to identify optic disc drusen. These tests may be less useful in children who typically have buried drusen that are more difficult to detect.…”

Section: Diagnostic Testingmentioning

confidence: 99%

“…186 Multiple investigators have studied visual evoked responses in eyes with optic disc drusen, and the results have been mixed, with P100 latency prolongation reported in 0 to 83% of eyes. 17; 18; 23; 121; 142; 186; 208 Given the variability in these electrophysiological changes, as well as the difficulty of performing these tests in young children, they are not routinely ordered for diagnosis of optic disc drusen in children.…”

Section: Diagnostic Testingmentioning

confidence: 99%

Optic disk drusen in children

Chang

Pineles

2016

Survey of Ophthalmology

112

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Optic disc drusen occur in 0.4% of children and consist of acellular intracellular and extracellular deposits that often become calcified over time. They are typically buried early in life and generally become superficial, and therefore visible, later in childhood, at the average age of 12 years. Their main clinical significance lies in the ability of optic disc drusen, particularly when buried, to simulate true optic disc edema. Misdiagnosing drusen as true disc edema may lead to an invasive and unnecessary workup for elevated intracranial pressure. Ancillary testing, including ultrasonography, fluorescein angiography, fundus autofluorescence, and optical coherence tomography, may aid in the correct diagnosis of optic disc drusen. Complications of optic disc drusen in children include visual field defects, hemorrhages, choroidal neovascular membrane, non-arteritic anterior ischemic optic neuropathy, and retinal vascular occlusions. Treatment options for these complications include ocular hypotensive agents for visual field defects and intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents for choroidal neovascular membranes. In most cases, however, children with optic disc drusen can be managed by observation with serial examinations and visual field testing, once true optic disc edema has been excluded.

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“…Of note, different techniques and inclusion–exclusion criteria were used in these studies, which makes detailed comparison difficult. For example, Mustonen et al9 included patients with concomitant eye disorders, and Scholl et al11 included eyes with suboptimal visual acuity and classified responses as abnormal if there was a delay in any one of the presented checkerboard patterns used for the study. The present study was motivated by these contradictory findings and by the availability of the recently developed mfVEP technique.…”

Section: Discussionmentioning

confidence: 99%

“…In cases of massive compression, latency delays are easily recognized using the pattern-reversal checkerboard visual evoked potential (VEP) 7,8. However when the compression is more subtle and localized, as may be the case in optic disc drusen, the delays may be obscured by the response from the surrounding healthy axons when local responses are summed, as with the VEP, especially considering the wide range of latencies in individuals with normal vision 9. These factors decrease the sensitivity of the VEP test in detecting localized latency delays and may play a role in the discrepancy among previous studies attempting to assess latency delays with the VEP in patients with optic disc drusen 9–11…”

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confidence: 99%

The Effects of Optic Disc Drusen on the Latency of the Pattern-Reversal Checkerboard and Multifocal Visual Evoked Potentials

Grippo

Ezon

Kanadani

et al. 2009

Invest. Ophthalmol. Vis. Sci.

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PURPOSE To determine the effect of optic disc drusen on the latency of the pattern-reversal checkerboard visual evoked potentials (VEPs) and multifocal (mf)VEPs and to better understand the pathophysiology of the condition. METHODS Eighteen eyes with optic disc drusen (10 patients) and 38 control eyes (19 subjects) underwent VEP, mfVEP, and visual field testing. Only one eye of each individual, the one with the more affected visual field, was used in the analyses. The VEPs were recorded with a 15′ and 60′ reversing checkerboard pattern, and the mfVEPs were elicited by a 60-sector dartboard display. RESULTS Unlike the VEP results, the mfVEP revealed a significant increase in the average monocular latency of the optic disc drusen group compared with that of the control group. The average mfVEP relative latency for the optic disc drusen group (4.1 ms) was greater than that (0.8 ms) in the control group. For monocular and interocular analyses, the average percentage of points delayed in the drusen group was significantly greater than that in the control group. CONCLUSIONS Optic disc drusen produced significant latency delays on the mfVEP test but not on the VEP test, presumably due to the mfVEP’s ability to detect the effects of local changes. The results are consistent with the hypothesis that local mechanical compression by optic disc drusen leads to abnormal retinal ganglion cell activity.

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Electroretinogram (Erg) and Visual Evoked Response (Ver) Studies in Patients With Optic Disc Drusen

Cited by 11 publications

References 34 publications

Bilateral presumed astrocytic hamartomas in a patient with retinitis pigmentosa

Bilateral presumed astrocytic hamartomas in a patient with retinitis pigmentosa

Optic disk drusen in children

The Effects of Optic Disc Drusen on the Latency of the Pattern-Reversal Checkerboard and Multifocal Visual Evoked Potentials

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