The Pattern Electroretinogram in Optic Nerve Demyelination

Abstract

The pattern electroretinogram (PERG) is probably generated by the ganglion cell layer of the retina whose axons constitute the conductive fibres of the optic nerves. A study was undertaken of the PERG in a group of patients with clinically definite multiple sclerosis who had suffered optic nerve demyelination to assess the value of recording the PERG as a method for electrophysiological determination of optic nerve dysfunction. Pattern visual evoked potentials (PVEP) were simultaneously recorded, each eye being stimulated separately, and four different check sizes were used. Although individual patients showed PERG abnormalities the results as a group showed no significant difference from the normal population so far as latency or amplitude of the PERG was concerned. Thus we conclude that the PERG, while an interesting measurement, does not satisfactorily reflect optic nerve dysfunction. Further, our results indicate that it is not such a useful measure as the pattern visual evoked response for detecting optic nerve disease. RESUME: L'electroretinogramme evoque par des patterns (PERG) semble avoir son origine au niveau des cellules de la couche ganglionnaire de la retine dont les axones constituent les fibres conductrices des nerfs optiques. Chez des malades souffrant de sclerose en plaques et d'atteinte optique demyelinisante, nous avons analyse les donnees de l'electroretinogramme evoque par des patterns pour en evaluer I'utilite dans la detection des lesions du nerf optique. Bien que des electroretinogrammes anormaux (PERG) aient ete obtenus chez plusieurs malades, les differences de lantence et d'amplitude ne se sont pas revelees significatives en comparaison de celles d'un groupe temoin normal. L'electroretinogramme evoque par des patterns (PERG) ne reflete done pas fidelement la presence de demyelinisation dans les nerfs optiques; en outre, il ne se revele pas aussi efficace que l'enregistrement des potentiels evoques visuels obtenus par renversement de pattern pour detecter une atteinte des nerfs optiques.

Seeing Beyond Retinopathy in Diabetes: Electrophysiological and Psychophysical Abnormalities and Alterations in Vision

“…Some studies have suggested that the PERG can be altered while the flash ERG is unaffected in cases of optic nerve damage (8 -10), but contradictory evidence has suggested that PERG has little or no place in the study of optic nerve disease (11,12).…”

A comparison of oscillatory potential and pattern electroretinogram measures in diabetic retinopathy

“…PERGs have been reported as abnormal in a variety of optic nerve diseases including optic neuritis (Kirkham and Coupland, 1983;Mashima and Oguchi, 1985), glaucoma (Wanger and Persson, 1985;Bobak et al, 1981;Trick, 1985), and PERG loss has been reported in a neurometabolic storage disease with macular cherry-red spots . Recently we reported that in a small group of insulindependent OP and PERG abnormalities were present in some who had normal fundus examinations and retinal photography (Coupland, 1985).…”

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

“…Similar results have been reported by other authors (25,26) . On the other hand, Kirkham, Coupland (27) did not find differences between the PERG amplitudes in patients with MS related optic neuritis and normal controls and concluded that PERG did not satisfactorily reflect optic nerve dysfunction.…”