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Marmoy OR, Viswanathan S. Clinical electrophysiology of the optic nerve and retinal ganglion cells. Eye (Lond) 2021; 35:2386-2405. [PMID: 34117382 PMCID: PMC8377055 DOI: 10.1038/s41433-021-01614-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/11/2021] [Accepted: 05/19/2021] [Indexed: 12/28/2022] Open
Abstract
Clinical electrophysiological assessment of optic nerve and retinal ganglion cell function can be performed using the Pattern Electroretinogram (PERG), Visual Evoked Potential (VEP) and the Photopic Negative Response (PhNR) amongst other more specialised techniques. In this review, we describe these electrophysiological techniques and their application in diseases affecting the optic nerve and retinal ganglion cells with the exception of glaucoma. The disease groups discussed include hereditary, compressive, toxic/nutritional, traumatic, vascular, inflammatory and intracranial causes for optic nerve or retinal ganglion cell dysfunction. The benefits of objective, electrophysiological measurement of the retinal ganglion cells and optic nerve are discussed, as are their applications in clinical diagnosis of disease, determining prognosis, monitoring progression and response to novel therapies.
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Affiliation(s)
- Oliver R Marmoy
- Clinical and Academic Department of Ophthalmology, Great Ormond Street Hospital for Children, London, UK.
- UCL-GOS Institute for Child Health, University College London, London, UK.
- Manchester Metropolitan University, Manchester, UK.
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Filgueiras TG, Oyamada MK, Preti RC, Apóstolos-Pereira SL, Callegaro D, Monteiro MLR. Outer Retinal Dysfunction on Multifocal Electroretinography May Help Differentiating Multiple Sclerosis From Neuromyelitis Optica Spectrum Disorder. Front Neurol 2019; 10:928. [PMID: 31507527 PMCID: PMC6718638 DOI: 10.3389/fneur.2019.00928] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 08/09/2019] [Indexed: 12/14/2022] Open
Abstract
Purpose: To evaluate the intermediate and outer retina of patients with multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) using OCT and multifocal electroretinography (mf-ERG). Methods: Patients with MS (n = 30), NMOSD (n = 30), and healthy controls (n = 29) underwent visual field (VF), OCT, and mf-ERG testing. The eyes were distributed into 5 groups: MS with or without history of ON (MS+ON, MS-ON), NMOSD with or without ON (NMOSD+ON, NMOSD-ON), and controls. The thickness of the macular retinal nerve fiber layer (mRNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer, outer plexiform layer, outer nuclear layer, and photoreceptor layer was measured. mf-ERG P1 and N1 responses were registered and grouped in 3 sets of rings. The groups were compared using GEE models, and effect size (ES) calculated. Results: Compared to controls, GCL and IPL thickness was significantly smaller in MS+ON (both p < 0.01), MS-ON (p < 0.01 and p = 0.015, respectively), NMOSD+ON (both p < 0.01) and NMOSD-ON (p = 0.03 and p = 0.018, respectively). ES was >0.80. mRNFL was smaller in three of the above groups (p < 0.01, p < 0.001, and p = 0.028; ES > 0.80) but not in MS-ON eyes (p = 0.18). No significant difference was observed for the remaining layers. Compared to controls, P1 and N1 peak times were shorter in MS (p-values in the range 0.049-0.002, ES < 0.50; and 0.049-0.010; ES < 0.50, respectively) but not in NMOSD. These abnormalities were strongly correlated with intermediate and outer retinal layer thickness. Conclusions: mf-ERG data suggest outer retinal abnormalities in MS, but not in NMOSD. Our results may help understand how the two conditions differ regarding retinal damage.
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Affiliation(s)
- Thiago G. Filgueiras
- Laboratory of Investigation in Ophthalmology (LIM 33), Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil
| | - Maria K. Oyamada
- Laboratory of Investigation in Ophthalmology (LIM 33), Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil
| | - Rony C. Preti
- Laboratory of Investigation in Ophthalmology (LIM 33), Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil
| | | | - Dagoberto Callegaro
- Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil
| | - Mário L. R. Monteiro
- Laboratory of Investigation in Ophthalmology (LIM 33), Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil
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Vecchi V, Maccolini E, Oddo Bravetti G, Guidelli Guidi S, Serra L. Transient Optic Neuropathy Secondary to Mopp Chemotherapy in Hodgkin's Disease: Report of a Case. TUMORI JOURNAL 2018; 70:571-3. [PMID: 6549418 DOI: 10.1177/030089168407000617] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The authors describe a case of optic neuropathy in a child undergoing MOPP chemotherapy for Hodgkin's disease stage IIISA. Visual acuity improved after substitution of the aforementioned regimen with ABVD chemotherapy, and reached 1 during maintenance therapy with vinblastine. Various neurologic deficits have been ascribed to vincristine, a well-known neurotoxin. This case of optic neuropathy is supposed to be a rare example of involvement of the 2nd cranial nerve due to vinca alkaloids. The absence of neurotoxicity of vinblastine in this case is emphasized.
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Ortiz G, Odom JV, Passaglia CL, Tzekov RT. Efferent influences on the bioelectrical activity of the retina in primates. Doc Ophthalmol 2016; 134:57-73. [PMID: 28032236 DOI: 10.1007/s10633-016-9567-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 12/13/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE The existence of retinopetal (sometimes referred to as "efferent" or "centrifugal") axons in the mammalian optic nerve is a topic of long-standing debate. Opposition is fading as efferent innervation of the retina has now been widely documented in rodents and other animals. The existence and function of an efferent system in humans and non-human primates has not, though, been definitively established. Such a feedback pathway could have important functional, clinical, and experimental significance to the field of vision science and ophthalmology. METHODS Following a comprehensive literature review (PubMed and Google Scholar, until July 2016), we present evidence regarding a system that can influence the bioelectrical activity of the retina in primates. RESULTS Anatomical and physiological evidences are presented separately. Improvements in histological staining and the advent of retrograde nerve fiber tracers have allowed for more confidence in the identification of efferent optic nerve fibers, including back to their point of origin. CONCLUSION Even with the accumulation of more modern anatomical and physiological evidence, some limitations and uncertainties about crucial details regarding the origins and role of a top-down, efferent system still exist. However, the summary of the evidence from earlier and more modern studies makes a compelling case in support of such a system in humans and non-human primates.
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Affiliation(s)
- Gonzalo Ortiz
- Department of Ophthalmology, University of South Florida, 12901 Bruce B. Downs Blvd., MDC 21, Tampa, FL, 33612, USA
| | - J Vernon Odom
- Department of Ophthalmology, West Virginia University, Morgantown, WV, USA
| | - Christopher L Passaglia
- Department of Ophthalmology, University of South Florida, 12901 Bruce B. Downs Blvd., MDC 21, Tampa, FL, 33612, USA.,Department of Chemical and Biomedical Engineering, University of South Florida, Tampa, FL, USA
| | - Radouil T Tzekov
- Department of Ophthalmology, University of South Florida, 12901 Bruce B. Downs Blvd., MDC 21, Tampa, FL, 33612, USA. .,The Roskamp Institute, Sarasota, FL, USA.
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Al-Louzi OA, Bhargava P, Newsome SD, Balcer LJ, Frohman EM, Crainiceanu C, Calabresi PA, Saidha S. Outer retinal changes following acute optic neuritis. Mult Scler 2015. [PMID: 26209589 DOI: 10.1177/1352458515590646] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Retinal nerve fiber and ganglion cell+inner plexiform (GCIP) layer thinning following multiple sclerosis-related acute optic neuritis (AON) is well described. However, whether AON results in changes in the inner nuclear (INL), outer plexiform (OPL), outer nuclear (ONL) and/or photoreceptor segment (PS) layers remains undetermined. OBJECTIVES The objective of this paper is to determine if INL+OPL and/or ONL+PS changes occur following AON. METHODS Thirty-three AON patients underwent serial optical coherence tomography (OCT) and visual function testing (mean follow-up: 25 months). Longitudinal changes in retinal layer thickness were analyzed using mixed-effects linear regression. RESULTS Four months following AON, the mean decrease in GCIP thickness relative to baseline was 11.4% (p < 0.001). At four months, a concomitant 3.4% increase in average ONL+PS thickness was observed (p < 0.001). The percentage decrease in GCIP thickness and increase in ONL+PS thickness were strongly correlated (r = -0.70; p < 0.001). Between months 4 to 12, ONL+PS thickness declined and, at 12 months, was no longer significantly different from baseline (mean change: 0.5%; p = 0.37). Similar, albeit less robust, changes in the INL+OPL were observed. CONCLUSIONS Following AON, dynamic changes occur in the deep retinal layers, which are proportional to GCIP thinning. These novel findings help further our understanding of the biological and/or anatomical sequelae resulting from AON.
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Affiliation(s)
- Omar A Al-Louzi
- Department of Neuroimmunology and Neuroinfectious Disorders, Johns Hopkins School of Medicine, USA
| | - Pavan Bhargava
- Department of Neuroimmunology and Neuroinfectious Disorders, Johns Hopkins School of Medicine, USA
| | - Scott D Newsome
- Department of Neuroimmunology and Neuroinfectious Disorders, Johns Hopkins School of Medicine, USA
| | - Laura J Balcer
- Department of Neurology, New York University-Langone Medical Center, USA
| | - Elliot M Frohman
- Departments of Neurology and Ophthalmology, University of Texas Southwestern, USA
| | - Ciprian Crainiceanu
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, USA
| | - Peter A Calabresi
- Department of Neuroimmunology and Neuroinfectious Disorders, Johns Hopkins School of Medicine, USA
| | - Shiv Saidha
- Department of Neuroimmunology and Neuroinfectious Disorders, Johns Hopkins School of Medicine, USA
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Stockard JJ, Hughes JF, Sharbrough FW. Visually Evoked Potentials to Electronic Pattern Reversal: Latency Variations with Gender, Age, and Technical Factors. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/00029238.1979.11079986] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Waldman HJ, Waldman SD. Evoked Potential Testing. Pain Manag 2011. [DOI: 10.1016/b978-1-4377-0721-2.00021-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Okuno T, Oku H, Sugasawa J, Utsumi T, Ikeda T. Shift of temporal responsivity curve of pattern reversal visually evoked potentials to lower frequencies in patients after recovery from optic neuritis. Acta Ophthalmol 2009; 87:780-3. [PMID: 18937806 DOI: 10.1111/j.1755-3768.2008.01341.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE To investigate the responsivity of the visual system to pattern reversal stimuli of different reversal rates in optic neuritis patients after a full recovery of visual acuity. METHODS Thirty eyes with optic neuritis and 30 eyes of age-matched normal controls were studied. Steady-state pattern reversal visually evoked potentials (P-VEPs) were recorded using reversal rates of 2, 10, 20 and 30 Hz. The relationship between the amplitudes of the P-VEPs and reversal rate was analysed. The temporal responsivity curves of the two groups were compared. RESULTS The means ± standard deviations (SDs) of the P-VEP amplitudes in the normal controls were 7.08 ± 2.97, 8.60 ± 2.37, 4.69 ± 1.99 and 2.11 ± 1.24 μV at reversal rates of 2, 10, 20 and 30 Hz, respectively. The comparable amplitudes from the recovered optic neuritis patients were 8.01 ± 2.45, 6.57 ± 2.54, 2.73 ± 1.76 and 0.94 ± 1.27 μV. The mean amplitude of the P-VEPs elicited at a reversal rate of 2 Hz was not significantly different from that of normal controls. However, the amplitudes of the P-VEPs at reversal rates of 10, 20 and 30 Hz were significantly smaller in the recovered optic neuritis patients than in the controls. In addition, the average maximum amplitude of the P-VEPs was obtained at 10 Hz in normal subjects and at 2 Hz in the recovered optic neuritis patients. CONCLUSION These results indicate that the peak of the temporal tuning curve of the P-VEP shifts to lower frequencies in recovered optic neuritis eyes, and that the reduced amplitudes at higher frequencies seem to be characteristic of the visual system of patients with recovered optic neuritis.
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Affiliation(s)
- Takashi Okuno
- Department of Ophthalmology, Osaka Medical College, Japan.
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Forooghian F, Adamus G, Sproule M, Westall C, O'Connor P. Enolase autoantibodies and retinal function in multiple sclerosis patients. Graefes Arch Clin Exp Ophthalmol 2007; 245:1077-84. [PMID: 17219105 DOI: 10.1007/s00417-006-0527-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2006] [Revised: 12/13/2006] [Accepted: 12/14/2006] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Electroretinographic (ERG) abnormalities have been reported in multiple sclerosis (MS), as well as the presence of circulating antiretinal antibodies. We and others have reported cases of impaired vision and diminished ERGs in MS patients with alpha-enolase autoantibodies. Anti-enolase antibodies have been implicated in autoimmune retinopathy. We performed this study to further explore the relationship between antiretinal antibodies and ERG changes in patients with MS. METHODS Patients with clinically definite MS and normal visual acuity were recruited for this study, along with healthy controls. All patients and controls had ERG testing done according to ISCEV standards. Patient and control sera were analyzed for the presence of antiretinal antibodies using Western blot and ELISA techniques, and HLA class II typing was performed using polymerase chain reaction. RESULTS We found a statistically significant difference between MS patients and controls in the rod-cone b-wave implicit time (p < 0.005). We found autoantibodies against alpha-enolase in 38% of MS patients and 11% of controls (p < 0.02). There was no statistically significant difference between ERG parameters of MS patients with alpha-enolase autoantibodies compared to those without alpha-enolase antibodies. Furthermore, the presence of alpha-enolase did not associate with a particular HLA haplotype. CONCLUSIONS Factors affecting the retina other than alpha-enolase antibodies may account for the delayed rod-cone b-wave implicit times observed in MS patients in this study. Anti-enolase antibodies are likely an epiphenomenon of autoimmune disease, and are not causing retinopathy in MS patients with normal visual acuity. However, the possibility of rare cases of patients with pathogenic alpha-enolase autoantibodies can not be excluded. The pathogenic contribution of these antibodies in MS patients with visual impairment deserves further investigation.
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Affiliation(s)
- Farzin Forooghian
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada.
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10
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Waldman HJ. Evoked Potential Testing. Pain Manag 2007. [DOI: 10.1016/b978-0-7216-0334-6.50021-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Uz E, Sahin S, Hepsen IF, Var A, Sogut S, Akyol O. The relationship between serum trace element changes and visual function in heavy smokers. ACTA OPHTHALMOLOGICA SCANDINAVICA 2003; 81:161-4. [PMID: 12752055 DOI: 10.1034/j.1600-0420.2003.00032.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE The aim of this prospective study was to evaluate serum manganese (Mn), zinc (Zn) and copper (Cu) levels and visual functions including visual acuity, colour vision, pattern visual evoked potentials (PVEPs), and contrast sensitivity in heavy smokers and to compare these with the equivalent levels and functions in non-smokers. METHODS Data were recorded in 24 healthy, chronic and heavy cigarette smokers and 16 healthy, non-smoking control subjects. Serum Zn, Cu and Mn concentrations in all subjects were measured by atomic absorption spectrophotometry. RESULTS Both study and control subjects had normal visual acuity and colour vision. Pattern visual evoked potentials were normal in all study and control subjects. Contrast sensitivity was significantly reduced in heavy smokers compared to non-smokers (p < 0.023), despite the fact that central vision and PVEP responses were not affected. Mean serum Mn and Zn levels were significantly lower in smokers than in non-smokers (p < 0.0001 and p < 0.005, respectively). CONCLUSIONS Reduced contrast sensitivity values associated with low levels of serum Mn and Zn, which function as cofactors of superoxide dismutase in erythrocyte and other nucleated cells, suggest a possible role of trace elements in smoking-induced early retinal toxicity.
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Affiliation(s)
- Efkan Uz
- Department of Medical Biology and Genetics, Suleyman Demirel University, Faculty of Medicine, Isparta, Turkey
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12
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Shpak AA. Diagnostic value of 33 Hz steady-state visual evoked potentials in low-vision children. ACTA OPHTHALMOLOGICA SCANDINAVICA 1995; 73:116-8. [PMID: 7656136 DOI: 10.1111/j.1600-0420.1995.tb00649.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Pattern-reversal visual evoked potentials elicited by patterns of 60' and 20' checks and 33 Hz steady-state flash visual evoked potentials were recorded in low-vision children (visual acuity less than 20/120) with optic atrophy (18 eyes), amblyopia (18 eyes), macular degeneration (7 eyes) and controls (24 eyes). Steady-state visual evoked potentials were non-recordable in 17 out of 18 eyes of optic atrophy patients and normal in other children. Abnormalities of pattern-reversal visual evoked potentials were similar in all groups of patients. 33 Hz steady-state flash visual evoked potentials are recommended for differential diagnosis of optic atrophy with other causes of low vision in children.
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Affiliation(s)
- A A Shpak
- IRTC Eye Microsurgery, Moscow, Russia
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13
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Sjöström A, Abrahamsson M. Patterned light flash evoked short latency activity in the visual system of visually normal and in amblyopic subjects. Acta Ophthalmol 1994; 72:195-202. [PMID: 8079625 DOI: 10.1111/j.1755-3768.1994.tb05016.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In a previous experimental study on anaesthetized cat it was shown that a short latency (35-40 ms) cortical potential changed polarity due to the presence or absence of a pattern in the flash stimulus. The results suggested one pathway of neuronal activation in the cortex to a pattern that was within the level of resolution and another to patterns that were not. It was implied that a similar difference in impulse transmission to pattern and non-pattern stimuli may be recorded in humans. The present paper describes recordings of the short-latency visual evoked response to varying light flash checkerboard pattern stimuli of high intensity in visually normal and amblyopic children and adults. When stimulating the normal eye a visual evoked response potential with a peak latency between 35 to 40 ms showed a polarity change to patterned compared to non-patterned stimulation. The visual evoked response resolution limit could be correlated to a visual acuity of 0.5 and below. In amblyopic eyes the shift in polarity was recorded at the acuity limit level. The latency of the pattern depending potential was increased in patients with amblyopia compared to normal, but not directly related to amblyopic degree. It is concluded that the short latency, visual evoked response that mainly represents the retino-geniculo-cortical activation may be used to estimate visual resolution below 0.5 in acuity level.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- A Sjöström
- Department of Opthalmology, Sahlgren's Hospital, University of Gothenburg, Sweden
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14
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Brigell M, Kaufman DI, Bobak P, Beydoun A. The pattern visual evoked potential. A multicenter study using standardized techniques. Doc Ophthalmol 1994; 86:65-79. [PMID: 7956687 DOI: 10.1007/bf01224629] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The peak latency of the pattern-reversal visual evoked potential is a sensitive measure of conduction delay in the optic nerve caused by demyelination. Despite its clinical utility, the pattern-reversal visual evoked potential has not previously been used in multicenter clinical trials, presumably because of difficulty in standardizing conditions between centers. To establish whether the pattern-reversal visual evoked potential could be adequately standardized for use as a measure in multicenter therapeutic trials for optic neuropathy or multiple sclerosis, stimulus and recording variables were equated at four centers and pattern-reversal visual evoked potentials were recorded from 64 normal subjects and 15 patients with resolved optic neuritis. Results showed equivalent latency and amplitude data from all centers, suggesting that stimulus and recording variables can be satisfactorily standardized for multicenter clinical trials. N70 and P100 peak latencies and N70-P100 interocular amplitude difference were sensitive measures of resolved optic neuritis.
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Affiliation(s)
- M Brigell
- Department of Neurology, Loyola University Chicago, Maywood, IL
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Janáky M, Szabó A, Benedek G. Elektrophysiologische und Ultraschall-Untersuchungen bei Neuritis retrobulbaris. SPEKTRUM DER AUGENHEILKUNDE 1993. [DOI: 10.1007/bf03163909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cadaveira F, Grau C, Roso M, Sanchez-Turet M. Multimodality exploration of event-related potentials in chronic alcoholics. Alcohol Clin Exp Res 1991; 15:607-11. [PMID: 1928634 DOI: 10.1111/j.1530-0277.1991.tb00568.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Short- and long-latency auditory evoked potentials (SAEPs and LAEPs), visual-evoked potentials (VEPs), and contingent negative variation (CNV) were studied in 32 chronic alcoholics and their age-, sex-, and education-matched control subjects. The alcoholics exhibited a delayed SAEP peak V and an increase in the III-V and I-V intervals, increased VEP P100 latency, increased LAEP N2 and P3 latencies and increased LAEP N1-P2 amplitude. The analysis of the anomalies at a clinical level indicates a differential sensitivity of the event-related potentials. The parameters most sensitive to chronic alcohol consumption were (in descending order) P3 latency, peak V latency, the I-V and III-V intervals, and P100 latency.
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Affiliation(s)
- F Cadaveira
- Department of Psychiatry and Clinical Psychobiology, Universitat de Barcelona, Spain
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17
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Holder GE. The incidence of abnormal pattern electroretinography in optic nerve demyelination. ELECTROENCEPHALOGRAPHY AND CLINICAL NEUROPHYSIOLOGY 1991; 78:18-26. [PMID: 1701710 DOI: 10.1016/0013-4694(91)90014-u] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This report describes the pattern electroretinogram (PERG) findings in 141 patients with optic nerve demyelination in one or both eyes. The overall incidence of PERG abnormality in the 199 eyes with abnormally delayed pattern visual evoked potential (PVEP) P100 component was 39.2%, with 84.6% of these PERG abnormalities being confined to the N95 component. The incidence of abnormal PERG was greater (53.3%) in those eyes with a history of retrobulbar neuritis than in those with sub-clinical demyelination (22.8%). The importance of stimulus parameters is noted. The value of the PERG in the improved interpretation of an abnormal PVEP is discussed.
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Affiliation(s)
- G E Holder
- Regional Dept. of Clinical Neurophysiology, Brook General Hospital, London, U.K
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18
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Shih YH, Huang ZJ, Chang CE. Color pattern-reversal visual evoked potential in eyes with ocular hypertension and primary open-angle glaucoma. Doc Ophthalmol 1991; 77:193-200. [PMID: 1760968 DOI: 10.1007/bf00161367] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Color pattern-reversal visual evoked potential testing was performed in 99 normal eyes, 27 eyes with ocular hypertension and 30 eyes with primary open-angle glaucoma with the use of black-white, black-red and black-blue color checkerboard stimuli. The P1 wave peak time and amplitude of the eyes with ocular hypertension and glaucoma were significantly different from those of age-similar normal eyes, especially on the black-red and black-blue checkerboards (p less than 0.001). The differences between the ocular hypertensive and glaucomatous eyes were of less significance. The P1 peak time difference between black-white and black-red checkerboards may serve as an important parameter in the early diagnosis of glaucoma.
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Affiliation(s)
- Y H Shih
- Beijing Institute of Ophthalmology, China
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19
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Lorenz R, Heider W. Retinal origin of VECP delays as revealed by simultaneously recorded ERG to patterned stimuli. Doc Ophthalmol 1990; 75:49-57. [PMID: 2265576 DOI: 10.1007/bf00142593] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Electroretinal and electrocortical potentials evoked by reversing checkerboards (PERG, PVECP) were simultaneously recorded in diseases of the central retina (10 patients) and in tumor-related optic nerve disorders (11 patients) exhibiting comparable P-100 delays in the PVECP. Retinal diseases showed a peak-time delay both in the PERG and in the PVECP, while optic nerve disorders revealed no delay in the PERG. Thus, simultaneous recording of PERG and PVECP may differentiate retinal from postretinal disorders of the visual system. The method also may provide information about the site of an underlying disorder in cases of visual disturbance without obvious changes of the ocular fundus.
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Affiliation(s)
- R Lorenz
- Max-Planck-Institute for Physiological and Clinical Research, Bad Nauheim, Germany
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Kermode AG, Plant GT, Miller DH, Kendall BE, McDonald WI. Tobacco-alcohol amblyopia: magnetic resonance imaging findings. J Neurol Neurosurg Psychiatry 1989; 52:1447. [PMID: 2614454 PMCID: PMC1031618 DOI: 10.1136/jnnp.52.12.1447] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Abstract
The pattern electroretinogram (PERG) has recently been introduced as a clinical procedure. It has been thought by many to represent activity of the retinal ganglion cells, although this is still a matter of contention. The exciting prospect of a selective test of ganglion cell function led to the application of the PERG in a variety of ophthalmological conditions. In the course of these investigations the PERG was found to be diminished in cases of maculopathy, optic atrophy, optic neuritis, toxic optic neuropathy, neurotransmitter disorders, glaucoma and ocular hypertension and in retinal vascular disorders such as diabetes. It was also affected in some cases of amblyopia. This paper briefly describes the techniques used to record the PERG and reviews current literature pertaining to its clinical application.
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Affiliation(s)
- B M Hull
- Department of Vision Sciences, Aston University, Birmingham, UK
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22
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Papakostopoulos D, Fotiou F, Hart JC, Banerji NK. The electroretinogram in multiple sclerosis and demyelinating optic neuritis. ELECTROENCEPHALOGRAPHY AND CLINICAL NEUROPHYSIOLOGY 1989; 74:1-10. [PMID: 2463143 DOI: 10.1016/0168-5597(89)90045-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The electroretinogram (ERG) to flashes of white light presented under photopic conditions and the pattern reversal visual evoked potentials (PR-VEPs) from both eyes were recorded from 14 patients with multiple sclerosis (MS) with monocular demyelinating optic neuritis (DON) and from 11 patients soon after presenting with monocular demyelinating optic neuritis alone. Fifteen and 10 normal subjects, matched for age and sex, were used as controls for each group of patients respectively. In the DON group of patients and controls the flicker following ERG (FF-ERG) to white flashes of light at 40 Hz was also recorded. Skin electrodes and averaging procedures were used for all the recordings. The PR-VEP elicited with stimulation of the affected eye was absent or abnormally delayed, and the amplitude of the 'b' wave of ERG of the affected eye was diminished in all patients. The 'b' wave latency, however, was similar in both affected and non-affected eyes and the controls. There was no difference in 'a' wave amplitude and latency between eyes of patients and normal subjects. The FF-ERG in 8 out of 10 patients with satisfactory recordings was diminished in the affected eye. These results provide neurophysiological evidence that retinal damage is not due to loss of myelin but is an early feature of demyelinating optic neuritis. This damage preferentially affects the retinal elements associated with the generation of the 'b' wave of the ERG, probably the glial cells of Müller.
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23
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Sandford NL, Saul RE. Assessment of hepatic encephalopathy with visual evoked potentials compared with conventional methods. Hepatology 1988; 8:1094-8. [PMID: 3417229 DOI: 10.1002/hep.1840080519] [Citation(s) in RCA: 32] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Thirty-six patients with advanced chronic liver disease of predominantly alcoholic etiology and with a documented history or current physical evidence of hepatic encephalopathy were studied and compared to 30 healthy controls. Assessment was made of their mental state, number connection test, venous blood ammonia, electroencephalography and visual evoked potentials with both pattern reversal and flash stimuli. Because of considerable inter- and intraindividual variation in waveform, visual evoked potentials from flash stimuli were considered unreliable. In pattern reversal visual evoked potentials, the latency of the N1 and P1 waves was significantly longer (p less than 0.05) in patients than in controls; however, the wave latencies did not correlate with the mental state score. The mental state score correlated with the number connection test (r = 0.69, p less than 0.001), asterixis (r = 0.36, p less than 0.05), electroencephalography mean dominant frequency (r = 0.44, p less than 0.01) and blood ammonia (r = 0.60, p less than 0.01). In 14 patients studied sequentially, change in the mental state score correlated with change in the number connection test (r = 0.80, p less than 0.01) and asterixis (r = 0.75, p less than 0.01) but not with change in the electroencephalography, blood ammonia or visual evoked potential wave latencies. Although visual evoked potentials are abnormal in patients with alcoholic cirrhosis and encephalopathy, they are less accurate in assessing the level of consciousness than simple bedside evaluation with a number connection test.
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Affiliation(s)
- N L Sandford
- Liver Unit, Rancho Los Amigos Medical Center, Downey, California 90242
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24
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Johnson LN, Yee RD, Hepler RS, Martin DA. Alteration of the visual evoked potential by macular holes: comparison with optic neuritis. Graefes Arch Clin Exp Ophthalmol 1987; 225:123-8. [PMID: 3582995 DOI: 10.1007/bf02160343] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Nine patients with maculopathy (macular holes, macular cysts, and lamellar holes) and ten patients with optic neuritis were examined in order to determine changes in the visual evoked potential (VEP) in response to pattern-reversal stimulation. Eyes with lamellar holes had normal P100 latency, but eyes with macular cysts and macular holes had prolonged P100 latency. Eyes with optic neuritis exhibited greater prolongation of the P100 latency than eyes with macular holes. In contrast, eyes with macular holes had a greater reduction in the steady-state VEP amplitude than eyes with optic neuritis. The prolonged latency occurring in maculopathy may be due to a peculiar amplitude summation noted with half-field VEP, rather than to a true conduction delay like that seen in eyes with optic neuritis. The amplitude slope, which is usually positive in normal controls, was negative for 85.7% of eyes with macular holes and 69.2% of eyes with optic neuritis. The negative amplitude slope may represent a subtle defect in retinal ganglion X cells. Eyes with significantly lower values for four or more of the nine central test points on quantitative automated perimetry had negative amplitude slopes and prolonged P100 latency.
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25
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Kerty E, Eide N, Skjeldal O. Visual evoked response in syphilitic optic atrophy. A case report. Acta Ophthalmol 1986; 64:553-6. [PMID: 3492857 DOI: 10.1111/j.1755-3768.1986.tb06972.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
A case of neurosyphilis is described. The presenting symptoms were reduced visual acuity and impaired colour vision. The examination revealed bilateral optic atrophy and acquired red-green colour defect. A syphilitic aetiology was based on positive serological tests in blood and CSF, pleocytosis and increased total protein in the CSF. The abrupt decline in visual acuity was arrested by treatment with penicillin and systemic steroids, but normalization of vision was not obtained. All VER-records, of P2 latencies and morphologies were surprisingly normal, but the amplitudes were reduced.
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26
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Sandrini G, Gelmi C, Rossi V, Bianchi PE, Alfonsi E, Pacchetti C, Verri AP, Nappi G. Electroretinographic and visual evoked potential abnormalities in myotonic dystrophy. ELECTROENCEPHALOGRAPHY AND CLINICAL NEUROPHYSIOLOGY 1986; 64:215-7. [PMID: 2427315 DOI: 10.1016/0013-4694(86)90168-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Pattern visual evoked potentials (VEPs) and electroretinograms (ERGs) were recorded in 20 patients with myotonic dystrophy. Thirteen out of 20 cases presented both VEP and ERG abnormalities, 3 only ERG alterations, 2 only abnormal VEPs. A significant inverse correlation between P100 latencies and b1 wave amplitude was observed, while N1-P100 and b1 wave amplitude exhibited a parallel change. These data suggest that retinal abnormalities may have a role in inducing subclinical visual pathway alterations in myotonic dystrophy.
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Chan YW, McLeod JG, Tuck RR, Walsh JC, Feary PA. Visual evoked responses in chronic alcoholics. J Neurol Neurosurg Psychiatry 1986; 49:945-50. [PMID: 3746328 PMCID: PMC1028958 DOI: 10.1136/jnnp.49.8.945] [Citation(s) in RCA: 35] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Visual evoked responses (VERs) were recorded on 52 chronic alcoholics patients without Wernicke-Korsakoff syndrome, 22 of whom had cerebellar ataxia, and eight chronic alcoholics with Wernicke-Korsakoff syndrome. Abnormal VERs were found in 23% of patients without and 37% of patients with Wernicke-Korsakoff syndrome. The main VER abnormalities of all the alcoholic groups were prolonged latency and reduced amplitude of the P100 component. Improvement followed a six month period of abstinence. VERs may be useful in the early detection of alcohol induced brain damage, and in following the progress of patients with the condition.
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Krumsiek J, Krüger C, Patzold U. Tobacco-alcohol amblyopia neuro-ophthalmological findings and clinical course. Acta Neurol Scand 1985; 72:180-7. [PMID: 4050326 DOI: 10.1111/j.1600-0404.1985.tb00861.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The clinical picture of 40 patients with tobacco-alcohol amblyopia (TAA) is described. In 15 patients the course of the disease was studied longitudinally over a period of 31 months. In addition in six patients the acute development of the disease was studied during a period of four weeks in-patient treatment. TAA is characterised by distinct bilateral visual disturbances, symmetric scotomas, acquired disturbances of colour vision and mostly normal fundi. Visual acuity is usually grossly diminished. Central scotomas were present in 80% of the cases while the centrocecal from prevailed in the rest. The acquired disturbances of colour vision usually concerned the red-green sense (84%). The amplitudes of the visual evoked potentials were always reduced and deformed. In 33% we could not detect a P-100. In 5% the latency of the P-100 was prolonged. Full field stimulation was the best method of defining the P-100. By foveal stimulation the deformations of the amplitudes were more evident. The prognosis of the visual disturbances was unpredictable. The abnormalities improved in one half of the patients, but complete recovery was never reached despite substitution with vitamins.
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Abstract
A 32-year-old fumigation assistant developed systemic and neuro-ophthalmic manifestations of methyl bromide poisoning, including increased serum bromide level (6.6 mg/100 ml), paresthesias and burning dysesthesia on his hands and feet, and visual impairment. Ocular examination showed mild bilateral decrease in vision, temporal optic nerve head pallor, severely attenuated visual-evoked response amplitudes and normal latencies, a normal electroretinogram, an abnormal electrooculogram, and a severe deuteranomalous (green) defect on Farnsworth-Munsell 100-hue testing. His vision had not improved 12 months after the initial exposure.
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30
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Smith JL. Myasthenia gravis and Charcot-Marie-Tooth disease. JOURNAL OF CLINICAL NEURO-OPHTHALMOLOGY 1985; 5:73-5. [PMID: 2947919 DOI: 10.3109/01658108509014425] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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31
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Wildberger H. Neuropathies of the optic nerve and visual evoked potentials with special reference to color vision and differential light threshold measured with the computer perimeter OCTOPUS. Doc Ophthalmol 1984; 58:147-227. [PMID: 6510191 DOI: 10.1007/bf00165761] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The contrast evoked potentials (VEPs) to different check sizes were recorded in about 200 cases of discrete optic neuropathies (ON) of different origin. Differential light threshold (DLT) was tested with the computer perimeter OCTOPUS. Saturated and desaturated tests were applied to evaluate the degree of acquired color vision deficiency. Delayed VEP responses are not confined to optic neuritis (RBN) alone and the different latency times obtained from other ON are confluent. The delay may be due to demyelination, to an increasing dominance of paramacular VEP subcomponents or to an increasing dominance of the upper half-field responses. Recording with smaller check sizes has the advantage that discrete dysfunctions in the visual field (VF) center are more easily detected: a correlation between amplitudes and visual acuity is best in strabismic amblyopias, is less expressed in maculopathies of the retina and weak in ON. The absence or reduction of amplitudes to smaller check sizes, however, is an important indication of a disorder in the VF center of ON in an early or recovered stage. Acquired color vision defects of the tritan-like type are more confined to discrete ON, whereas the red/green type is reserved to more severe ON. The DLT of the VF center is reduced in a different, significant and non significant extent in discrete optic neuropathies and the correlation between DLT and visual acuity is weak. A careful numerical analysis is needed in types of discrete ON where the central DLT lies within normal statistical limits: a side difference of the DLT between the affected and the normal fellow eye is always present. Evaluation of visual fatigue effects and of the relative sensitivity loss of VF center and VF periphery may provide further diagnostic information.
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32
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Persson HE, Wanger P. Pattern-reversal electroretinograms and visual evoked cortical potentials in multiple sclerosis. Br J Ophthalmol 1984; 68:760-4. [PMID: 6477857 PMCID: PMC1040461 DOI: 10.1136/bjo.68.10.760] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Pattern-reversal and flash electroretinograms (ERG) and visual evoked cortical potentials (VECP) were recorded from 15 patients with definite multiple sclerosis (MS). All patients had prolonged VECP latency, indicating demyelination of one or both optic nerves. The pattern-reversal ERG amplitude was reduced below the level of normal variation (mean -2 SD) in 11 of the 22 eyes with prolonged VECP latency and in one of the eight eyes with normal VECP latency. The mean pattern-reversal ERG amplitude from eyes with prolonged VECP latencies was significantly lower than the mean amplitude from the normal controls. No abnormalities were observed in the flash ERGs. Degeneration of retinal ganglion cell axons has been demonstrated in MS patients. The amplitude reduction in the pattern-reversal ERG, observed in some 50% of the eyes with prolonged VECP latencies, is supposed to reflect retinal ganglion cell dysfunction or degeneration secondary to demyelination of the optic nerve.
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Serra G, Carreras M, Tugnoli V, Manca M, Cristofori MC. Pattern electroretinogram in multiple sclerosis. J Neurol Neurosurg Psychiatry 1984; 47:879-83. [PMID: 6470731 PMCID: PMC1027957 DOI: 10.1136/jnnp.47.8.879] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The pattern electroretinogram obtained in patients affected by multiple sclerosis were compared with those in a normal population. The pattern electroretinogram amplitude in multiple sclerosis optic neuritis frequently appeared normal, but pattern electroretinogram amplitude abnormalities were found in patients suffering from recurrent multiple sclerosis optic neuritis. Pattern electroretinogram examination appears a useful method in the differential diagnosis between axonal and demyelinating optic nerve impairment.
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Abstract
It is commonly believed that diabetic optic neuropathy is very rare and visual loss in diabetes usually is attributed to other causes. We studied the extent of optic nerve involvement in 16 diabetics with no retinopathy or ocular disease and having an almost visual acuity, using visual evoked responses produced by pattern reversal stimulation. Comparing the responses with a group of 35 healthy subjects, the latency was increased by more than one standard deviation in 13 diabetics (81%) and by more than three standard deviations in 10 diabetics (62.5%), often associated with marked reduction in amplitude. There was good correlation between conduction in the optic nerve and peripheral sensory nerve. No correlation was noted to occur with duration of diabetes or diabetic control except perhaps with juvenile onset diabetes. Normal visual acuity was noted in many cases with severely slowed conduction showing early subclinical affection of optic nerves in diabetes. The extent of central nervous system involvement in diabetes has only recently been realised because of lack of physiological techniques and study of optic nerves in diabetes has not been attempted so far. The high incidence of abnormality of visual evoked potentials in diabetes could invalidate the usefulness of this test in diagnosing multiple sclerosis.
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35
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Kupersmith MJ, Weiss PA, Carr RE. The visual-evoked potential in tobacco-alcohol and nutritional amblyopia. Am J Ophthalmol 1983; 95:307-14. [PMID: 6829677 DOI: 10.1016/s0002-9394(14)78298-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Twelve subjects, nine with tobacco-alcohol amblyopia and three with nutritional amblyopia, were studied with pattern and flash visual-evoked potentials. We found abnormal steady-state responses in all 12 patients, including those with minor visual abnormalities, when the contrast of the stimulus was decreased. The latency of the first major positive wave (P100) of the flash- or pattern-evoked potential was not delayed in 11 of the 12 patients. The normal P100 latencies differed from the prolonged latencies found in other patients with loss of central nervous system myelin caused by vitamin B12 deficiency or multiple sclerosis.
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36
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MacCana F, Kulikowski JJ, Bhargava SK. CHANGES IN SPATIAL RESOLUTION FOR PATTERN AND MOVEMENT DETECTION IN CLINICAL CASES. Ophthalmic Physiol Opt 1983. [DOI: 10.1111/j.1475-1313.1983.tb00579.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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37
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MacCANA F, Bhargava SK, Kulikowski JJ. FLASH AND PATTERN VEPs: EXAMPLES OF CASES OF HYSTERICAL AMBLYOPIA AND PROVOKED VISUAL IMPAIRMENT (UHTHOFF'S SIGN). Ophthalmic Physiol Opt 1983. [DOI: 10.1111/j.1475-1313.1983.tb00580.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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38
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Patterson VH, Foster DH, Heron JR. Rod- and cone-mediated visual function in multiple sclerosis. J Neurol Sci 1982; 57:385-93. [PMID: 7161625 DOI: 10.1016/0022-510x(82)90043-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Visual thresholds and perceptual latencies were determined in patients with multiple sclerosis (MS) and in normal control subjects. Measurements were made under light- and dark-adapted conditions, with stimuli chosen to stimulate rod and cone receptors selectively. More abnormalities in perceptual latency and luminance threshold were recorded in the light-adapted condition than in the dark-adapted condition, but this result was not specific to the rod or cone systems. Possible underlying pathophysiological processes are discussed, and it is suggested that reduced conduction velocity in the demyelinated visual pathway is the most likely explanation of the observed perceptual delays and that there is no evident retinal contribution.
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39
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Coupland SG, Kirkham TH. Flash electroretinogram abnormalities in patients with clinically definite multiple sclerosis. Neurol Sci 1982; 9:325-30. [PMID: 7116240 DOI: 10.1017/s0317167100044152] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
We studied the flash electroretinograms (ERGs) of 105 patients with multiple sclerosis who were divided into four groups. The first group had no history or clinical evidence of optic nerve dysfunction, the second and third groups had either left or right optic nerve disease respectively, and the fourth group had historical or clinical evidence of bilateral optic nerve disease. Statistical analysis of the data using analysis of variance (ANOVA) showed that the group of patients with no history or clinical evidence of optic nerve disease had no significant difference from the control group for their peak b-wave implicit times but the other three groups were significantly delayed on the affected side(s). Using the Mann-Whitney U-test we found all four patient groups had significantly greater absolute interocular latency differences from the control group. The electroretinal contribution to flash VEP delay was also investigated. In those patients with unilateral or bilateral optic nerve disease we found that in 14-31% of those patients with flash VEP delay there was also abnormal prolongation of the ERG b-wave. These results confirm a high incidence of retinal dysfunction in multiple sclerosis patients and may suggest that transynaptic degeneration of retinal structures occurs in optic nerve demyelination. The significant absolute interocular latency difference in particular may provide another electrophysiological parameter to establish a diagnosis of multiple sclerosis in suspect cases.
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40
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Sherman J. Simultaneous pattern-reversal electroretinograms and visual evoked potentials in diseases of the macula and optic nerve. Ann N Y Acad Sci 1982; 388:214-26. [PMID: 6953869 DOI: 10.1111/j.1749-6632.1982.tb50793.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Although it is well established that the flash electroretinogram (ERG) is preganglionic in origin, conflicting evidence exists concerning the main source of the pattern-reversal ERG(PERG). In this study, PERGs were recorded simultaneously with visual evoked potentials (PVEPs) in a group of patients and controls. In those patients with obvious macular disease, both the PERG and PVEP were reduced, whereas the standard flash ERG was normal. This result is consistent with either a preganglionic or ganglion cell origin of the PERG. In those patients with obvious optic nerve disease (n = 7), normal or near-normal PERGs were recordable even when PVEPs were completely absent. If the PERG reflects ganglion cell activity, one would anticipate both abnormal PVEPs and PERGs in these patients. These results suggest a preganglionic origin of the PERG in humans.
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Guerreiro CA, Ehrenberg BL. Pattern shift visual evoked response: application in neurology. ARQUIVOS DE NEURO-PSIQUIATRIA 1982; 40:14-20. [PMID: 7092603 DOI: 10.1590/s0004-282x1982000100002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The technique that we use for pattern shift visual evoked response (PSVER) is described. PSVER is a non-invasive, practical and reliable clinical test in detecting anterior visual pathways lesions even when asymptomatic. The ability to find unsuspected lesions in multiple sclerosis, making possible an early diagnosis, is underscored. We also discuss some pathophysiologic aspects and the findings of the PSVER in some neurologic disorders with visual system involvement.
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44
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Abstract
The visually evoked potential is defined and described. The development of this test as a valuable clinical aid is traced. Its assistance in the diagnosis of Lesions of the Optic Nerve and Visual Pathways is shown, together with its use and assessment of visual acuity and visual fields both in infancy and adults. Future developments of this test are reviewed.
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45
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Abstract
A series of 21 patients admitted to St Thomas' Hospital, Medical Ophthalmology Unit, with a diagnosis of West Indian or West African amblyopia is reported. Patients were investigated for haematological, biochemical, serological, and radiological abnormalities and particular attention was paid to dietary history. Patients admitted in recent years also underwent neurophysiological investigations. No definite correlation between visual loss and dietary or family history was found, and there was no evidence that the improvement in vision which occurred in just under half the patients on follow-up was related to treatment with hydroxocobalamin or multivitamins. Visual-evoked responses in 4 patients showed a prolonged latency suggesting optic nerve demyelination, while in only one case was the electro-oculogram definitely subnormal. These findings contrast with those in 'toxic' amblyopias and suggest that the syndrome of West Indian amblyopoa may be due to bilateral optic nerve demyelination of unknown aetiology rather than the effect of toxic substances or nutritional deficiency on the retina.
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46
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Sherman J. SIMULTANEOUS PATTERN-REVERSAL ELECTRORETINOGRAMS AND VISUAL EVOKED POTENTIALS IN DISEASES OF THE MACULA AND OPTIC NERVE. Ann N Y Acad Sci 1980. [DOI: 10.1111/j.1749-6632.1980.tb19358.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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47
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van Lith GH. The application of visually evoked cerebral potentials in ophthalmological diagnosis. Clin Neurol Neurosurg 1980; 82:85-91. [PMID: 6254713 DOI: 10.1016/0303-8467(80)90002-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
A short survey is presented of what can be done with electrophysiological techniques in ophthalmological diagnosis. It is stressed that more investigation has to be done to elucidate the discrepancies between electrophysiological and psychophysical disturbances. These discrepancies can be used for the differential diagnosis. More, though still too little, is known about differences between a disturbance of latency time and that of amplitude. It seems that latencies are more disturbed in active pathological processes like demyelination, compression of nerve fibres and oedema, whereas isolated reduction of amplitudes occurs in optic atrophies. Some optic nerve diseases are found to be combined with ERG abnormalities, such as tobacco-alcohol neuropathy and some hereditary diseases.
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48
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Deltenre P, Vercruysse A, van Nechel C, Ketelaer P, Capon A, Colin F, Manil J. Early diagnosis of multiple sclerosis by combined multimodal evoked potentials: results and practical considerations. JOURNAL OF BIOMEDICAL ENGINEERING 1979; 1:17-21. [PMID: 537330 DOI: 10.1016/0141-5425(79)90006-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
It is shown that using four combined types of evoked potentials one can disclose new localisations in 62.5% of as yet undiagnosed M.S. patients. Brainstem auditory EP recordings must be considered in detail to avoid missing slight anomalies. Blink reflexes yielding bilateral R1 seem to bear the same significance as an augmented latency with respect to the problem of disclosing new localisations.
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