Electrophysiological examination in uveitis: a review of the literature

Abstract

Purpose: Uveitis 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.

Methods: We 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.

Results: Our 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.

Conclusion: This 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.

Keywords: ERG; VEP; mfERG; uveitis.

Figure 1

(A and B) Fundus of a 30-year-old man diagnosed with acute multifocal placoid pigment epitheliopathy. (A) Acute phase of disease; (B) scar phase of the disease.

Figure 2

(A) Electrooculogram recording of the same patient as in Figure 1, showing decrease in the acute phase in both eyes. (B) Electrooculogram showing improvement after treatment.

Figure 3

Fundus photograph in a 56-year-old woman with birdshot chorioretinopathy (A) before and (B) after treatment. Note: Left images correspond to the left eye and right images correspond to the right eye.

Figure 4

(A) Electroretinogram recordings before treatment. (B) Electroretinogram recordings after treatment. b-Wave amplitude is increased. Abbreviation: ms, millisecond.

Figure 5

Fundus photograph of the right eye of a patient with Adamantiades–Behçet disease, showing optic nerve involvement.

Figure 6

Visual evoked potential recording shows increased latency of P100 to 124.9 milliseconds. Abbreviations: ms, millisecond; R, right eye; OZ, mid-occipital electrode is placed on the midline.