Elbaz Hisham, Besgen Volker, Rechberger Klara, Sekundo Walter, Apfelstedt-Sylla Eckart
Ophthalmology Department, Klinikum Barnim, Werner Forßmann Krankenhaus, Eberswalde, Germany.
Ophthalmology Department, Philipp University of Marburg, Marburg, Germany.
Doc Ophthalmol. 2017 Apr;134(2):149-153. doi: 10.1007/s10633-017-9581-2. Epub 2017 Mar 9.
This case report explores the role of the visual field perimetry and electroretinogram (ERG) in cases of non-infectious uveitis in the assessment and monitoring of retinal function and response to treatment.
A 59-year-old Caucasian female presenting with bilateral posterior uveitis newly diagnosed as birdshot chorioretinopathy (BSCR) presenting with bilateral decrease in visual acuity and cystoid macular edema, as well as a paracentral scotoma in the right eye. The diagnosis and follow-up of the case was done using visual field perimetry, optical coherence tomography (OCT), and ERG.
Baseline ERG showed a marked decrease in the amplitudes of the scotopic and photopic responses and a delay of peak times mainly in the right eye. Mycophenolate mofetil at 2 g/day and oral prednisolone at 1 g/kg/day were administered with gradual tapering of the corticosteroids. After 5 months, there was a noticeable improvement in the visual acuity, macular edema in OCT, and an obvious increase in the amplitudes of the ERG associated with a decrease in peak times, particularly in the 30 Hz photopic 3.0 Flicker of the right eye.
This case report highlights the importance of the peak time and wave amplitudes of the 30 Hz photopic DA 3.0 Flicker as being a sensitive parameter in the diagnosis and follow-up of BSCR.
本病例报告探讨视野检查和视网膜电图(ERG)在非感染性葡萄膜炎病例中对视网膜功能评估及治疗反应监测的作用。
一名59岁的白种女性,双侧后葡萄膜炎,新诊断为鸟枪弹样视网膜脉络膜病变(BSCR),表现为双侧视力下降、黄斑囊样水肿,右眼有旁中心暗点。通过视野检查、光学相干断层扫描(OCT)和ERG对该病例进行诊断和随访。
基线ERG显示主要在右眼,暗视和明视反应的振幅显著降低,峰值时间延迟。给予霉酚酸酯2g/天和口服泼尼松龙1mg/kg/天,并逐渐减少皮质类固醇剂量。5个月后,视力、OCT显示的黄斑水肿有明显改善,ERG振幅明显增加,峰值时间缩短,尤其是右眼30Hz明视3.0闪烁检查。
本病例报告强调30Hz明视DA 3.0闪烁检查的峰值时间和波幅作为BSCR诊断和随访的敏感参数的重要性。