Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, The Netherlands.
Bartiméus Diagnostic Centre for Complex Visual Disorders, Zeist, The Netherlands.
Acta Ophthalmol. 2019 Jun;97(4):372-377. doi: 10.1111/aos.13923. Epub 2018 Sep 14.
A major point of concern in uveitis is the development of irreversible retinal changes after inflammation. In this study, we assess how nonanterior childhood uveitis affects retinal function using full-field electroretinography (ERG).
Cross-sectional study. ERGs of 63 uveitis eyes (33 children) were measured according to extended International Society for Clinical Electrophysiology of Vision (ISCEV) protocols. ERG abnormalities were investigated in relation to the following clinical parameters: demographics, uveitis characteristics, including severity of inflammation, treatment, best corrected visual acuity (BCVA), cystoid macular oedema (CME) on optical coherence tomography and fluorescein angiography score.
The ERG showed abnormalities in 34 eyes (54%). The most frequent ERG abnormalities were prolonged implicit times of the cone b-wave (37%; n = 23/63) and an abnormal 30-Hz flicker response (implicit time and/or amplitude) (33%; n = 21/63). Factors associated with these ERG abnormalities were CME (p = 0.021) and 3+ vitreous cells (p = 0.021). BCVA in eyes with and without these ERG abnormalities did not statistically differ and was relatively good (median: 0.05 LogMAR, IQR: 0.00-0.15 LogMAR).
The ERG is frequently affected in childhood uveitis indicating a global retinal dysfunction. ERG abnormalities seem to be associated with a more severe posterior segment inflammation and a younger age. If an association between ERG abnormalities and long-term visual outcome can be made in the future, these early ERG findings during the course of childhood uveitis have significance for treatment strategies.
葡萄膜炎的一个主要关注点是炎症后不可逆转的视网膜变化。在这项研究中，我们使用全视野视网膜电图（ERG）评估非前部儿童葡萄膜炎对视网膜功能的影响。
横断面研究。根据扩展的国际临床视觉电生理学协会（ISCEV）方案，测量 63 只葡萄膜炎眼（33 名儿童）的 ERG。研究了 ERG 异常与以下临床参数之间的关系：人口统计学、葡萄膜炎特征，包括炎症严重程度、治疗、最佳矫正视力（BCVA）、光学相干断层扫描和荧光素血管造影评分的黄斑囊样水肿（CME）。
ERG 在 34 只眼（54%）中存在异常。最常见的 ERG 异常是锥体 b 波的潜伏期延长（37%；n=23/63）和异常的 30-Hz 闪烁反应（潜伏期和/或幅度）（33%；n=21/63）。与这些 ERG 异常相关的因素是 CME（p=0.021）和 3+玻璃体细胞（p=0.021）。有和没有这些 ERG 异常的眼睛的 BCVA 没有统计学差异，且相对较好（中位数：0.05 LogMAR，IQR：0.00-0.15 LogMAR）。
儿童葡萄膜炎的 ERG 经常受到影响，表明存在全视网膜功能障碍。ERG 异常似乎与更严重的后节炎症和更年轻的年龄有关。如果未来能证明 ERG 异常与长期视力结果之间存在关联，那么在儿童葡萄膜炎病程中早期的 ERG 发现对治疗策略具有重要意义。
