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视觉通路的电诊断测试及其在神经眼科中的应用。

Electrodiagnostic tests of the visual pathway and applications in neuro-ophthalmology.

机构信息

Department of Electrophysiology, Moorfields Eye Hospital, London, UK.

Institute of Ophthalmology, University College London, London, UK.

出版信息

Eye (Lond). 2024 Aug;38(12):2392-2405. doi: 10.1038/s41433-024-03154-6. Epub 2024 Jun 11.

Abstract

This article describes the main visual electrodiagnostic tests relevant to neuro-ophthalmology practice, including the visual evoked potential (VEP), and the full-field, pattern and multifocal electroretinograms (ffERG; PERG; mfERG). The principles of electrophysiological interpretation are illustrated with reference to acquired and inherited optic neuropathies, and retinal disorders that may masquerade as optic neuropathy, including ffERG and PERG findings in cone and macular dystrophies, paraneoplastic and vascular retinopathies. Complementary VEP and PERG recordings are illustrated in demyelinating, ischaemic, nutritional (B12), and toxic (mercury, cobalt, and ethambutol-related) optic neuropathies and inherited disorders affecting mitochondrial function such as Leber hereditary optic neuropathy and dominant optic atrophy. The value of comprehensive electrophysiological phenotyping in syndromic diseases is highlighted in cases of SSBP1-related disease and ROSAH (Retinal dystrophy, Optic nerve oedema, Splenomegaly, Anhidrosis and Headache). The review highlights the value of different electrophysiological techniques, for the purposes of differential diagnosis and objective functional phenotyping.

摘要

本文介绍了与神经眼科实践相关的主要视觉电诊断测试,包括视觉诱发电位(VEP)以及全视野、图形和多焦视网膜电图(ffERG;PERG;mfERG)。本文通过参考获得性和遗传性视神经病变以及可能伪装成视神经病变的视网膜疾病,说明了电生理解释的原则,包括在圆锥体和黄斑营养不良、副肿瘤和血管性视网膜病变中 ffERG 和 PERG 的发现。本文还介绍了脱髓鞘、缺血、营养(B12)和毒性(汞、钴和乙胺丁醇相关)视神经病变以及影响线粒体功能的遗传性疾病(如莱伯遗传性视神经病变和显性视神经萎缩)中补充 VEP 和 PERG 记录。在 SSBP1 相关疾病和 ROSAH(视网膜营养不良、视神经水肿、脾肿大、无汗和头痛)的病例中,强调了综合电生理表型在综合征疾病中的价值。该综述强调了不同电生理技术在鉴别诊断和客观功能表型中的价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b00/11306601/f68c1fb9aab3/41433_2024_3154_Fig1_HTML.jpg

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