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The pattern visual evoked potential and pattern electroretinogram in drusen-associated optic neuropathy.

G B Scholl1, H S Song, D E Winkler

  • 1Department of Neurology, Massachusetts General Hospital, Boston 02114.

Archives of Ophthalmology (Chicago, Ill. : 1960)
|January 1, 1992
PubMed
Summary

Optic disc drusen commonly impair optic nerve function, affecting visual fields and electrophysiologic tests. Pattern electroretinography reveals ganglion cell dysfunction, primarily through N95 component abnormalities.

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Area of Science:

  • Ophthalmology
  • Neuroscience

Background:

  • Optic disc drusen are abnormal calcifications within the optic nerve head.
  • Their impact on optic nerve conduction and retinal function requires further elucidation.

Purpose of the Study:

  • To prospectively evaluate clinical and electrophysiologic evidence of optic nerve conduction impairment in patients with optic disc drusen.

Main Methods:

  • Prospective study of 16 patients (29 eyes) with optic disc drusen.
  • Clinical assessments included visual acuity, kinetic visual fields, and Farnsworth-Munsell 100-Hue testing.
  • Electrophysiologic tests comprised flash visual evoked potentials (FVEP), pattern visual evoked potentials (PVEP), and pattern electroretinograms (PERG).

Main Results:

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  • Abnormalities were frequent: visual acuity (28%), kinetic visual field (76%), Farnsworth-Munsell 100-Hue (41%), and FVEP (54%).
  • PVEP showed prolonged P100 latency in 41% of eyes.
  • PERG analysis revealed reduced P50 amplitude (17%) and, most commonly, reduced or absent N95 component (79%), indicating ganglion cell dysfunction.
  • Conclusions:

    • Optic disc drusen are associated with significant optic nerve dysfunction, particularly affecting visual fields and electrophysiologic responses.
    • The pattern electroretinogram's N95 component is a sensitive indicator of ganglion cell dysfunction in this condition.
    • Findings support distinct retinal origins for P50 and N95 components in PERG.