Electroretinogram as an Early Diagnostic Biomarker for Acute Retinal Necrosis: A Multicenter Comparative Study

Area of Science:

• Ophthalmology
• Retinal Diseases
• Diagnostic Tools

Background:

• Acute retinal necrosis (ARN) is a severe ocular condition leading to vision impairment or blindness.
• Early diagnosis and treatment are critical for improving the prognosis of ARN.

Purpose of the Study:

• To determine if acute retinal necrosis (ARN) exhibits a distinct electroretinogram (ERG) waveform compared to other uveitis forms.
• To evaluate the diagnostic utility of ERG in identifying ARN.

Main Methods:

• A retrospective observational multicenter study included 73 patients: 21 with ARN, 9 with bacterial endophthalmitis, 16 with other infectious uveitis, and 27 with non-infectious uveitis.
• Full-field electroretinography (ERG) was performed to assess retinal function, measuring a- and b-wave amplitudes.
• Initial and post-treatment visual acuity were recorded.

Main Results:

• Patients with ARN showed significantly reduced a- and b-wave amplitudes compared to other uveitis groups (p < 0.01).
• ERG analysis demonstrated high sensitivity and specificity in differentiating ARN from other infectious and non-infectious uveitis forms.
• Reduced pre-treatment visual acuity was the strongest predictor of visual prognosis.

Conclusions:

• ERG responses are significantly diminished in early-stage ARN, suggesting its value as a diagnostic tool.
• Early ERG assessment can aid in timely ARN diagnosis, especially when clinical evaluation is delayed.
• Prompt diagnosis through ERG is vital for initiating early treatment and preventing vision loss in ARN patients.