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Hepatic retinopathia. Changes in retinal function

A K Eckstein1, A Reichenbach, P Jacobi

  • 1University Eye Hospital, Tübingen, Germany.

Vision Research
|June 1, 1997
PubMed
Summary
This summary is machine-generated.

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Hepatic encephalopathy (HE) causes functional changes in the retina, detectable by electroretinogram (ERG). These retinal abnormalities correlate with HE severity, suggesting Müller cell damage.

Area of Science:

  • Ophthalmology
  • Neurology
  • Hepatology

Background:

  • Hepatic failure leads to brain changes (hepatic encephalopathy, HE), involving glial cells.
  • Similar morphological changes occur in retinal Müller cells in HE patients.
  • The functional impact of these Müller cell changes in HE remains unclear.

Purpose of the Study:

  • To investigate functional deficits in the retina of patients with hepatic encephalopathy.
  • To correlate retinal function abnormalities with the severity of hepatic encephalopathy.

Main Methods:

  • Ophthalmological examination, color vision testing, and standard electroretinogram (ERG) recordings were performed on 11 patients with varying stages of HE.
  • Patients were divided into two groups based on HE stage (0-1 and 2-3).

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Main Results:

  • Color vision tests showed increased confusions, particularly in the tritan axis, correlating with higher HE stages.
  • Scotopic and photopic ERG showed decreased and delayed waves, especially in higher HE stages.
  • Oscillatory potentials on ERG were most sensitive, with delayed latencies even in early HE stages and decreased amplitudes in advanced stages.

Conclusions:

  • Patients with hepatic failure and HE exhibit functional retinal abnormalities.
  • Electroretinogram (ERG) effectively demonstrates these abnormalities, which correlate with HE severity.
  • Elevated ammonia levels may damage Müller cells, impairing retinal function through altered neurotransmission and glial-neuronal interaction.