Article
Electrophysiological diagnostics in acquired diseases of the retina and the optic pathway
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Published: | September 22, 2004 |
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Outline
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Objective
Drug-induced toxic retinopathies and optic neuropathies are rare. However, an early and sufficient diagnosis is essential and should be performed in tight collaboration with other medical disciplines.
Methods
Typical cases of chloroquin-, vigabatrin- and tamoxifen-related retinopathies and of ethambutol-induced optic neuropathy are presented. Specific diagnostic tools are proposed. Beside the importance of visual field and color vision testing the role of electrophysiological methods is stressed.
Results
Unfortunately, chloroquin- and hydroxy-chloroquin related retinopathies tend to be diagnosed rather late. Beside visual acuity, visual field testing and the fundus morphology the multifocal ERG has shown to be a powerful tool for an early diagnosis. The VEP can be useful for the diagnosis of the ethambutol induced optic neuropathy. Because of the reversibility of this side effect, an early diagnosis is of utmost importance. The early diagnosis of the retinopathy induced by tamoxifen has become recently more important as alternative drugs has been made available. The vigabatrin retinopathy has become an issue almost exclusively related to pediatric ophthalmology.
Conclusions
The ophthalmologist is obliged to recover any drug related side effects on the retina and optic nerve as early as possible. For this reason, a good collaboration with other medical disciplines is essential. The diagnostic tools should be as specific as possible and should therefore include electrophysiological methods.