Diopsys Flicker ERG findings in Retinal Vasculitis

Abstract

Purpose : Retinal vasculitis (RV) is a sight-threatening condition that can be idiopathic or associated with local or systemic inflammation due to infectious, neoplastic, or autoimmune diseases. While the structural changes associated with RV, as seen on ophthalmoscopy, angiography, optical coherence tomography, and other imaging modalities have been well documented, functional changes as may be seen on electrophysiology have not been well characterized. This retrospective study examines the Diopsys® Flicker Electroretinogram (ERG) findings present in cases of RV and tests whether these findings correlate with RV severity.

Methods : All retinal vasculitis cases seen by the uveitis service at a tertiary care center over a 14-month period were retrospectively reviewed and screened for inclusion in the study. Eyes with retinal vasculitis were included if there was at least one pair of Diopsys® flicker ERG recording and corresponding Fluorescein Angiogram (FA) within 2 months of each other for that eye. Eyes with other confounding retinal diagnoses were excluded. Each FA was scored for retinal vasculitis severity by two independent graders using the semi-quantitative Angiography Scoring
for Uveitis Working Group FA scale and the mean RV severity score was compared to the corresponding Diopsys® Flicker ERG findings (phase and magnitude values) across eyes and time points.

Results : A total of 50 eyes from 33 patients (mean age 26.3 years) were included. There was a moderate, highly significant correlation between retinal vasculitis severity and the Diopsys® flicker ERG Phase, both for Fixed-Luminance (FL) (-0.65, p<0.001) and for Multi-Luminance (ML) ERG settings (-0.63, p=<0.001) (Figure). Similarly, there was a mild correlation between RV severity and ERG Magnitude for both FL (-0.26, p=0.04) and ML (-0.33, p<0.001).

Conclusions : Increasing retinal vasculitis severity is associated with increasingly abnormal flicker ERG findings suggesting progressive dysfunction of the cone photoreceptor pathway.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

Correlation between retinal vasculitis severity score and the magnitude and phase obtained by Diopsys® Flicker ERG for both the Fixed-Luminance (A and B) and Multi-Luminance settings (C and D).