Abstract
Purpose To report a case illustrating the value of pattern VEP and pattern ERG (PERG) in monitoring optic nerve gliomata (OG). Case report A 15-year-old girl presented with a 3-year history of frontal headaches and a 5-month history of blurred vision in the right eye. MRI scanning revealed a thickened, right optic nerve extending to the cranial opening of the optic canal, consistent with an optic nerve glioma. Pattern VEP showed a mildly delayed major positive component consistent with optic nerve dysfunction. The PERG N95:P50 ratio was subnormal in keeping with retinal ganglion cell involvement. Visual acuity decreased over the following 2 years and repeat VEP objectively demonstrated marked deterioration in optic nerve function despite neuroradiology showing no significant change in the tumour. Conclusions Pattern VEPs and pattern ERGs can provide early objective evidence of optic nerve/retinal ganglion cell dysfunction in optic nerve gliomata. Serial recordings can objectively demonstrate worsening function in the absence of significant neuroradiological change.
References
North K, Cochineas C, Tang E, Fagan E (1994) Optic gliomas in neurofibromatosis type 1: role of visual evoked potentials. Pediatr Neurol 10:117–123
Halliday AM (1976) Visually evoked responses in optic nerve disease. Trans Ophthalmol Soc UK 96:372–376
Brecelj J, Stirn-Kranjc B, Skrbec M (2000) Visual electrophysiology in children with tumours affecting the visual pathway. Case reports. Doc Ophthalmol 101:125–154
Rossi LN, Pastorino G, Scotti G, Gazocchi M, Maninetti MM, Zanolini C et al (1994) Early diagnosis of optic glioma in children with neurofibromatosis type 1. Childs Nerv Syst 10:426–429
Groswasser Z, Kriss A, Halliday AM, McDonald WI (1985) Pattern- and flash-evoked potentials in the assessment and management of optic nerve gliomas. J Neurol Neurosurg Psychiatry 48:1125–1134
Jabbari B, Maitland CG, Morris LM, Morales J, Gunderson CH (1985) The value of visual evoked potential as a screening test in neurofibromatosis. Arch Neurol 42:1072–1074
Vanasse M, Gabet JY, De Lean J, Mauguiere F, Sabouraud P, Bouchard JP et al (1990) Utility of short-latency evoked potentials in the classification of progressive, early onset cerebellar ataxias. Electroencephalogr Clin Neurophysiol Suppl 41:223–235
Holder GE (1978) The effects of chiasmal compression on the pattern visual evoked potential. Electroencephalogr Clin Neurophysiol 45:278–280
Robson AG, El-Amir A, Bailey C, Egan CA, Fitzke FW, Webster AR, Bird AC, Holder GE (2003) Pattern ERG correlates of abnormal fundus autofluorescence in patients with retinitis pigmentosa and normal visual acuity. Invest Ophthalmol Vis Sci 44:3544–3550
Wolsey DH, Larson SA, Creel D, Hoffman R (2006) Can screening for optic nerve gliomas in patients with neurofibromatosis type I be performed with visual-evoked potential testing? J AAPOS 10:307–311
Listernick R, Ferner RE, Liu GT, Gutmann DH (2007) Optic pathway gliomas in neurofibromatosis-1: controversies and recommendations. Ann Neurol 61:189–198
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Moradi, P., Robson, A.G., Rose, G.E. et al. Electrophysiological monitoring in a patient with an optic nerve glioma. Doc Ophthalmol 117, 171–174 (2008). https://doi.org/10.1007/s10633-008-9118-9
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DOI: https://doi.org/10.1007/s10633-008-9118-9