Anna Brouwer

ERG abnormalities in non-anterior childhood uveitis Introduction Non-anterior, non-infectious uveitis is a serious disease with unilateral blindness developing in up to 19% of children, despite intensive immunomodulating treatment. This blindness is often caused by complications such as cystoid macular edema (CME) and glaucoma. 1–3 In addition, after a prolonged course of inflammation, patients with uveitis may develop thinning of the retina with “retinal dystrophy-like” changes and dragged disk vessels. 3–5 To gain a better understanding of the effects of uveitis on retinal function, a full field (Ganzfield) electroretinogram (ERG) can be used. The ERG objectively measures retinal function and may therefore provide useful additional information to imaging techniques. Electroretinography abnormalities have been described in various uveitis entities. Particularly in birdshot chorioretinopathy (BSCR), 5,6 the ERG is used for monitoring disease activity and treatment, but it may also be useful in other uveitis entities. 5,7,8 However, there are few studies on ERG abnormalities in childhood uveitis and knowledge is still lacking on the effects of uveitis on retinal function in children. 9 In this study, we retrospectively analyzed ERG abnormalities in children with a non-infectious and non-anterior uveitis. We correlate their ERG abnormalities to clinical parameters and investigate the value of the ERG as an additional tool to objectively assess retinal damage in childhood uveitis. Methods Study population We included 33 patients (63 eyes) with a non-infectious, non-anterior uveitis. The median age at diagnosis was 8.9 years (range 3.5 - 14.6 years). All patients were seen at the ophthalmology department of the University Medical Centre Utrecht (UMC Utrecht). Here we perform an ERG as part of the clinical work-up if no obvious underlying cause for uveitis is found, to exclude a retinal dystrophy. 10 In case of doubt regarding the ERG abnormalities, such as reduction of amplitudes, DNA was tested for retinal dystrophy mutations, which was negative (N = 3). Furthermore, none of the patients had alterations suggestive of a retinal dystrophy on their latest optical coherence tomography (OCT) and/or visual fields. All patients had an ERG examination between May 2015 and December 2016. 111 5