Anna Brouwer

Conclusions This thesis highlights that in uveitis the retinal function is frequently affected. We describe a characteristic ERG abnormality: the prolonged cone b-IT, which was associated with the severity of the inflammation in both present and past. It can be observed in all anatomical localizations of uveitis, and both in adults and in children. In some cases it can improve, but in most cases it persists, even when the inflammation becomes quiescent. This indicates that in some cases the retinal dysfunction is probably permanent, but in other cases the ERG can detect retinal dysfunction in uveitis when it is still reversible. These findings indicate that theremay be a role for the ERG in themanagement of uveitis. However, future studies are necessary to determine if this is in fact true. Such studies should use a multivariable and multivariate analysis of both ERG parameters and uveitis parameters including the Standardization of Uveitis Nomenclature criteria, but also OCT results in a large cohort of uveitis patients where an ERG is recorded at set time points. ERG results would need to be correlated to predefined outcome measures, such as visual prognosis, uveitis activity, or the need for systemic medication. Based on the findings in this thesis, the prolonged cone b-IT may be the most sensitive ERG marker in uveitis, but other ERG parameters should be investigated as well. Future studies should also focus on the measurement error of the ERG, and international guidelines are necessary to determine when an ERG outcome has changed significantly. It would be preferable if ISCEV would take the lead in creating such a guideline. On a final note, we would like to stress the importance that all recorded ERG data are made available in new scientific papers, either in the printed text, or in supplemental files and that researchers adhere to ISCEV standards. Too often the ERG is only briefly described as being either normal or abnormal, which makes it impossible to properly compare results and to gain an overview of the types of ERG abnormalities that may be observed in uveitis. 170 Chapter 8