Electroretinography in central retinal vein occlusion

In 149 eyes with central retinal vein occlusion (CRVO), we prospectively investigated the role of routine, clinical electroretinography (ERG) in differentiating ischemic (60 eyes) from nonischemic CRVO (89 eyes). Single-flash photopic and scotopic ERGs were recorded. Data for the amplitudes and implicit times of a- and b-waves and for the b-/a-wave amplitude ratio were analyzed in detail. The study revealed that the best ERG parameter (for both photopic and scotopic ERG) for differentiating ischemic from nonischemic CRVO was a subnormal b-wave amplitude (reduced to 60% or by 1 SD from the normal mean value, or 64%–69% of that in the fellow normal eye), with a sensitivity of 80%–90% and a specificity of 70%–80%. ERG findings were correlated with the relative afferent pupillary defect (RAPD). An RAPD of 0.7 log units showed a sensitivity of 88% and a specificity of 90% in differentiating ischemic from nonischemic CRVO. ERG and RAPD findings showed a good correlation. The combined ERG and RAPD tests could differentiate 97%–100% of ischemic from nonischemic CRVO cases, with a specificity of about 70%.Presented in part at the Annual Meeting of the Association for Research in Vision and Ophthalmology, Sarasota, Florida, USA, 2 May 1988Supported by grant EY-1151 from the National Institutes of Health, and in part by unrestricted grants from Research to Prevent Blindness, Inc., and from Alcon Research Institute