The dystrophic retina in multisystem disorders

The electroretinogram in neuronal ceroid lipofuscinoses

Research output: Contribution to journalArticle

54 Citations (Scopus)

Abstract

The neuronal ceroid lipofuscinoses (NCL) are neurodegenerative disorders with psychomotor deterioration, seizures, visual failure and premature death, all associated with abnormal storage of lipoproteins within lysosomes. The most common forms of NCL are an infantile form (INCL, CLN1), a late infantile form (LINCL, CLN2) and a juvenile onset form (JNCL, CLN3). The electroretinogram (ERG) is abnormal early in all three of these forms and eventually is totally ablated. The purpose of this report is to describe the ERG in INCL, LINCL and JNCL. The ERGs of 7 patients who were examined by the author over the past 15 years were reviewed. Ganzfeld ERG responses were recorded using the ISCEV standard protocol and an intensity response series over a 3.7 log unit range. The earliest ERG manifestation of INCL is a marked loss of the scotopic and photopic b-wave with relative preservation of the a-wave; this defect, which was evident for both rods and cones, suggests preservation of photoreceptor outer segment function with severe disturbance of transmission of the signal to the second-order neuron, the bipolar cells. For LINCL, the rod responses were mildly abnormal but more preserved than in INCL or JNCL. The cone b-wave amplitudes in patients with early LINCL were severely subnormal with prolonged implicit times. Patients with JNCL invariably showed severe to profound ERG abnormalities when first tested, with essentially no rod-mediated activity and marked loss of a-wave amplitudes with even greater loss of b-wave amplitudes, creating electronegative configuration waveforms. Differences in the ERG responses were thus found that provide further clues to the earliest site of pathology within the retina.

Original languageEnglish (US)
Pages (from-to)580-590
Number of pages11
JournalEye
Volume12
Issue number3 B
StatePublished - Jun 1998

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Neuronal Ceroid-Lipofuscinoses
Retina
Vertebrate Photoreceptor Cells
Premature Mortality
Lysosomes
Neurodegenerative Diseases
Lipoproteins
Seizures
Pathology
Neurons

Keywords

  • Electroretinogram
  • Neuronal ceroid lipofuscinosis
  • Retina

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems

Cite this

The dystrophic retina in multisystem disorders : The electroretinogram in neuronal ceroid lipofuscinoses. / Weleber, Richard.

In: Eye, Vol. 12, No. 3 B, 06.1998, p. 580-590.

Research output: Contribution to journalArticle

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