Potential retinal causes: when and how to investigate

• Published in: Acta ophthalmologica (Oxford, England) England), 2015-10, Vol.93 (S255), p.n/a
• Main Author: Leroy, B.P.
• Format: Article
• Language: English
• Subjects: Macular degeneration; Medical imaging; Ophthalmology
• ISSN: 1755-375X; 1755-3768
• DOI: 10.1111/j.1755-3768.2015.0273

Summary Purpose To describe the retinal conditions that need to be excluded when non‐organic visual loss is suspected, and the investigations required to either confirm or exclude them. Methods A case presentation format will be used to illustrate those conditions which can be discovered using psychophysical and electrophysiological tests as well as special imaging including blue and near‐infrared autofluorescence and reflectance imaging and spectral‐domain optical coherence tomography, in patients in whom a non‐organic origin for visual loss is initially suspected. Results Inherited retinal diseases such as Stargardt macular dystrophy, X‐linked retinoschisis and cone dystrophy as well as Batten disease in their early stages all need to be excluded when visual loss is thought to be non‐organic. In addition, several acquired retinal conditions such as acute acular neuroretinopathy need to be taken into account. Visual field testing, ISCEV‐standard full‐field flash electroretinography, pattern electroretinography and visual evoked potentials and specialised imaging techniques contribute significantly to making the correct diagnosis. Conclusions Visual loss in a list of organic conditions may mimic non‐organic visual loss. Functional testing as well as specialised imaging techniques are essential in differentiating true organic from non‐organic visual loss.