Visual electrophysiology in the assessment of toxicity and deficiency states affecting the visual system

• Published in: Eye (London) 2021-09, Vol.35 (9), p.2344-2353
• Main Authors: O’Neill, Emily K., Smith, Richard
• Format: Article
• Language: English
• Subjects: 692/1807/1482; 692/699/3161/3164; Arthritis; Cardiovascular disease; Diagnosis; Drug dosages; Electrophysiology; Electroretinography; Humans; Laboratory Medicine; Medical personnel; Medicine; Medicine & Public Health; Nutrient deficiency; Ophthalmology; Optic nerve; Optic Nerve Diseases - diagnosis; Patients; Pharmaceutical Sciences/Technology; Photoreceptors; Retina; Retina - diagnostic imaging; Review; Review Article; Surgery; Surgical Oncology; Surveillance; Toxicity; Vision Disorders - diagnosis; Vision Disorders - etiology; Visual perception; Visual system; Vitamin A
• ISSN: 0950-222X; 1476-5454; 1476-5454
• DOI: 10.1038/s41433-021-01663-2

Visual disturbance or visual failure due to toxicity of an ingested substance or a severe nutritional deficiency can present significant challenges for diagnosis and management, for instance, where an adverse reaction to a prescribed medicine is suspected. Objective assessment of visual function is important, particularly where structural changes in the retina or optic nerve have not yet occurred, as there may be a window of opportunity to mitigate or reverse visual loss. This paper reviews a number of clinical presentations where visual electrophysiological assessment has an important role in early diagnosis or management alongside clinical assessment and ocular imaging modalities. We highlight the importance of vitamin A deficiency as an easily detected marker for severe combined micronutrient deficiency.