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August 06, 2013; 81 (6) Editorial

Optic nerve head component analysis enters the clinic

Will multifocal ERG be the next OCT?

Marc Dinkin, Matthew J. Thurtell
First published July 3, 2013, DOI: https://doi.org/10.1212/WNL.0b013e31829e702e
Marc Dinkin
From the Neuro-ophthalmology Service (M.D.), Department of Ophthalmology and Neurology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY; and the Departments of Ophthalmology and Visual Sciences and Neurology (M.J.T.), University of Iowa, Iowa City.
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Matthew J. Thurtell
From the Neuro-ophthalmology Service (M.D.), Department of Ophthalmology and Neurology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY; and the Departments of Ophthalmology and Visual Sciences and Neurology (M.J.T.), University of Iowa, Iowa City.
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Optic nerve head component analysis enters the clinic
Will multifocal ERG be the next OCT?
Marc Dinkin, Matthew J. Thurtell
Neurology Aug 2013, 81 (6) 518-519; DOI: 10.1212/WNL.0b013e31829e702e

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Over the last decade, assessment of the optic nerve has blossomed not only as a means of evaluating the integrity of the anterior visual pathways but also as an indirect reflection of cortical and subcortical integrity in demyelinating and degenerative neurologic disease.1,2 The bulk of research has involved optical coherence tomography (OCT), which utilizes low coherent light, much like an ultrasound, to measure the thickness of the retinal nerve fiber layer (RNFL), which contains the axons forming the optic nerve, and, more recently, the thickness of the macular ganglion cell layer, which contains the cell bodies of those axons.3,4 Despite the many advantages of OCT, its weakness is that it fails to detect an acute lesion that has not yet altered the structure of the associated retinal components, or any nonstructural optic nerve dysfunction, for that matter. The visual evoked potential (VEP) measures the amplitude and delay of occipital electrical activity while one eye is subject to flashes of light, thus measuring the function of the optic apparatus more directly, but its ability to finely localize injury or to determine a specific etiology is limited.

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  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the editorial.

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  • © 2013 American Academy of Neurology
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