Vitiligo: ocular and electrophysiological findings.

AIM: The aim of this study was to analyze the involvement of the retinal pigment epithelium (RPE) and optic nerve in patients with vitiligo (N.=40, 12 males and 28 females, age 12-82 years; average 45.8). METHODS: The dermatological and ophthalmological examinations have been followed by electro-oculography (EOG) and pattern visual evoked potential (VEP) tests. RESULTS: The results of the fundus examination were normal, showing no characteristics that might be considered typical of vitiligo. Sixteen patients had an altered VEP (9 with amplitude reduction, 7 with amplitude reduction and increased latency); 4 patients showed only an Arden Index (AI) > or =180; and 4 patients showed both an altered VEP and AI < or =180. EOG detected 1 pathological case (AI < or =160); 7 subnormal patients (AI 160-180); and 32 normal patients (AI > or =180). The mean AI was 249 in the vitiligo patients compared to 277.2 in the normal controls. Patients with both an altered VEP and an abnormal EOG had higher than average skin involvement and a longer disease duration, and the alterations in VEP (amplitude and latency) were much more marked than in the other patients. CONCLUSION: These results confirm that the simultaneous presence of abnormal VEP and EOG is characteristic of severe disease. Patients with only a pathological VEP (N.=12) had a noticeably longer mean disease duration, while those only with AI < or =180 showed a slightly higher degree of skin involvement. It may be concluded that patients with more extensive skin involvement and a longer disease duration will also exhibit more markedly negative ocular electro-physiologic findings. Pattern VEP and EOG offer useful tools to evaluate the evolution of vitiligo, because they can detect subclinical involvement of the optic nerve and RPE. The results of these two tests are correlated with the disease duration and extent of cutaneous involvement.

Interaction between the serotonin and dopamine systems in humans: preliminary findings.

The availability of peripheral tools, such as platelet [3H]-imipramine binding and electroretinogram b-wave amplitude, for investigating serotonin and dopamine systems respectively, prompted us to explore the possible relationships between these two systems in a group of 8 healthy drug-free volunteers. The results showed a significant correlation between the peripheral parameters of serotonin and dopamine systems and underline the importance of studying different neurotransmitters at the same time in humans.

Evaluation of the central dopaminergic activity in gestational hyperprolactinaemia by means of the electroretinographic technique.

Electroretinography, a simple, bloodless technique commonly used in ophthalmological diagnostic practice, seems to give important informations on the level of activity of the retinal and/or other central dopaminergic systems. The Authors have employed this technique in a group of 30 normal pregnant women in the ninth month of gestation, in order to evaluate the dopaminergic activity in a condition of physiological hyperprolactinemia, such as pregnancy, and in a group of 25 normal nonpregnant control women. The b wave amplitude of the electroretinographic traces was significantly higher in pregnant women than in controls, suggesting an over-activity of dopaminergic systems in late pregnancy. The possible interpretations of these data are discussed.

[Clinical value of electroretinographic tests in Parkinson's disease (author's transl)]. / Intérêt clinique du test électrorétinographique dans la maladie de Parkinson.

The authors studied the behaviour of the b wave in the ERG in patients with Parkinson's disease treated with L-Depa (Sinemet). The results demonstrated that a significant reduction of the voltage of the b wave coincides with a therapeutic overdose and side-effects of the neuropsychiatric type. The authors recommend, therefore, that a periodic ERG examination should be conducted in patients with Parkinson's disease during the course of treatment in order to prevent reactions from pharmacological overdosage.

Pattern VEP alterations in psoriatic patients may indicate a sub clinic optic neuritis.

We examined 44 subject (Group A) of both sexes (27 males and 17 females) aging between 16 and 80 (average: 45+/-16.6), divided into age bands, affected by mild-medium psoriasis with PASI (psoriasis area and severity index) between 1.2 and 48.6 (average: 11.2+/-9.7) without any other disease and we performed pattern transient VEP (Visual Evoked Potential) at the frequencies usually used in clinical experience (73', 36', 18' check size). For a good statistic comparison we choose 55 healthy subjects (group B) divided into age bands on which we performed the same test. Comparison of VEP parameters between psoriatic and healthy subjects, showed in group A 10 normal (22.7%) and 34 pathological (77.3%). In the latter group there are 16 subjects who show only a P100 reduced amplitude (36.3%), 3 with only increased latency (6.8%), 15 with alterations of both values (34%). The achieved data show that more than 3/4 of group A subjects have VEP alterations as index of the presence of a sub clinic optic neuritis with a probably toxic autoimmune origin due to the action of TNFalpha, of IgG, of ECP or of other cytokines (IL6, IL7, etc) that are increased in the blood of this patients. The electro physiologic monitoring of optic nerve seems to represent a good routine test to evaluate the global conditions of psoriatic patients.

Electroretinographic effects induced in humans by psychopharmacologic agents.

We studied the effects of single doses of different dopamine agonists and antagonists on the electroretinogram of a group of healthy volunteers. The results demonstrated significant b-wave amplitude changes after drug administration, suggesting that electroretinograms can be employed to evaluate the effects on retinal dopaminergic activity induced by psychotropic drugs and that the study of the electroretinographic effects of psychopharmacologic agents can provide new insights into the relationship between retinal dopaminergic mechanisms and the electroretinogram b-wave origin.