How pattern, flicker ERG can impact cataract treatment decisions
Testing detects disease behind cataracts without relying on refraction, pattern recognition
Retinal issues can impact cataract surgery outcomes, especially for those with multifocal or other premium lenses. While multifocal lenses may allow the patient to see more clearly across a range of distances, they may also decrease the amount of light that reaches the retina, exacerbating any issues that may already be present.
In addition, cataract surgery will not restore optimal vision if the cataract is not the main issue for the decline of visual acuity. Removing the cataract would only be treating part of the problem.
Knowledge of the posterior segment health is essential prior to moving forward with cataract surgery, whether using a premium lens or not. However, when a cataract is present, it can be difficult to view the macula. As cataracts worsen, they may impinge on the visual field quality and make it more difficult to determine if any other pathology must be addressed.
Even without cataracts, traditional diagnostics only provide valuable information on the structure of the cells but do not objectively reveal how well those cells are functioning. Electrophysiology testing—particularly, pattern electroretinography (PERG)—solves this issue and can be effectively and efficiently performed with an in-office device (Diopsys NOVA Vision Testing System, Diopsys).While examination with optical coherence tomography (OCT) provides valuable information, it is not always sufficient when cataracts are present. The media opacity can render information gathered unreliable or unobtainable.
Consequently, testing that does not rely on the ability to detect patterns is needed.
Full-field electroretinography (ffERG), including flicker ERG do not rely on refraction or recognition of patterns and can therefore provide the ability to detect disease behind cataracts.