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Abstract
The pattern electroretinogram (PERG) provides an objective measure of central retinal
function, and has become an important element of the author's clinical visual electrophysiological
practice. The PERG contains two main components, a positivity at approximately 50ms
(P50) and a larger negativity at approximately 95ms (N95). The P50 component is affected
by macular dysfunction with concomitant reduction in N95. The PERG therefore complements
the Ganzfeld ERG in the assessment of patients with retinal disease. In contrast,
the ganglion cell origins of the N95 component allow electrophysiological evaluation
of ganglion cell function both in primary disease and in dysfunction secondary to
optic nerve disease, where selective loss of N95 can be observed. Both macular dysfunction
and optic nerve disease can give abnormalities in the visual evoked cortical potential
(VEP), and the PERG thus facilitates more meaningful VEP interpretation. This review
addresses the origins and recording of the PERG, and then draws on extensive clinical
data from patients with genetically determined retinal and macular dystrophies, other
retinal diseases and a variety of optic nerve disorders, to present an integrated
approach to diagnosis.