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Electrophysiologic Testing in Disorders of the Retina, Optic Nerve, and Visual Pathway

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    Electrophysiologic Testing in Disorders of the Retina, Optic Nerve, and Visual Pathway. 2nd ed. By Gerald A Fishman, David G Birch, Graham E Holder, Mitchell G Brigell. Pp 308; $95. San Francisco: American Academy of Ophthalmology, 2001. ISBN1-56055-198-4.

    This is a concise, well written reference for students, residents, and clinicians interested in gaining a better understanding of electrophysiological tests of the visual system.

    The book is divided into five chapters, each devoted to one of the following electrophysiological tests: the electroretinogram (ERG), the electro-oculogram (EOG), the focal and multifocal ERG, the pattern electroretinogram (PERG), and the visual evoked potential (VEP). Each chapter begins with a description of the physiology underlying each test and the specific techniques used to record responses. The chapters then include examples of the results commonly seen in different hereditary and acquired disorders, with accompanying fundus photographs in many cases. The book also explains the molecular basis of diseases which have been genetically characterised.

    The authors have made significant improvements to the second edition of this book. The first edition included only a page each on focal and pattern ERG. In response to the development of the multifocal ERG, the current edition devotes an entire chapter to both the focal and multifocal ERG. The multifocal ERG holds promise in early diagnosis of many diseases, including glaucoma, and both of these techniques will probably become increasingly important in future investigations of macular disorders. The section on pattern ERG has been greatly expanded and includes a lucid description of clinical applications for which the PERG is useful. In addition, the description of the PERG is integrated with the section on VEP, explaining how these tests can best be used to differentiate between macular and optic nerve dysfunction. The authors have included numerous clinical photographs and examples, making the text particularly relevant and easy to comprehend.

    This textbook successfully meets the authors' stated objectives to “provide a background on the physiologic principles that underpin the measurement of various electrophysiologic components, describe the clinical phenotypes of various disorders . . .for which electrophysiologic investigations are of potential value, discuss the various electrophysiologic findings . . .anticipated in different disorders . . .(and to) clarify how the enlightened use of various procedures can be of value in the diagnosis and monitoring of patients with hereditary or acquired disorders of the retina, optic nerve, and visual pathway.” It is a valuable reference for anyone interested in obtaining a clear understanding of the objective measurement of visual function in a variety of diverse clinical disorders.

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