Evaluation of the electrodiagnostic investigation of children using the Greenwich Grading System.
OBJECTIVE
To evaluate the contribution of electrodiagnostic testing (EDT) to the management of children in a paediatric ophthalmology service using the Greenwich Grading System (GGS).


METHODS
A retrospective analysis was performed of the case notes of 105 of the 113 paediatric patients referred from the Strabismus and Paediatric Service at Moorfields Eye Hospital for electrophysiological testing over a 1-year period. The GGS was used to quantify the contribution of EDT to the diagnosis, overall investigation, and treatment of each patient. Patients were further subdivided into different diagnostic groups to allow comparison of the value of EDT in different conditions.


RESULTS
EDT was found to be of value in 91% of the children tested and was considered an essential investigation in 71%. EDT made a new diagnosis in 7% of patients, changed it in 5%, and confirmed or excluded a diagnosis in 79%. EDT made a useful contribution to the overall investigation of 89% of the patients and was considered the only test that could provide the required information in 71%. The results of EDT allowed reassurance and/or explanation with regard to the diagnosis, prognosis, and treatment in 91% of children. In one patient, treatment was changed as a result of EDT. The clinical outcome was not adversely affected in any patient.


CONCLUSIONS
EDT was of value to the clinical management of most of the children reviewed, mainly by confirming or excluding a clinical diagnosis and allowing explanation and reassurance to children and parents. Electrodiagnostic information gave a new or changed diagnosis in 12% of the children.
Woodruff
S A
SA
Strabismus and Paediatric Service, Moorfields Eye Hospital, London, UK.
Fraser
S
S
Burton
L C
LC
Holder
G E
GE
Sloper
J J
JJ
D000293:Adolescent; D017677:Age Distribution; D000550:Amblyopia / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D004568:Electrodiagnosis; D004585:Electrooculography; D004596:Electroretinography; D005074:Evoked Potentials, Visual; D005128:Eye Diseases / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D007223:Infant; D010043:Outcome and Process Assessment, Health Care / Q000379:methods; D012164:Retinal Diseases / Q000175:diagnosis; D012189:Retrospective Studies