Multifocal Electroretinography in Retinitis Pigmentosa With Non-recordable Full-field Electroretinography

Sun Young Jang; Sang Hyun Lim; Young-Hoon Ohn

doi:10.3341/jkos.2009.50.12.1817

Journal List > J Korean Ophthalmol Soc > v.50(12) > 1008444

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Jang, Lim, and Ohn: Multifocal Electroretinography in Retinitis Pigmentosa With Non-recordable Full-field Electroretinography

Original Article

J Korean Ophthalmol Soc 2009;50(12):1817-1823.

Published online: 7 September 2009

DOI: https://doi.org/10.3341/jkos.2009.50.12.1817

Multifocal Electroretinography in Retinitis Pigmentosa With Non-recordable Full-field Electroretinography

Sun Young Jang, MD¹, Sang Hyun Lim, MD², Young-Hoon Ohn, MD¹

¹Department of Ophthalmology, Soonchunhyang University, College of Medicine, Bucheon, Korea

²Department of Ophthalmology, University of California at San Francisco, Cornea Service, California, USA

Address reprint requests to Young-Hoon Ohn, MD, Department of Ophthalmology, Soonchunhyang University, College of Medicine #1174 Jung 1-dong, Wonmi-gu, Bucheon 420-767, Korea Tel: 82-32-621-5053, Fax: 82-32-621-5435, E-mail: yhohn@schbc.ac.kr

Received 18 May 2009 Accepted 19 October 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To investigate the clinical potential of multifocal electroretinography (mf-ERG) for the evaluation of residual retinal function in retinitis pigmentosa (RP).

Methods

From a group of 41 patients with RP examined for full-field and mf-ERGs, 24 patients were selected in whom the full-field ERGs were non-detectable. Data from the mf-ERGs of this group were reviewed retrospectively. Patients were divided into two groups based on best corrected visual acuity (BCVA); Group A, with a BCVA of less than 0.5, and group B with a BCVA greater than 0.5. The amplitudes and implicit times of Ring 1 and Ring 2 among six concentric rings were measured for comparison between mf-ERG groups.

Results

In the mf-ERGs, the amplitudes of Ring 1 and Ring 2 were reduced and implicit time was delayed in all 48 eyes of 24 patients in whom scotopic and photopic responses were non-detectable in full-field ERGs, whereas, there were no detectable responses in Rings 3 thru 6. There was a greater reduction in amplitude and an increased delay in implicit time in group A.

Conclusions

The mf-ERG can estimate the residual macular function in a group of patients with RP in whom the full-field ERG is non-recordable.

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Keywords: Multifocal electroretinography (mfERG), Retinitis pigmentosa

References

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Figure 1.

The pedigree charts of the subjects' families, A) Three families represented autosomal dominant inheritance, B) One family represented autosomal recessive trait, C) Two families represented X-linked recessive trait.

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Figure 2.

A case of a 52-year-old man whose visual acuity was 0.7 in both eyes. A) Typical fundus findings of retinitis pigmentosa. B) Humphrey perimetry (central 30–2 threshold test) discloses the scotomas of affected areas. Note that only central tunnel vision was remained. C) Rod and Cone response were undetectable in full-field ERGs. Note the 30 Hz flicker response (below 10 μV; noise level).

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Figure 3.

Result of multifocal electoretinogram (mf-ERG) of the same patient in Figure 1 (Right eye, first row; Left eye, second row) Three-dimensional plot of response densities, Ring averages in response density scale, Trace arrays (From left to right column). Sizable ERGs were detected within the central ring 1 and ring 2 using mf ERG techniques (The Amplitude of the red hexagons >1 nV, others <1 nV, noise level). Note that the response pattern is different between both eyes of which visual acuity is the same.

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Table 1.

Comparison of amplitude and latency of average N1, P1 responses between study group^* and normal control

	Ring 1				Ring 2
	N1^‡		P1^§		N1^‡		P1^§
	Amplitude(nV/deg²)	Latency(msec)	Amplitude	Latency	Amplitude	Latency	Amplitude	Latency
Study group^*	−6.35	17.02	8.504	31.78	−2.273	17.10	3.56	31.82
Normal controls^†	−53.4	16.3	109.9	30.0	−33.6	15.3	60.9	29.3

^* Study group=24 patients with retinitis pigmentosa whose full field ERGs were non recordable

^† Normal controls= result in 22 normal volunteers tested under same condition (Ohn and Ahn⁶)

^‡ N1=initial negative component of mf ERG.

^§ P1=initial positive component of mf ERG.

Table 2.

Comparison of average responses (N1, P1) between Group A and B in ring 1 and ring 2. Reduced amplitudes and delayed implicit times are noted in group A compared with Group B

	Ring 1				Ring 2
	N1^‡		P1^§		N1^‡		P1^§
	Amplitude	latency	Amplitude	latency	Amplitude	latency	Amplitude	latency
Group A^*	−6.15	17.60	3.74	32.31	−1.83	17.74	1.97	32.24
Group B^†	−6.58	16.34	14.13	31.15	−2.80	16.37	5.31	31.33
P	0.037	0.029	0.032	0.039	0.006	0.055	0.023	0.013

p-value less than 0.05 were considered significant, independent t-test

^* Group A=defined by visual acuity less than 0.5

^† Group B=defined by visual acuity more than 0.5

^‡ N1=initial negative component of mf ERG.

^§ P1=initial positive component of mf ERG.

Table 3.

Correlation between best corrected visual acuity (BCVA) and average responses (N1, P1) in Ring 1 and Ring 2

	Ring 1				Ring 2
	N1^‡		P1^§		N1^‡		P1^§
	Amplitude	latency	Amplitude	latency	Amplitude	latency	Amplitude	latency
R^*	0.057	0.321^†	−0.344^†	0.208	0.056	0.316^†	−0.377^†	0.172
P^†	0.700	0.026^†	<0.001^†	0.157	0.705	0.029^†	0.01^†	0.243

^* R=correlation coefficient (Spearman correlation)

^† P=p-value less than 0.05 were considered significant

^‡ N1=initial negative component of mf ERG.

^§ P1=initial positive component of mf ERG.

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