Detection using the multifocal electroretinogram of mosaic retinal dysfunction in carriers of X-linked retinitis pigmentosa

PURPOSE: To examine whether a mosaic pattern of retinal dysfunction in obligate carriers of X-linked retinitis pigmentosa (XLRP) could be observed in local electroretinographic responses obtained with the multifocal electroretinogram (mfERG). DESIGN: Prospective observational case series. PARTICIPANTS: Five obligate carriers of XLRP (mean age, 53.2 years) were recruited into the study. METHODS: Examination of each subject included a complete ocular examination, Humphrey visual field, standard full-field electroretinogram (ERG), and mfERG testing. For the mfERG, we used a 103-scaled hexagonal stimulus array that subtended a retinal area of approximately 40 in diameter. The amplitudes and implicit times in each location for the mfERG was compared with the corresponding value determined for a group of normally sighted, age-corrected control subjects. MAIN OUTCOME MEASURES: Mapping of 103 local electroretinographic response amplitudes and implicit times within the central 40 with the multifocal electroretinogram. RESULTS: Localized regions of reduced mfERG amplitudes and/or delayed implicit times were found in four of five carriers. In one of these four carriers, a mosaic pattern of mfERG dysfunction was present even in the absence of any clinically apparent retinal changes, retinal sensitivity losses on Humphrey field testing, or abnormal full-field cone ERG responses. However, one carrier with a typical tapetal-like reflex demonstrated no deficit on any functional tests. CONCLUSIONS: The mfERG demonstrated patchy areas of retinal dysfunction in some carriers of XLRP. This mosaic pattern of dysfunction may be observed in some patients with a normal-appearing fundus, normal psychophysical thresholds, and normal amplitude and implicit time full-field ERG cone responses.     

Localized retinal electrophysiological and fundus autofluorescence imaging abnormalities in maternal inherited diabetes and deafness

PURPOSE: To investigate retinal function in patients with maternally inherited diabetes and deafness (MIDD) and to correlate the findings with fundus autofluorescence (FAF) imaging. METHODS: FAF was imaged in five patients (age range, 49-60 years) confirmed to have the mitochondrial DNA nucleotide A3243G point mutation. Retinal function was measured by full-field (Ganzfeld) electroretinography (ERG) and pattern ERG, incorporating the International Society for Clinical Electrophysiology of Vision (ISCEV) standards. Multifocal ERG (mfERG) was also performed. For analysis of the mfERG data, five regional ring groups of equal eccentricity were formed. For each ring, the peak amplitude (defined as the difference between P1 and N1) and the implicit time of P1 were determined and compared with normative values. RESULTS: Visual acuity in the patients was between 20/20 and 20/40 (Early Treatment Diabetic Retinopathy Study [ETDRS] chart). Irregular increased FAF signals were observed adjacent to and between areas of atrophy of the retinal pigment epithelium (RPE). Ganzfeld ERGs were within normal limits in three patients. Pattern ERG was abnormal in five eyes of three patients. mfERG peak amplitude abnormalities were particularly present in rings 2 and 3 and were consistent with the distribution of FAF abnormalities. In all but one eye, no implicit times changes were present. CONCLUSIONS: Significant mfERG abnormalities with normal Ganzfeld ERG are consistent with nonuniform damage to the central retina in MIDD, in keeping with the FAF findings. Reduced peak amplitudes with normal implicit times in the mfERG suggest localized loss of function and may indicate damage to the cone photoreceptor outer segments or cone photoreceptor loss in MIDD.     

Assessing Responses of the Macula in Patients with Macular Holes using a New System Measuring Localized Visual Acuity and the mfERG

Purpose: To evaluate acuity and multifocal electroretinogram (mfERG) responses from the macula in affected and unaffected fellow eyes of patients with macular holes. Methods: We tested 10 eyes with macular hole and 10 fellow eyes from 11 patients. We measured local visual acuity thresholds at 27 discrete locations within 21° diameter using the Functional Fundus Imaging System (FFIS), a psychophysical system that measures visual acuity as a function of visual field location, and local ERG responses within 45° diameter using the mfERG. Results: In the affected eyes, the mean FFIS visual acuity thresholds were significantly elevated within the central 21° diameter area, compared to a group of control eyes. No significant differences were found between the acuities of the fellow eyes compared to those of the control group. The amplitudes of the first positive peak of the mfERG were reduced in the central 7.8° in affected eyes. In the central 2°, 4 out of 10 affected eyes showed non-measurable ERG signals. The remaining six eyes showed significantly reduced mean amplitudes, but not delayed implicit times, when compared to the control group. For the fellow eyes, the mean amplitudes of the mfERG and implicit times did not differ from the means of the control eyes. Conclusions: Both local psychophysical and electrophysiological testing demonstrated retinal dysfunction extending beyond the site of the macular holes in some patients (three of the patients had central mfERG amplitudes falling within the normal range).     

Phenotypic characterization of a large family with RP10 autosomal-dominant retinitis pigmentosa: an Asp226Asn mutation in the IMPDH1 gene

PURPOSE: To evaluate the clinical features associated with the RP10 form of autosomal-dominant retinitis pigmentosa in 11 affected members of various ages from one family with a defined IMPDH1 mutation (Asp226Asn). DESIGN: Prospective, observational case series. METHODS: Visual function assessment included visual acuity, color vision, visual field, dark adaptometry, full-field electroretinography (ffERG), and multifocal electroretinography (mfERG). Ophthalmologic examinations, fundus photography, and optical coherence tomographic scans were also performed. Blood samples were obtained to screen for basic immune function. RESULTS: Visual acuity was slightly reduced in the teenage years and substantially reduced in association with cystoid macular edema (CME) at all ages. Color defects were observed in three patients (one teen, two adults). Dark-adapted thresholds were elevated. Visual fields were markedly constricted by age 40 (相似文献   

Localized retinal dysfunction in central serous chorioretinopathy as measured using the multifocal electroretinogram

PURPOSE: To determine the extent of electrophysiologic dysfunction in patients with central serous chorioretinopathy (CSC). DESIGN: Prospective observational case series. PARTICIPANTS: Six patients with unilateral CSC (mean age, 40 years) were recruited into the study. METHODS: Six patients with CSC underwent multifocal electroretinogram (mfERG) testing on both their clinically affected and opposite uninvolved eyes using the VERIS System, with a stimulus array of 103 scaled hexagons. The first positive peak responses were analyzed within six concentric ring annuli centered on the fovea. Amplitudes and implicit times were compared with those of an age-similar control group. MAIN OUTCOME MEASURES: Local electroretinographic response amplitudes and implicit times within the central 40 degrees with the mfERG. RESULTS: All the clinically uninvolved eyes showed mfERG amplitudes and implicit times within the normal range throughout the central 40 degrees of the retina. All six eyes with CSC showed reduced amplitudes and/or delayed implicit times that were limited to the regions of the macula in which clinical changes associated with CSC were apparent. CONCLUSIONS: We observed electroretinographic changes only in the clinically affected eyes, and these were limited to regions with ophthalmoscopically apparent fundus changes. Our findings do not support the conclusion that functional impairment, as measured by the mfERG, in eyes with CSC extends beyond clinically observed fundus changes. We did not observe abnormal mfERG responses in the clinically normal eyes of such patients.     

In diabetic retinopathy, foveal thickness of 300 μm seems to correlate with functionally significant loss of vision

Purpose To study the relationship between foveal thickness assessed by optical coherence tomography (OCT) and foveal function measured with multi focal electroretinography (mfERG) in patients with non-proliferative diabetic retinopathy, and with no previous laser treatment. Methods Twenty-six eyes from 18 diabetic patients (13 men), aged 59 years, (range 28–79 years), diabetes duration 15 years, (range 2–27 years), with a macular thickness between 200 and 600 μm were evaluated by mfERG, visual acuity (ETDRS score) and OCT. Mean amplitudes and implicit times of the mfERG responses were analyzed within the four innermost (14 degrees) of the six concentric rings. For comparison with the results from the OCT (diameter of measured area = 6 mm) we analyzed the summed response from the first and second ring (central zone), corresponding to the central area of the OCT. The third(zone 2) and fourth (zone 3)of the four innermost of the six concentric rings measured by the mfERG corresponding to the second and third area of OCT. Results An increased macular thickness in the central area of the OCT correlated to reduced amplitudes (r = −0.541; P = 0.004) and prolonged implicit times (r = 0.548; P = 0.004) in the central zone of the mfERG, and inversely correlated with visual acuity, −0.49; P = 0.045. Retinal thickness in the second area was correlated to prolonged implicit times in the second mfERG zone (r = −0.416; P = 0.034). No correlations were found for the third area of the OCT. When macular thickness exceeded 300 μm the decrease of amplitudes and prolonged implicit times, measured by mfERG, seemed to be more pronounced. Conclusion In conclusion increased macular thickness is correlated with reduced amplitudes and prolonged implicit times on the mf ERG and worse visual acuity.     

Retinal disorders in northern Brazilian patients treated with chloroquine assessed by multifocal ERG

The effects of chloroquine intake on the retinal function in a Brazilian population of patients were assessed by multifocal electroretinography. Twenty-four randomly chosen eyes of patients treated with chloroquine for rheumatoid arthritis and systemic lupus erythematosus were examined using multifocal electroretinography (mfERG). Control measurements were acquired from 21 randomly chosen eyes of age-matched healthy subjects. None of the study participants had an inherited retinal disease or a Snellen visual acuity reduced to less than 20/40. In patients and control subjects, cumulative chloroquine dose, total daily dose, duration of treatment, retinal examination, visual field defects, visual acuity, and the mfERG were assessed. The average amplitudes and implicit times of the N1, P1, and P2 components of the mfERGs were measured in the central hexagon (R1) and in five rings (R2–R6). The values measured in patients and normal subjects were compared. The P1 amplitudes in R2 were significantly decreased in the patients. In addition, the amplitudes of N1 and N2 in R1 were significantly smaller in the patients. The implicit times of none of the components were significantly different between patients and controls. The response amplitude was not significantly correlated with cumulative dose and duration of intake. There was no correlation with retinal appearance, visual field, and visual acuity. In agreement with earlier data, the central mfERG amplitudes were decreased in chloroquine patients indicating functional alterations in the retina. These changes are also present in a Brazilian population suggesting that the effects of chloroquine are general and that genetic background and life circumstances probably have, if at all, only little effect.     

First and second-order kernel multifocal electroretinography abnormalities in acute central serous chorioretinopathy

Purpose To evaluate the first and second-order kernel multifocal electroretinogram (mfERG) response abnormalities in patients with acute central serous chorioretinopathy (CSC). Methods This was a cross-sectional observational study in which 45 eyes of 45 patients with acute CSC underwent mfERG recordings. Peak amplitudes and implicit times of the first and second-order kernel responses were analyzed and compared with 20 age-matched normal controls. Correlation analyses were performed between the patients’ visual acuity and the first and second-order amplitudes and implicit times. Results The first-order N1 and P1 mfERG amplitudes in the central three concentric rings were reduced in eyes with acute CSC compared with controls (P < 0.05). The first-order P1 implicit times of the central four rings were also delayed (P < 0.05). For the second-order mfERG response, there were significant reductions in the second-order P1 and N1 amplitudes in rings 3–5 compared with controls (P < 0.05). No significant difference between the second-order P1 and N1 implicit times was found compared with controls (P > 0.05). Correlation analyses showed significant correlations between visual acuity and the first-order N1 response amplitudes of rings 1 and 2, and for the first-order N1 and P1 implicit times of rings 1–4 (P < 0.05). Conclusion Both first and second-order mfERG response abnormalities occur in eyes with acute CSC. These results suggest that in acute CSC, while outer retinal dysfunction is mostly localized to the central macula, there might be more widespread impairment in adaptive mechanisms of the inner retina or outer plexiform layer dysfunction in the more peripheral macula. Presented in part in the 44th annual symposium of the International Society of Clinical Electrophysiology of Vision (ISCEV), Fontevraud, France, June 2006.     

Multifocal ERG findings in carriers of X-linked retinoschisis

Purpose To determine whether retinal dysfunction in obligate carriers of X-linked retinoschisis (XLRS) could be observed in local electroretinographic responses obtained with the multifocal electroretinogram (mfERG). Methods Nine obligate carriers of XLRS (mean age, 46.2 years) were examined for the study. Examination of each carrier included an ocular examination and mfERG testing. For the mfERG, we used a 103-scaled hexagonal stimulus array that subtended a retinal area of approximately 40° in diameter. The amplitudes and implicit times in each location for the mfERG were compared with the corresponding values determined for a group of 34 normally-sighted, age-similar control subjects. Results Mapping of 103 local electroretinographic response amplitudes and implicit times within a central 40° area with the mfERG showed regions of reduced mfERG amplitudes and delayed implicit times in two of nine carriers. Conclusions The mfERG demonstrated areas of retinal dysfunction in two carriers of XLRS. When present, retinal dysfunction was evident in the presence of a normal-appearing fundus. Multifocal ERG testing can be useful for identifying some carriers of XLRS.     

Multifocal electroretinography in patients with exudative amd and intravitreal treatment with pegaptanib sodium

BACKGROUND: To objectively investigate central retinal function in patients with choroidal neovascularization (CNV) due to age-related macular degeneration (AMD) before and after treatment with pegaptanib sodium (PS). METHODS: Patients with CNV due to exudative AMD received intravitreal injections of 0.3 mg PS every sixth week if angiographic activity was evident. Longitudinal observation included recordings with multifocal electroretinography (mfERG) before the first treatment and before each injection at follow-up intervals. RESULTS: During the observation period of 30.5 +/- 8 weeks (mean +/- SD) a mean number of 5.3 +/- 1.3 injections were applied. Final mean log(MAR) visual acuity decreased, statistically nonsignificant, from 0.67 +/- 0.3 at baseline to 0.74 +/- 0.16. mfERG recordings in 12 patients after 25 +/- 9 weeks evinced a decrease in response density which was statistically significant in the central 5 degrees . Mean P1-amplitudes of ring 1, 2, and 3 were reduced by 66%, 39% and 30%, respectively. During follow-up, implicit times of the P1 components remained stable within 4% of baseline. In three of four patients with vision loss of 2 lines or more, P1-response amplitudes decreased substantially at least 6 weeks prior vision loss. CONCLUSION: Treatment with PS resulted in a decrease of central retinal function more obvious in mfERG than in VA longitudinal testing. Good correlations were seen between changes in mean vision and changes in mfERG response density components. As a decline in P1-response amplitudes anteceded vision loss in this study, our results indicate a possible role of mfERG to predict vision loss during intravitreal pharmacotherapy.     

Myopia Progression in Children Is Linked with Reduced Foveal mfERG Response

Purpose. To study the changes in retinal electrophysiology in children during myopia progression during a 1-year period. Methods. Twenty-six children aged from 9 to 13 years were recruited for the global flash multifocal electroretinogram (mfERG) measured at 49% and 96% contrast, in two visits 1 year apart. The amplitudes and implicit times of both direct component (DC) and induced component (IC) measured at these two visits were analyzed and compared. Pearson's correlation was used to study the association between the changes of mfERG response and myopia progression during the test period. Results. Myopia increased by -0.48 ± 0.32 diopter (D) (P < 0.001) during the year, with 24 of 26 children becoming more myopic (range = 0.00 to ～ -1.38 D); axial length increased by 0.25 ± 0.11 mm (P < 0.001) during the year. The increased myopia was highly correlated with increase in axial length (r = -0.70; P < 0.001). The central DC and IC amplitudes at 49% contrast reduced significantly as myopia progressed and the paracentral implicit times of these two components were reduced considerably. However, the high-contrast responses were virtually unaffected. Conclusions. Our findings suggested that the inner retinal functions in the central retina, with some involvement of the paracentral region, were decreased as myopia progressed in children.     

多焦视网膜电图检测糖尿病早期视功能的变化

目的：了解多焦视网膜电图（mfERG）在糖尿病患早期视功能的变化规律。方法：将所有被检分为正常对照组（33例）、糖尿病无视网膜病变组（63例）以及单纯期糖尿病视网膜病变组（43例）。采用mfERG对上述3组进行检测,比较3组mfERG一阶反应N1波与P1波的潜伏期与反应密度。结果：在糖尿病无视网膜病变组中,N1波与P1波反应密度低于正常对照组,异常范围位于环1一环3。其中P。波反应密度在单纯期糖尿病视网膜病变组中进一步降低。N1波与P1波的潜伏期在糖尿病无视网膜病变组中的变化无统计学意义,在糖尿病视网膜病变组中延长,异常范围扩大到环4与环5。结论：mfERG在糖尿病视网膜病变出现之前已发生异常变化,且能够定量地反映随着病情的进展,视功能的损害程度及范围。     

Multifocal electroretinography and fluorescein angiography in retinal vein occlusion

PURPOSE: To interpret the responses of multifocal electroretinography (mfERG) of the central macula in retinal vein occlusion and correlate them with findings of fluorescein angiography, optical coherence tomography (OCT), and visual acuity. METHODS: In a prospective observational case series, 25 patients with branch or hemiretinal vein occlusion were examined by means of mfERG, fluorescein angiography, OCT, and visual acuity. RESULTS: In eyes with macular ischemia shown by fluorescein angiography, the implicit time was significantly longer than that in eyes without macular ischemia (P = 0.006; Mann-Whitney test). The amplitudes in the first-order kernel responses in the ischemic eyes were more reduced (P = 0.04; Mann-Whitney test), and the amplitudes in the central macula correlated well with visual acuity (P = 0.006; Pearson correlation). There was no significant correlation between the degree of retinal thickening as measured by OCT and the mfERG responses, although there was a trend toward reduced amplitudes in the maculae with central retinal thickening (P = 0.08; Pearson correlation). CONCLUSION: Macular ischemia as measured by fluorescein angiography correlates well with the prolonged implicit time on the first-order kernel response in mfERG, but no significant correlation was detected between the responses of mfERG and the OCT findings. Further investigations will demonstrate if this can be used as a prognostic instrument in the selection of patients, who will most likely benefit from future treatments.     

中心性浆液性脉络膜视网膜病变OCT与mfERG图像的相关性

目的利用光学相干断层扫描（OCT）与多焦视网膜电图（mfERG）分析中心性浆液性脉络膜视网膜病变（csc）患者的OCT与mfERG图像的关系。方法横断面研究。应用德国CarlZeissCirrusHD-OCT及美国EDI VERIS Science^TM4．9视诱发反应图像系统对40只急性期CSC眼（40例）进行检查。将CSC患者OCT黄斑厚度图三个环的视网膜平均厚度与相对应的多焦视网膜电图（mfERG）的1＋2环、3环、4环的N1、P1波的平均反应密度和峰时间进行比较,并将黄斑区体积、总的黄斑中心凹的厚度、视网膜下液高度、视网膜下液范围和中心凹神经上皮厚度与mfERG6个环的N1、P1波反应密度和潜伏期比较分析。采用Spearman秩相关进行数据分析。结果CSC患者OCT内环、中环、外环的视网膜平均厚度与mfERG1＋2环、3环、4环的N1、P1波的峰时间呈正相关。黄斑区体积、总的黄斑中心凹的厚度、视网膜下液高度和视网膜下液范围与mfERG的N1、P1波反应密度和峰时间有显著的相关性。结论CSC患者的黄斑平均视网膜厚度及积液情况与mfERG之间有一定的相关性,可用OCT测量黄斑区视网膜下液的积液量,尤其是用积液范围来评估黄斑区视网膜功能的改变。OCT与mfERG的检测可以综合评价CSC患者的形态与功能的变化。     

Multifocal electroretinograms in X-linked retinoschisis

PURPOSE: To study local retinal cone function in patients with X-linked retinoschisis (XLRS) by multifocal ERGs (mfERGs). METHODS: mfERGs were recorded from seven eyes of seven patients with XLRS (mean age +/- SD, 22.1 +/- 3.2 years; range, 18 to 25 years). Five eyes had microcystic changes in the macula and two eyes had nonspecific macular degeneration. Two eyes had peripheral retinoschisis, and some of the stimuli fell on this area. The stimulus array consisted of 103 hexagons and the total recording time was set at approximately 4 minutes. The amplitudes and implicit times of both focal and summed responses for the first- and second-order kernels were analyzed. RESULTS: The amplitudes of the first-order kernel were markedly reduced in the central retina in all eyes. A large variation was observed in the amplitudes outside the fovea. The amplitudes of the focal cone ERGs at the peripheral retinoschisis did not differ from those recorded from adjacent retinal loci without the retinoschisis. The implicit times of the first-order kernel were significantly delayed, and the amplitudes of the second-order kernels were more affected than the first-order kernels across the whole field in all XLRS eyes. CONCLUSIONS: The cone-mediated retinal responses were more impaired in the central than peripheral retina in eyes with XLRS. Delayed implicit times of the first-order kernel and reduced second-order kernel across the whole testing field in all XLRS eyes suggest that there is widespread cone-system dysfunction in XLRS.     

Evaluation of focal retinal function using multifocal electroretinography in patients with X-linked retinoschisis

Objective: To evaluate focal retinal function in patients presenting with features of X-linked retinoschisis (XLRS), with the use of multifocal electroretinography (mfERG).Design: Consecutive observational case-control study.Participants: Eighteen eyes of 9 patients who presented to the retina clinic of Sankara Nethralaya from 2005 to 2008.Methods: XLRS was diagnosed clinically and corroborated with full-field electroretinogram (ffERG), mfERG, and optical coherence tomography. ffERG and mfERG recordings were done with VERIS 5.2.2X according to International Society for Clinical Electrophysiology of Vision standards. The mfERG stimulus consisted of 103 hexagons flickered at a 75 Hz frame rate, subtended 35° horizontally and 31° vertically at a viewing distance of 53 cm. The amplitudes and implicit times of ffERG and first-order kernels of mfERG were analyzed and compared with those of the controls.Results: P1 and N1 amplitudes were reduced and P1 and N1 implicit times were prolonged significantly in patients with XLRS, compared with controls.Conclusions: mfERG helps estimate focal retinal function in patients with XLRS.     

Atypical multifocal ERG responses in patients with diseases affecting the photoreceptors

The purpose of this study was to investigate atypical multifocal ERG (mfERG) responses for patients with diseases that can affect the photoreceptors. MfERGS were obtained from seven patients with retinitis pigmentosa (RP), three with progressive cone dystrophy (CD) and eight with diabetic retinopathy (DR). Both first- and second-order kernel responses were analyzed. The amplitudes and implicit times of the first-order responses were compared to those obtained from age-similar controls. For the first slice of the second-order response, the root-mean-square (RMS) and the signal-to-noise ratio (SNR) of each response were calculated. Achromatic visual fields were also obtained from each subject. For the three groups of patients, first-order responses with relatively large amplitudes, broad-shaped waveforms and markedly increased implicit times had non-measurable second-order responses. These responses were associated with areas of decreased visual field sensitivity. As RP, CD and DR affect the outer retina, the results are consistent with damage to the outer plexiform layer rather than damage to the inner retina.     

Oscillatory potentials of multifocal electroretinogram retinopathy

Purpose: To investigate the physiological function in the posterior pole of the retina in eyes with preproliferative diabetic retinopathy using the oscillatory potentials (OPs) of the multifocal electroretinogram (mfERG). Methods: Multifocal ERGs were recorded from 61 eyes of 61 patients with preproliferative diabetic retinopathy (pre-PDR) and 16 eyes of 16 age-similar normal control subjects. The amplitudes and implicit times of the first positive component, P1, and the OPs of the mfERGs, recorded with a slow m-sequence, from diabetics were compared with those in normal control subjects. Among the 61 eyes, the mfERGs were recorded before and after panretinal photocoagulation (PRP) in 19 eyes of 19 patients. Results: The amplitudes of P1 and OPs were significantly smaller in all tested areas in the diabetics as compared with those in the normal subjects, and the degree of reduction was greater for the OPs than P1. The implicit times of P1 and OPs were significantly delayed in the diabetics in the peripheral tested regions (20–40°) but not in the central area. After PRP, the amplitudes of P1 were markedly reduced in all areas tested; however, the changes of the P1 implicit time were not significant. The amplitudes of the OPs were significantly reduced in the peripheral regions after PRP; however, the changes in the implicit times were not significant. Conclusions: These results indicate that retinal function in the posterior pole is markedly impaired in eyes with pre-PDR. PRP altered the mfERGs significantly, however, the reductions were limited to the amplitude.     

Early changes of retinal function in diabetic patients detected by multifocal electroretinogram

To investigate the early changes of retinal function in diabetic patients detected by multifocal electroretinogram (mfERG). ·METHODS: The first-order kernel responses of mfERG were recorded fromeyes of 33 normal control subjects, 63 diabetic patients without retinopathy and 43 diabetic patients with background retinopathy. The response densities and implicit times of N₁ and P₁ were compared among the control, diabetic patients without retinopathy and diabetic patients with retinopathy. ·RESULTS: The response densities of N1 and P1 in central 3 rings were reduced significantly in diabetic eyes with and without retinopathy. And the implicit times of N₁ and P₁ were delayed significantly only in diabetic eyes with retinopathy. ·CONCLUSION: mfERG can detect the early changes of retinal function quantitatively in diabetic patients. Analysis of response densities and implicit times of N₁ and P₁ can reflect the progress of local retinal dysfunction in diabetes     

PFCL and ILM peeling in macular hole with retinal detachment

To investigate the early changes of retinal function in diabetic patients detected by multifocal electroretinogram (mfERG). ·METHODS: The first-order kernel responses of mfERG were recorded fromeyes of 33 normal control subjects, 63 diabetic patients without retinopathy and 43 diabetic patients with background retinopathy. The response densities and implicit times of N₁ and P₁ were compared among the control, diabetic patients without retinopathy and diabetic patients with retinopathy. ·RESULTS: The response densities of N1 and P1 in central 3 rings were reduced significantly in diabetic eyes with and without retinopathy. And the implicit times of N₁ and P₁ were delayed significantly only in diabetic eyes with retinopathy. ·CONCLUSION: mfERG can detect the early changes of retinal function quantitatively in diabetic patients. Analysis of response densities and implicit times of N₁ and P₁ can reflect the progress of local retinal dysfunction in diabetes