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R.J. Brockhurst, M.A. Sandberg; Reduced Central Foveal Thickness in Patients with Unexplained Visual Acuity Loss . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3251.
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To determine whether decreased central retinal thickness occurs in some patients with reduced visual acuity and no diagnostic abnormalities in the macula by ophthalmoscopy.
We evaluated 7 patients (ages 14–81 years) with visual acuity loss of 20/30 to 10/400 measured with a projected Snellen chart. All had a normal routine ocular examination, normal full–field electroretinograms (ERGs), and no systemic disease known to affect vision. We evaluated central retinal thickness with optical coherence tomography (OCT 3, Zeiss Meditec). We generally recorded from each eye six 6mm line scans in a radial spoke pattern through the central fovea. Each tomogram consisted of 512 A–scans with each A–scan comprising 1024 data points. We also recorded foveal cone ERGs with a hand–held stimulator ophthalmoscope (Doran Instruments).
All 7 patients had reduced central foveal thickness by OCT. Retinal thicknesses ranged from about 20% to 75% below normal. None of these patients had cystic changes, hole formation, or an epiretinal membrane. Five of the 7 had reduced foveal cone ERG amplitudes with or without delayed implicit times.
OCT evaluation established that visual acuity reduction was due to loss of central foveal photoreceptors in these patients. OCT provides an added dimension to evaluate patients with visual acuity loss of unexplained etiology.
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