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MF Marmor, AM Serrato, R Tzekov; Alcohol-induced Electro-oculographic Responses are Reduced Bilaterally in Central Serous Chorioretinopathy . Invest. Ophthalmol. Vis. Sci. 2002;43(13):524.
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Purpose:To study clinical applications of the electro-oculographic alcohol response recently described by Arden, and to evaluate the functional integrity of the retinal pigment epithelium (RPE) in affected and fellow eyes of patients with active central serous chorioretinopathy (CSC). Methods:We studied 6 patients with active CSC (mean age of 51 + 13 years) and 6 volunteer control subjects (mean age of 41 + 6 years). All gave informed consent. Subjects were given 40 proof vodka (0.5 ml/lb) orally on an empty stomach, and electro-oculographic (EOG) responses were recorded from both eyes in room illumination (30 cd/m2) for 45 minutes after which an ISCEV standard EOG (dark trough method) was recorded. Blood alcohol levels were monitored at regular intervals with a breath analyzer. Results:Blood alcohol levels 25 min after ingestion averaged 0.06 in normal subjects and 0.08 in CSC patients. Normal subjects had an average EOG Arden ratio of 2.75 and an alcohol peak/baseline ratio of 1.6. CSC patients had normal EOG Arden ratios in both affected (2.6) and fellow (2.5) eyes. However, the alcohol peak/baseline ratios were weak in both affected (1.3) and fellow (1.3) eyes. Conclusion:The origin of the electro-oculographic alcohol response is unknown but is presumed to involve an effect on the RPE cell. Our findings support Arden's conclusion that the alcohol response is independent of the light induced EOG, and suggest that CSC is characterized by a diffuse abnormality of RPE physiology. The finding of similar results in affected and fellow eyes indicates that the RPE dysfunction of CSC is bilateral, and the disease is not simply the result of a unilateral focal RPE defect or leak.
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