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N. W. Khan, J. R. Heckenlively; Foveal Dystrophy or Dysfunction: A Clinical Entity. Invest. Ophthalmol. Vis. Sci. 2008;49(13):6103. doi: https://doi.org/.
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To demonstrate that the multifocal electroretinogram (mfERG) is an effective tool for the detection of foveal dysfunction in the face of a normal standardized electroretinogram and other functional testing in patients complaining of subnormal vision and who have no foveal changes.
Eight patients ages 16 to 62 years with complaints of reduced acuity were assessed with visual acuity, color vision testing (CV), Goldmann visual fields (GVF), mfERG (multifocal ERG), full-field ERG, fundus ophthalmoscopy, fundus photos, and optical coherence tomography (OCT). The mfERG was recorded as a scaled array of 103 hexagons and the amplitude and implicit time of six concentric rings were compared to those of normal control subjects (n=15). For each ring, the peak amplitude (difference between P1 and N1) and the implicit time of P1 were compared with controls.
In all subjects, acuity ranged from 20/30 to 20/400 in the worse eye. Color vision, tested with Ishihara Plates and the Farnsworth D-15 ranged from normal to severely affected color discrimination. GVFs were normal in six subjects and two subjects had central scotomas. Dark-adapted and light-adapted ERGs were normal in all subjects. Fundus examinations revealed no overt degeneration in the macular region. OCTs which were done on 6 patients, showed broadening and thinning of foveal pits. mfERGs showed significant amplitude reduction in the central rings 1 and 2 when compared to control.
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