Artikel
Multifocal electroretinogram in patients with Retinitis pigmentosa and annular fundus autofluorescence
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Autoren
Veröffentlicht: | 22. September 2004 |
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Gliederung
Text
Objective
Dependent on the stage of the disease patients with Retinitis pigmentosa show an intense annular autofluorescence (AF) spanning the parafoveal 4° to 10°-15°. We examined the functional significance of changes in fundus autofluorescence with the multifocal electroretinogram (mfERG).
Methods
11 patients (ADRP 2, ARRP 1, RPsimplex 4, XLRP 4) were examined. Color vision (Panel D15) and visual fields (kinetic Goldmann perimetry) were tested and AF imaging was performed with a Heidelberg Retina Angiograph. Ganzfeld-ERGs (ISCEV standard, Nicolet, Madison, WI) and mfERGs (VERIS, EDI, CA) were recorded.
Results
As fundus AF was symmetrical we evaluated one eye per patient. AF extended from 2,5° (SD±1,7°) to 9° (SD±2,4°) in XLRP, 3,7° (SD±0,5°) to 10° (SD±1°) in RPsimplex, 3,5° (SD±0,5°) to 7° (SD±0°) in ADRP and from 3° to 11° in ARRP. Focal ERGs of rings 2 to 4 (3° -12°) fall within these areas. Compared to age-matched normal values N1 and P1 amplitudes of rings 2 to 4 were significantly (p=0,05) reduced. Amplitudes of 9 patients could not be distinguished from the average noise level. In 10 patients, N1 and P1 amplitudes of the central element showed significant reduction with only 4 answers falling in the noise. The reduction of the remaining 6 amplitudes correlated with visual acuity (r=0.75). N1 and P1 implicit times were significantly prolonged for the central element as well as elements of rings 2 to 4.
Conclusions
Areas of intense annular AF in patients with RP are likely to be associated with reduced retinal function. In the very center retinal function is variable.