Abstract
Aims A scanning laser ophthalmoscope (SLO) has been used for multifocal electroretinography (mf ERG) measurements under simultaneous fundus monitoring. The aim of this study was to prove if the SLO-mfERG measurement reflects reliably the clinically registered underlying disease, and to demonstrate the importance of its main advantage, fixation monitoring.
Methods In all, 10 patients with macular hole stage II/III were included in the study, and 19 normal individuals served as the control group. The mf ERG device was combined with an SLO, which was used both as a stimulus and trigger unit as well as a fundus-monitoring system. Monitoring of the fundus was guaranteed by an infrared laser (780 nm). The stimulus matrix consisted of 61 hexagonal elements, covering 24° of the posterior pole. We examined both, patients with macular holes and healthy individuals.
Results Compared to normal controls, patients with a macular hole (Gass stage III) showed a significant decrease in response density in the centre of the stimulus array, which correlated well with the morphological alteration observed by clinical examination. However, variation of response density of the central hexagonal area has been proved to be high.
Conclusions SLO-mfERG is a feasible and reliable new technique to investigate macular function under simultaneous fundus control. The main advantage is that control of fixation can be used in order to obtain more reliable results that correlate well with visible fundus abnormalities such as in patients with macular holes. However, further investigations have to be performed in order to overcome sufficiently the problem of fixation instability.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Carr RE, Siegel IM . Fundamentals of Electroretinography. In: Visual Electrodiagnostic Testing. William and Wilkins: Baltimore, London, 1982, pp 3–8.
Heckenlively JR, Weleber RG, Arden GB . Testing levels of the visual system: In: Heckenlively JR, Arden GB (eds). Principles and Practice of Clinical Electrophysiology of Vision. Mosby Yearbook. St Louis, 1991, pp 485–493.
Marmor M, Zrenner E . Standard for clinical electroretinography (1994 update). Doc Ophthalmol 1995; 89: 199–210.
Arden GB, Carter RM, Macfarlan A . Pattern and Ganzfeld electroretinograms in macular disease. Br J Ophthalmol 1984; 68(12): 878–884.
Arden GB, Vaegan, Hagg CR . Clinical and experimental evidence that the pattern electroretinogram (PERG) is generated in more proximal retinal layers than the focal electroretinogram (FERG). Ann NY Acad Sci 1982; 388: 580–607.
Armington JC, Tepas DI, Kropfl WJ, Hengst WH . Summation of retinal potentials. J Opt Soc Am 1961; 51: 877.
Sandberg MA, Ariel M . A hand held two channel stimulator ophthalmoscope. Arch Ophthalmol 1977; 95:1881–1882.
Sutter EE, Vaegan . Lateral interaction component and local luminance nonlinearities in the human pattern reversal ERG. Vision Res 1990; 30: 659–671.
Sutter EE, Tran D . The field topography of ERG components in man. I. The photopic luminance response. Vision Res 1992; 32: 433–446.
Kondo M, Miyake Y, Horiguchi M, Suzuki S, Tanikawa A . Recording multifocal electroretinograms with fundus monitoring. Invest Ophthalmol Vis Sci 1997; 38: 1049–1052.
Seeliger M, Narfström K . Functional assesment of the regional distribution of disease in a cat model of hereditary retinal degeneration. Invest Ophthalmol Vis Sci 2000; 41: 1998–2005.
Lachenmayr B . Scanning-Laser-Ophthalmoskop (SLO): Prinzip und Wirkungsweise. In: Lund OE, Waubke T (eds) Bücherei des Augenarztes, Vol 133. Stuttgart, Enke Verlag: 1994, pp 54–61.
Mainster MA, Timberlake GT, Webb RH, Hughes GW . Scanning laser ophthalmoscopy. Clinical applications. Am Acad Ophthalmol 1982; 89: 853–857.
Seeliger MW, Narfström K, Reinhard J, Zrenner E, Sutter E . Continuous monitoring of the stimulated area in multifocal ERG. Doc Ophthalmol 2000; 100: 167–184.
Van de Velde FJ, Jalkh AE, Katsumi O, Hirose T, Timberlake G, Scheppens C . Clinical scanning laser ophthalmoscope applications: an overview. In: Nasemann JE, Burk ROW (eds). Scanning laser ophthalmoscopy and tomography, Munich, Quintessenz, 1990, pp 35–47.
Webb RH, Hughes GW, Delori FC . Confocal scanning laser ophthalmoscope. Applied Optics 1980; 26: 1492–1492.
Woon WH, Fitzke FW, Birg AC, Marshall J . Confocal imaging of the fundus using a scanning laser ophthalmoscope. Br J Ophthalmol 1992; 76: 470–474.
Curcio CA, Sloan KR, Kalina RE, Hendrickson AE . Human photoreceptor topography. J Comp Neurol 1990; 292: 497–523.
Curcio CA, Sloan KR Jr, Packer O, Hendrickson AE, Kalina RE . Distribution of cones in human and monkey retina. Individual variability and radial asymmetry. Science 1987; 236: 579–582.
Oesterberg GA . Topography of the layer of rods and cones in the human retina. Acta Ophthalmol 1935; 13(6):1–102.
Sutter EE . A deterministic approach to non-linear system analysis. In: Printer RB, Nabet B (eds) Nonlinear Vision. CRC Press: Cleveland, 1992, pp 171–220.
Teping C, Wolf S, Schippers V, Plesch A, Silny J . Use of the scanning laser ophthalmoscope for recording pattern electroretinography and visual evoked cortical potentials. Klin Mbl Augenheilk 1989; 195: 203–206.
Nagatomo A, Nobushima N, Maruiwa F, Arai M, Sawada A . Multifocal electroretinograms in normal subjects. Jpn J Ophthalmol 1998; 42: 129–135.
Kretschmann U, Seeliger M W, Ruether K, Usui T, Apfelstedt-Sylla E, Zrenner E . Multifocal electroretinography in patients with Stargardt's macular dystrophy. Br J Ophthalmol 1998; 82: 267–275.
Seeliger M, Kretshmann U, Apfelstedt-Sylla E, Ruther K, Zrenner E . Multifocal electroretinography in retinitis pigmentosa. Am J Ophthalmol 1998; 125: 214–226.
Palmowski AM, Sutter EE, Bearse MA, Fung W . Mapping of retinal function in diabetic retinopathy using the multifocal electroretinogram. Invest Ophthalmol Vis Sci 1997; 38: 2586–2596.
Wildberger H, Monhart M . Some reflexions concerning the effect of eccentric fixation during mERG recording. ISCEV XXXIX, Montreal-Mont-Orford, June 2001, p 144 (Abstract).
Rohrschneider K, Bueltmann S . Correlation between fundus perimetry and multifocal ERG using the scanning laser ophthalmoscope. Invest Ophthalmol Vis Sci 2001; (424): S69 (Abstract).
Chisholm JA, Keating D, Parks S, Evans AL . The impact of fixation on the multifocal electroretinogram. Doc Ophthalmol 2001; 102(2): 131–139.
Parks S, Keating D, Williamson TH, Evans AL, Elliot AT, Jay JL . Functional imaging of the retina using the multifocal electroretinograph: a control study. Br J Ophthalmol 1996; 80: 831–834.
Rudolph G, Kalpadakis P, Bechmann M, La Rocca G, Hormann C, Berninger T . Scanning laser ophthalmoscope-evoked multifocal-ERG ((SLO-m-ERG) by using short m-sequences. Eur J Ophthalmol 2002; 12(2): 109–116.
Jackson GR, Ortega J, Girkin C, Rosenstiel CE, Owsley C . Aging-related changes in the multifocal electroretinogram. J Opt Soc Am A Opt Image Sci Vis 2002; 19: 185–189.
Nabeshima T . The effect of ageing on the multifocal electroretinogramm. Jpn J Ophthalmol 2001; 45: 114–115.
Barber C . The multifocal technique: a new era in clinical electrophysiology of vision. Focus 2002; 21.
Haritoglou C, Gass C, Schaumberger M, Ehrt O, Gandorfer A, Kampik A . Macular changes after peeling of the internal limiting membrane in macular hole surgery. Am J Ophthalmol 2001; 132: 363–368.
Moschos M, Apostolopoulos M, Ladas J, Theodossiadis P, Malias J, Moschou M et al. Multifocal ERG changes before and after macular hole surgery. Doc Ophthalmol 2001; 102(1): 31–40.
Si YJ, Kishi S, Aoyagi K . Assessment of macular function by multifocal electroretinogram before and after macular hole surgery. Br J Ophthalmol 1999; 83(4): 420–424.
Terasaki H, Miyake Y, Nomura R, Piao CH, Hori K, Niwa T et al. Focal macular ERGs in eyes after removal of macular ILM during macular hole surgery. Invest Ophthalmol Vis Sci 2001; 42: 229–234.
Rohrschneider K, Bueltmann S . Correlation between fundus perimetry and multifocal ERG using the scanning laser ophthalmoscope. Invest Ophthalmol Vis Sci 2001; 42(4): 69 (Abstract).
Author information
Authors and Affiliations
Corresponding author
Additional information
This study has not been supported by any grant or research funding
Rights and permissions
About this article
Cite this article
Rudolph, G., Kalpadakis, P., Bechmann, M. et al. Scanning laser ophthalmoscope-evoked multifocal ERG (SLO-mfERG) in patients with macular holes and normal individuals. Eye 17, 801–808 (2003). https://doi.org/10.1038/sj.eye.6700502
Received:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/sj.eye.6700502
Keywords
This article is cited by
-
The mfERG response topography with scaled stimuli: effect of the stretch factor
Documenta Ophthalmologica (2009)
-
Effects of unsteady fixation on multifocal electroretinogram (mfERG)
Graefe's Archive for Clinical and Experimental Ophthalmology (2006)
