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Impressum
Correlation between fundus perimetry and multifocal ERG using the Scanning Laser Ophthalmoscope
Rohrschneider K., Bültmann S.
Univ.-Augenklinik Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
Purpose: Fundus perimetry using the SLO allows fundus testing
with exact correlation between function and morphology. The new technique
of multifocal ERG (MERG) using the SLO allows electrophysiological testing
under the same conditions. Aim of this study was to compare the findings
from these two methods as well as the pathology on the fundus.
Methods: 43 eyes of 30 patients with macular pathology or visual
field deterioration (e.g. Stargard's disease,cone-rod dystrophies, Retinitis
pigmentosa) and visual deterioration (visual acuity 0.1 -0.8) were examined
using the SLO (Rodenstock,Germany) for automatic fundus perimetry with
various test patterns as well as MERG in an identical field. Latter was
performed using the RETIscan system (Roland Consult, Germany). Fundus
perimetry was evaluated according to the depth of the scotoma and the
location and stability of fixation. MERG examinations were observed for
the N1 and P1 amplitude for each single hexagon as well as for defined
segments and rings. Fundusperimetric results were compared to the electroretinographic
findings especially according to the behavior of fixation.
Results: Examination time for reliable results was comparable for
both methods (10-15 minutes). There was good agreement for eyes with retinitis
pigmentosa with only central answers while pathology was more pronounced
during MERG. In contrast, patients with Stargardt's disease demonstrated
more defined scotomata during perimetry while MERG showed diffuse loss
of amplitudes due to instable fixation. Patients alternating between two
points of fixation showed no good concordance between both methods.
Conclusions: The different setting with supra-threshold stimuli
during ERG in contrast to near-threshold stimulus presentation during
perimetry might be the major reason for differences even in the beginning
of retinal diseases. Besides this, reduced stability of fixation leads
to artifacts during MERG causing inaccurate results while this is of neglectible
influence during fundus perimetry. Further development of automatic correction
for eye movements will allow more precise functional mapping of the retina
during fundus controlled MERG.