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Impressum
Topographic mapping of retinal function in patients with Stargardt`s macular dystrophy with a scanning-laser-ophthalmoscope evoked multifocal-ERG (SLO-m-ERG).
Rudolph G., Kalpadakis P., Hörmann C., Froehlich S. J., Berninger T.
Augenklinik der Ludwig-Maximilians-Universität, Mathildenstrasse 8, D - 30336-München
Objective: To evaluate retinal function in patients with Stargardt`s
macular dystrophy (SMD) by using a scanning-laser-ophthalmoscope evoked
multifocal ERG (SLO-m-ERG) and to demonstrate, that simultaneous control
of fixation may be helpful to correlate the response densities with the
corresonding retinal areas also in situations with eccentric fixation.
Methods and subjects: A confocal scanning-laser-ophthalmoscope
was used as a stimulator and trigger unit to perform multifocal ERG measurements
under simultaneous control of fixation in patients with SMD. The measurement
was performed by applying no distortion factor (1:1) in 15 patients, and
a distortion factor of 1:4 in 11 patients of a total of 26 patients. Seventy
eight healthy individuals were examined to serve as a control group. Sixty
two persons were examined with a distortion factor of 1:1 and 16 persons
with a distortion factor of 1:4. Ages from patients and controls ranged
from 20 to 50 years. The local ERG responses from the 61 stimulated local
areas, covering a visual field of 24°, were analysed with a fast m-transform
algorithm. Local ERG`s were grouped in concentric rings.
Results: To summarize the results 5%, 25%, 50%, 75% and 95% quantiles
were calculated. In the group with distortion factor 1:1 there was a significant
statistical difference between the volunteers and the patients with SMD
in the central element and all rings. A statistical difference of response
densities could also be demonstrated by using a distortion factor of 1:4,
but the difference of amplitudes between patients and controls were lower
in the central element and the first ring.
Conclusion: The SLO-m-ERG represents a technique for topographic
mapping of retinal function. The areas of dysfunction were found to be
larger than the morphological alteration. Simultaneous control of fixation
during the measurement allows to detect loss of fixation in the vertical
axis and to correlate the measured values to the corresponding retinal
areas.