Abstract
Multifocal electroretinogram (mfERG) is an important diagnostic tool in the clinical evaluation of central electro-retinal function of the macula. To enhance the diagnostic values and to improve its accuracy and internal consistency, it is crucial to examine carefully the endogenous and exogenous factors that affect mfERG recordings and clinical interpretations. This mini review focuses on three aspects of exogenous factors including (1) physiological variations pertaining to age and gender; (2) systemic changes owing to oxygen, blood pressure and glucose levels; (3) individual variables due to refractive status, pupil size, luminance and viewing condition.
Highlights
The first clinical recording of a focal electroretinogram (ERG) was conducted using foveal and parafoveal focal stimuli projected on the retina with a handheld ophthalmoscopic stimulator (Sandberg et al, 1977; Sandberg et al, 1983)
The purpose of this review is to identify, segregate, and analyse the contributing factors that affect Multifocal electroretinogram (mfERG) measurements through categorisation to facilitate clinical interpretation
After undertaking multiple gap analyses to map the determinants that might potentially affect mfERG measurements, it was found that they were frequently related to factors such as age, gender, axial length, refractive error, pupil size, ambient light, stimulus luminance, fixation, alignment, suppression, stretch factor, blood pressure, and blood oxygen and glucose levels
Summary
The first clinical recording of a focal electroretinogram (ERG) was conducted using foveal and parafoveal focal stimuli projected on the retina with a handheld ophthalmoscopic stimulator (Sandberg et al, 1977; Sandberg et al, 1983). One of its inadequacies was the difficulty in applying multiple focal stimulations to cover a wider retinal area. This shortfall was overcome by the introduction of the multifocal electroretinogram (mfERG). The mfERG employs special binary m-sequence with flash on– and flash off–stimuli in unique orders to map different retinal locations within a short time. This was done over a much larger area of the retina (Bearse & Sutter, 1996; Sutter & Tran, 1992). The mathematical m-sequence model enables the electrical activity of the retina to be recorded as a single timedomain signal to produce a single derived mfERG within 45° in the posterior pole (Bearse & Sutter, 1996)
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