Multifocal electroretinography in retinitis pigmentosa

Abstract

To investigate the diagnostic potential of multifocal electroretinography for the evaluation of retinal affection by retinitis pigmentosa in a clinical setting. For this prospective study, multifocal electroretinograms were obtained from 38 patients who matched the inclusion criteria of either a detectable photopic Ganzfeld response or visual fields of 10 degrees or more, and from 30 normal volunteers. Recordings were performed with the visual evoked response imaging system, using a resolution of 61 hexagonal elements within a 30-degree visual field. The results of the left eye of each patient and control subject were used for statistical evaluation by the Mann-Whitney U test. The 38 eligible patients included those with Usher syndrome types I and II (one patient and six patients, respectively) and those with autosomal-recessive (18), X-recessive (two), and autosomal-dominant (11) forms of retinitis pigmentosa. In 27 (71%) of these 38 patients, at least a central response of the multifocal electroretinogram was detectable. Loss of multifocal electroretinogram response density in patients with retinitis pigmentosa was significant (P < .00001) in all five eccentricity groups (concentric rings), with a progression from center to periphery. Implicit time was significantly elevated in the third eccentricity group (P < .0038) and increased further toward the periphery (P < .00001). The results did not differ notably between retinitis pigmentosa subgroups. Because the multifocal electroretinogram differentiates between affected and nonaffected retinal areas, eccentricity-dependent changes in both amplitude and implicit time were found. It can therefore add to the diagnostic information of many patients with retinitis pigmentosa.