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Posterior Segment
22.97nV/deg
2
, SD 3.6). In area 2, representing the perifoveal area, the are decreased. After recovery, the mf-ERG amplitudes slightly
average mean retinal response density was 7.64nV/deg
2
(SD 3.21). This increase, but still remain significantly lower than normal. These
value is 37.2% lower compared with normal controls (mean findings imply a functional recovery of the central retinal area.
12.18nV/deg
2
, SD 2.27) (see Figure 1). However, a degree of functional impairment persists in spite of the
absorption of subretinal fluid. This is not surprising as various stress
After recovery from CSCR, an improvement of the mean retinal factors or systemic causes that affect CSCR patients are likely to
response density was noted (see Figure 2). The average mean persist even after the attack.
5
Also, our findings show that at
retinal response density of area 1 was improved to 16.05nV/deg
2
(SD presentation in some cases the mf-ERG of the fellow non-affected
3.87), still 30.1% lower compared with the normal controls. In area 2, eye is abnormal compared with normal subjects, and this
the average mean retinal response density of the affected eyes was abnormality persists especially in area 1 after the clinical recovery.
also increased to 9.27nV/deg
2
(SD 3.25); lower by 23.9% to normal The latter does not concur with the findings of Vajaranant et al.,
6
controls. Both differences are statistically significant (p<0.001). who concluded that the elecroretinographic changes are limited in
the affected eye.
The correlations between VA and mf-ERG values of affected eyes
were calculated, and the only correlation found was between VA The findings of diffuse bilateral macular dysfunction in CSCR is
after resolution and VA at presentation (R=0.70) and between mf-ERG consistent with the concept that this disease is conditioned by
after resolution and mf-ERG at presentation (R=0.82). It is interesting systemic humoral factors such as adrenaline and corticosteroids or
that in six of 21 fellow non-affected eyes the mf-ERG values were by diffuse underlying choroidal vascular disease.
7
The findings of our
pathological. The mf-ERG average mean retinal response density in study support this view. n
areas 1 and 2 was 12 and 7.86nV/deg
2
, respectively (see Table 2). For
the remaining 15 eyes, the mf-ERG averaged mean retinal response
density in areas 1 and 2 was 19.7nV/deg
2
and 12.3nV/deg
2
,
Marilita M Moschos is a Senior Lecturer in the
Department of Ophthalmology at Athens University,
respectively (see Figure 3 and Table 3).
where she has the clinical and scientific
co-responsibility for the Laboratory of Electrophysiology
Discussion
of Vision and the Department of Glaucoma. She has
authored or co-authored over 45 scientific papers in
mf-ERG helps us to evaluate the functional component of the
peer-reviewed journals and is a reviewer for several
macular area, especially in the absence of macular findings.
ophthalmological journals,including Clinical and
However, in our study no correlation between the mf-ERG findings
Experimental Ophthalmology, the Expert Review of
Ophthalmology, the Journal of Neuroscience Methods, Graefe’s Archive for Clinical
and the best corrected VA was observed. This finding could be
and Experimental Ophthalmology, BMC Ophthalmology, Clinical Ophthalmology and
attributed to the fact that the retinal response densities in areas 1
the Indian Journal of Ophthalmology. Professor Moschos also wrote a chapter entitled
and 2 reflect not only the integrity of the photoreceptors of the
Multifocal-Electroretinogram in Retinal Vascular Diseases for the annual edition of
Société Française d’Ophtalmologie (SFO). She has presented at over 50 international
fovea, which are few and responsible for the VA, but also the
conferences, some as invited speaker and is a member of many international
electrical responses of the bipolar and the Müller cells of the inner
ophthalmological societies. Professor Moschos graduated from the Pharmacy School
layers of the parafoveal area. At presentation, the mean retinal
of the University of Patras and the Medical School of the University of Athens.
response densities of mf-ERG in areas 1 and 2 of the affected eyes
1. Robertson DM, Argon laser photocoagulation treatment in decompensation. I Clinical features and natural course, 6. Vajaranant TS, Szlyk JP, Fishman GA, et al., Localized retinal
central serous chorioretinopathy, Ophthalmology, 1986; Ophthalmology, 1984;91:1544–8. disfunction in central chorioretinopathy as measured using
93:972–4. 4. Brancato R, Lumbroso B, Guide to OCT intrerpretation, Rome: the multifocal electroretinogram, Ophthalmology,
2. Chaine G, Houat M, Menard-Molcard C et al., Choriorétine INC Innovation News Communication, 2004;38. 2002;109:1243–50.
séreuse centrale et corticothérapie systémique, J Fr 5. Chappelow AV, Marmor MF, Multifocal Electroretinogram 7. Iida T, Hagimura N, Sato T, et al., Evaluation of central
Ophtalmol, 2001;24:139. abnormalities persist following resolution of central serous serous chorioretinopathy with optical coherence
3. Jalkh AE, Jabbour N, Avia MP Retinal pigment epithelium chorioretinopathy, Arch Ophthalmol, 2000;118: 1211–15. tomography, Am J Ophthalmol, 2000;129:16–20.
Editor’s Recommendation
Tilted Disc Syndrome: An OCT and mfERG Study
Moschos MM, Triglianos A, Rotsos T, Papadimitriou S, Margetis I, Minogiannis P, Moschos M, Doc Ophthalmol, 2009;119(1):23–8.
The purpose of this study was to evaluate retinal thickness and that the OCT-derived RNFL thickness was significantly decreased
function in eyes with tilted disc syndrome with optical coherence in the superior area of eyes with tilted disc with a mean value
tomography (OCT) and multifocal electroretinogram (mfERG). equal to 106.47 microns (SD 24.1). The mean response amplitude
Twenty-one eyes of 12 patients (four males and eight females) density of the fovea (11.75nV/deg
2
) and parafovea (8.22nV/deg
2
)
with tilted disc were studied with OCT3 and mfERG and was significantly lower in eyes with tilted disc than in normal
compared with 40 eyes of 20 age- and sex-matched control eyes. In conclusion, OCT and mfERG were found to be objective
subjects. The thickness of the fovea and the thickness of the tools for assessing anatomical and functional damage of the
retinal nerve fibre layer (RNFL) along a 3.4mm-diameter circle macula. Our results suggest that in tilted disc syndrome even
centred on the optic nerve head were evaluated using OCT3. The without visual impairment the optic nerve and the macula show
macular cone function was tested by mfERG. Results showed dysfunction not visible by other means. n
74 EUROPEAN OPHTHALMIC REVIEW