Multifocal Electroretinograms in Stargardt's Disease/Fundus Flavimaculatus

Abstract

Purpose: To determine whether the characteristics of multifocal electroretinograms (mfERGs) were correlated with the ophthalmic appearance of the fundus in patients with Stargardt's disease/fundus flavimaculatus (SFF). Methods: Full-field ERGs, mfERGs, and general ophthalmic examinations were performed on 49 eyes with SFF. Results: The SFF patients were divided into four subtypes according to the classification of Noble and Carr [Arch Ophthalmol 1979;97:1281-1285]. The patients with type 1 SFF had severely reduced mfERGs in the macular area and reduced and delayed responses in the mid-periphery. The type 2 SFF patients had reduced but recordable mfERGs from the center of the macula with more depressed responses in the paramacular area, and the type 3 SFF patients had reduced and delayed mfERGs both in the macula and periphery. The patients with type 4 SFF had normal mfERGs in the macular area and delayed responses in all outer zones. Conclusions: These mfERG findings indicate that each subtype of SFF has unique characteristics corresponding to the abnormal retinal functions.

Macular Electroretinogram in Stargardt's Disease/Fundus Flavimaculatus

“…The cone responses (photopic b-wave) were significantly reduced in SFF, and the retinal function was the worst in SFF type 3E [4]. The full-field and multifocal ERG findings in our patients [2] are in good agreement with the results presented in the paper by Itabashi et al [4]. …”

“…1e). As shown previously [table 1 in [2]], the BCVA and the multifocal ERGs' responses appear to depend more on the fundus appearance including SFF type than on age. However, Itabashi et al [4] reported, for each patient, that the BCVA in eyes with SFF decreased with increasing age, and 25% of the patients over 40 years became legally blind.…”

“…We appreciate the comments by Gundogan et al [1] on our paper entitled ‘Multifocal electroretinograms in Stargardt's disease/fundus flavimaculatus', published in Ophthalmologica [2]. They asked us to present more details on the full-field electroretinograms (ERGs) and also to calculate the correlation between the visual amplitudes of the multifocal ERGs' central response, the visual acuity and age for each type of Stargardt's disease/fundus flavimaculatus (SFF) [3].…”

Stargardt disease – what general ophthalmologists should know about this macular dystrophy

“…Electroretinographic tests, such as multifocal electroretinography (mfERG) [17,18] (Figure 7), pattern ERG (PERG) [19] ( Figure 8) and flash full-field ERG (ERG) [10,11], are helpful in confirming the diagnosis and have prognostic value in STGD. These tests estimate objectively actually generalized bioelectrical function of the retina including the macular region.…”

Comment on the Paper by Kuniyoshi et al. Entitled ‘Multifocal Electroretinograms in Stargardt's Disease/Fundus Flavimaculatus'

“…We congratulate Kuniyoshi et al [1] on their study entitled ‘Multifocal electroretinograms in Stargardt's disease/fundus flavimaculatus'. The authors grouped their patients into 4 types according to the classification by Noble and Carr [2].…”