PubMed · 13372671
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G GOODMAN, G ISER. 1956. Physiologic studies with flicker electroretinography.. https://doi.org/10.1016/0002-9394(56)90373-7
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PURPOSE: To present a case of occult macular dystrophy accompanying normal-tension glaucoma. DESIGN: Observational case report. METHODS: Visual function and ophthalmoscopic and electroretinographic findings in a 56-year-old man suffering from gradually progressive photophobia and visual dysfunction were followed up over 4 years. RESULTS: Best-corrected visual acuity was below 20/200, and intraocular pressures remained in the low teens in both eyes. A wedge-shaped visual field defect in the right eye, corresponding to the enlarged disk cupping, and a relative central scotoma in the left were detected. Ophthalmoscopy and fluorescein angiography detected no apparent abnormality at the macular region in either eye. Severely attenuated multifocal electroretinographic responses were recorded from only the central areas, with normal full-field responses. CONCLUSION: Clinicians must look for additional pathologic conditions in patients with normal-tension glaucoma who have unexplained central visual dysfunction.
To study the L- and M-cone pathways and their interactions in patients with cone and cone-rod dystrophies, ERG responses were measured to stimuli which modulated exclusively the L- or the M-cones, or the two simultaneously. The L- and M-cone driven ERG amplitudes were considerably reduced in the patients. The mean phases of the L-cone driven ERGs in the patients lagged those of normals significantly, whereas the mean M-cone driven ERGs were significantly phase advanced resulting in a substantial phase difference between the two ERG responses. These phase changes in the L- and M-cone driven responses in the patients cannot be detected with standard ERG techniques.