PubMed · 13747959
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B SCHMIDT, W MUELLER-LIMMROTH. 1961-04-08. [Electroretinography].. https://pubmed.ncbi.nlm.nih.gov/13747959/
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OBJECTIVE: To report the subjective and objective improvement in vision in a patient with autosomal dominant retinitis pigmentosa after transplantation of a sheet of fetal neural retina together with its retinal pigment epithelium. DESIGN: A sheet of fetal neural retina with its retinal pigment epithelium was transplanted into the subretinal space under the fovea unilaterally in a patient with retinitis pigmentosa with visual acuity of 20/800 in the treated eye. Early Treatment Diabetic Retinopathy Study visual acuity testing, scanning laser ophthalmoscope, tissue typing of the donor and recipient, fluorescein angiography, multifocal electroretinogram, multifocal visually evoked potential, and clinical examination were used. RESULTS: No clinical evidence of rejection was observed. There was no retinal edema or scarring. The transplant sheet lost its pigmentation by 6 months. MAIN OUTCOME MEASURES: A change in visual acuity from 20/800 to 20/400 (7 months), 20/250 (9 months), and 20/160 (1 year) was observed by Early Treatment Diabetic Retinopathy Study visual acuity testing. Independently, scanning laser ophthalmoscope testing at a different institution at 9 months showed a visual acuity of 20/270 at a 40 degrees field of view. CONCLUSION: This study indicates that fetal retina transplanted with its retinal pigment epithelium can survive 1 year without apparent clinical evidence of rejection and show continued improvement in Early Treatment Diabetic Retinopathy Study visual acuity.
Multifocal VEP and mfERG techniques show promise for routine clinical use in neuro-ophthalmology. OCT is now used in many subspecialty areas of ophthalmology, especially in studies of the retina and glaucoma. Although neuro-ophthalmologists must still rely on time-consuming history taking and careful clinical examination, the three modalities described herein can provide objective proof regarding clinical diagnoses in selected cases, saving time and avoiding costly neurologic investigations.
To assess the quantitative effect of optical deficiencies on the Pattern Electroretinogram (PERG), we degraded the optical imaging onto the retina by dioptric defocus (+1.75-5 D), and by scatter transparencies. With optimal and degraded optics we measured the visual acuity and the steady-state PERG, evoked by checkerboards (check size 0.2-16 degrees), and flash stimuli. When the two optical degradation methods were equated for acuity, scatter transparencies reduced the PERG amplitude more than defocus. For scatter transparencies, there was a significant (p < 0.001) effect at 16 degrees, escalating for smaller checks. For defocus, significant effects were only observed for check sizes of 1.6 degrees and smaller. We explain the differences between the two blur techniques by their differing angular scattering functions. Dioptrical defocus leads to an underestimation of the effect of media opacities on the PERG. For the clinically relevant check size of 0.8 degrees, halving acuity reduces the amplitude by 15% with defocus and by 30% with scatter. With an acuity of 0.8 or higher, no clinically relevant effect of suboptimal refraction is seen.