PubMed · 13277536
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A SCHLOSSMAN. 1956. Electroretinography.. https://pubmed.ncbi.nlm.nih.gov/13277536/
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PURPOSE: To evaluate whether a normal subject can deliberately produce abnormal electroretinogram (ERG) results that simulate disorders of the retina. DESIGN: Prospective study. METHODS: Five normal subjects were evaluated twice with full-field ERGs. The subjects were randomly assigned to be compliant or noncompliant (i.e., to deliberately attempt to alter the test results) at each visit. Results from compliant eyes were compared with those of noncompliant eyes. RESULTS: While the amplitudes of all parameters were decreased in the noncompliant group, the difference was not statistically significant, and the results were usually within the normal limits of our laboratory. No subject was able to alter the results to mimic a retinal disease or to reproduce a specific pattern of changes. CONCLUSIONS: Although ERG results can be altered by noncompliant subjects, the results are usually only "borderline abnormal" and do not correspond to any pattern of retinal disease. These results confirm that abnormal full-field ERGs indicate true retinal disease.
INTRODUCTION: Idiopathic epiretinal membranes are considered the consequence of glial proliferation through a defect of the internal limiting membrane and can induce a functional macular syndrome associating mainly metamorphopsia and visual acuteness. Visual disturbance is not bound to the area and the degree of transparency of the membrane, but to distortion of external layers of the retina. Multifocal electroretinography (ERGm) can assess the macular area and retina extending 20 degrees. We used this tool to study macular function pre- and post-operatively with seven patients presenting idiopathic epiretinal membrane. PATIENT AND METHOD: All patients had successful vitrectomy, with 0.2 ml of 0.15% trypan blue (TB) staining to facilitate peeling. This stain is not toxic for the pigment epithelium but it becomes so for photoreceptors at doses exceeding 0.2%. We tried to estimate the echo of TB 0.15% on photoreceptors through this exam. An ERGm was done 1 week before the operation as well as 1 month and 4 months after on 14 eyes of seven patients with ERMs. RESULTS: Results show a pre-operative decrease in the electrical retinal response densities in the foveal, perifoveal and parafoveal areas. One month after operation, no significant difference was found compared to pre-operative results. However, at 4 months, an improvement of the retinal response density was observed. Retinal response densities in the macular area increased progressively after ERM surgery. CONCLUSION: The 0.15% TB facilitated ERM peeling and does not seem to present any retinal toxicity.