Foveal outer retinal function in eyes with unexplained visual symptoms or acuity loss

• Published in: Archives of ophthalmology (1960) Vol. 116; no. 9; p. 1161
• Main Authors: Weiner, A, Schmidt, M E, Patel, S, Gussler, C H, Remler, B F, Kaufman, S R, Kohn, H D, Weidenthal, D T
• Format: Journal Article
• Language: English
• Published: United States 01.09.1998
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Child; Electroretinography; Female; Fovea Centralis - physiopathology; Humans; Male; Middle Aged; Prospective Studies; Retina - physiopathology; Retinal Cone Photoreceptor Cells - physiopathology; Retinal Diseases - diagnosis; Retinal Diseases - physiopathology; Vision Disorders - diagnosis; Vision Disorders - physiopathology; Visual Acuity; Visual Field Tests
• ISSN: 0003-9950
• DOI: 10.1001/archopht.116.9.1161

To determine whether foveal outer retinal dysfunction is common in eyes with unexplained visual symptoms or acuity loss. Prospective study. Seventy-three eyes of 44 consecutive patients with unexplained visual symptoms or acuity loss, 39 eyes of 39 control subjects, and 12 eyes of 7 patients with known maculopathy. Foveal cone electroretinography (ERG) and letter recognition perimetry. Foveal cone ERG data. Abnormal foveal cone ERG data were recorded in 35 (48%) of 73 eyes (23 [52%] of 44 patients). Among these 35 eyes, amplitude was lower than in normal controls (P<.001) and was correlated with visual acuity and the number of letter recognition perimetry errors (P<.05 for both). The latter was higher in eyes with abnormal retinal responses than in symptomatic eyes with normal responses (P<.01). However, initial symptoms, visual acuity, and macular appearance did not differentiate between these 2 groups. Foveal cone ERG test vs retest data showed consistent results. Foveal outer retinal dysfunction is a common underlying mechanism of previously unexplained visual symptoms or acuity loss. Foveal cone ERG testing should be considered early in the evaluation of eyes with this presentation.