Programm                 "Degeneration und Regeneration– Grundlagen, Diagnostik und Therapie"

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The mfERG in Glaucoma: A Review of Possibilities and limitations

Palmowski A. M.
University Eye Hospital, Basel/CH

Purpose: To review the ability of the multifocal ERG (MF-ERG) to detect retinal dysfunction in normal tension (NT) or high tension (HT) open angle glaucoma (OAG).
Method: In MF-ERG recordings m-sequence stimulation enables simultaneous and independent stimulation of multiple retinal areas. Under high contrast and fast stimulation, the first order response component, KI, is predominated by components of outer retinal origin. In an attempt to enhance signs of glaucomatous dysfunction in the MF-ERG, stimulation conditions have been varied primarily in order to try and increase inner retinal contributions. In an attempt to gain further insight into the retinal origin of different mfERG response components and therefore into the origin of mfERG changes observed in glaucoma, mfERG recordings have been obtained in patients with other diseases such as Parkinson`s disease as well as under pharmacologic blocking in a primate model.
Results: MfERG recordings with 50% contrast relatively enhanced the contribution of the so called optic nerve head component (ONHC) which is presumed to be of inner retinal origin and has been reported to be impaired in glaucoma. Unfortunately this did not increase sensitivity enough to detect individual patients as having OAG. Interposition of bright global flashes into the m-sequence, as suggested by Sutter, increased the MF-ERG sensitivity to detect retinal dysfunction in glaucoma. When the stimulus base interval was increa

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