Assessment of multifocal electroretinogram abnormalities and their relation to morphologic characteristics in patients with large drusen

Christina Gerth, David Hauser, Peter B. Delahunt, Lawrence S. Morse, John S. Werner

Research output: Contribution to journalArticle

51 Scopus citations


Objectives: To determine the extent of functional changes in the first-order kernel multifocal electroretinogram (mfERG) responses in patients with large drusen by means of a localized analysis and to determine correlations between mfERG responses and morphologic changes. Methods: Thirty-one eyes from 20 patients ages 58 to 84 years with large drusen (≥5 drusen ≥63 μm diameter) were studied. The mfERGs were recorded with a stimulus of 103 hexagons and a flash intensity of 2.67 candela (cd)·s-1·m-2. Each of the 103 single first-order kernel mfERG responses was analyzed and compared with those of age-matched healthy control subjects. Imaging studies, including color stereo fundus photography, red-free fundus photography, and fluorescein angiography, were performed in all patients, and morphologic changes (drusen in red-free fundus photography, staining or window defect in fluorescein angiography) were determined with a digital measurement tool. The mfERG responses were correlated to areas with and without morphologic changes. Results: Reduced responses were found in 10.0% (scalar products) and 4.0% (response densities) and delayed implicit times in 13.8% (N1), 18.9% (P1), and 23.8% (N2) of all mfERGs. Abnormal mfERG responses extended up to 25° in radius. Significant morphologic-functional relations were detected in only a few patients. Abnormal mfERG variables were present in areas without morphologic changes. Conclusions: Patients with large drusen exhibit functional changes in the cone-driven pathways evaluated by the mfERG, indexed particularly by implicit times. Morphologically visible changes do not predict retinal function. Large drusen are associated with a more general retinal dysfunction.

Original languageEnglish (US)
Pages (from-to)1404-1414
Number of pages11
JournalArchives of Ophthalmology
Issue number10
StatePublished - Oct 2003


ASJC Scopus subject areas

  • Ophthalmology

Cite this