Multifocal pattern electroretinography for the detection of neural loss in eyes with permanent temporal hemianopia or quadrantanopia from chiasmal compression.

Abstract

To evaluate the ability of multifocal transient pattern electroretinography (mfPERG) to detect neural loss and assess the relationship between mfPERG and visual-field (VF) loss in eyes with chiasmal compression. 23 eyes from 23 patients with temporal VF defects and band atrophy of the optic nerve and 21 controls underwent standard automated perimetry and mfPERG using a stimulus pattern of 19 rectangles, each consisting of 12 squares. The response was determined for the central rectangle, for the nasal and temporal hemifields (eight rectangles each) and for each quadrant (three rectangles) in both patients and controls. Comparisons were made using variance analysis. Correlations between VF and mfPERG measurements were verified by linear regression analysis. Mean ± SD mfPERG amplitudes from the temporal hemifield (0.50 ± 0.17 and 0.62 ± 0.32) and temporal quadrants (superior 0.42 ± 0.21 and 0.52 ± 0.35, inferior 0.51 ± 0.23 and 0.74 ± 0.40) were significantly lower in eyes with band atrophy than in controls (0.78 ± 0.24, 0.89 ± 0.28, 0.73 ± 0.26, 0.96 ± 0.36, 0.79 ± 0.26 and 0.91 ± 0.31, respectively). No significant difference was observed in nasal hemifield measurements. Significant correlations (0.36-0.73) were found between VF relative sensitivity and mfPERG amplitude in different VF sectors. mfPERG amplitude measurements clearly differentiate eyes with temporal VF defect from controls. The good correlation between mfPERG amplitudes and the severity of VF defect suggests that mfPERG may be used as an indicator of ganglion cell dysfunction.