Electrodiagnostic and two-wavelength fundus autofluorescence imaging investigations in acute idiopathic maculopathy
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The aim is to characterise a case of acute idiopathic maculopathy (AIM) using detailed electrophysiology and 2-wavelength fundus autofluorescence (FAF) imaging. A 32-year-old woman presented with reduced visual acuity in her right eye. Imaging investigations performed included 1 & 2 wavelength FAF, fluorescein and ICG angiography and Fourier domain OCT imaging. International-standard pattern and full-field electroretinography (PERG; ERG), electro-oculography (EOG) and multifocal ERG testing were performed. Multifocal ERGs demonstrated evidence of localised macular dysfunction consistent with mild right pattern ERG P50 reduction. Full-field ERGs were within normal limits. The EOG was normal bilaterally. The use of 1 & 2 wavelength FAF imaging revealed a low density macular area, not explained by luteal pigment absorption, that was associated with macular dysfunction. Two-wavelength FAF imaging allows the accurate quantification of macular pigment and the imaging of the underlying relative distribution of lipofuscin. AIM was characterised by a discrete area of disrupted retinal pigment epithelium metabolism and atrophy associated with localised macular dysfunction. Complimentary use of dual-wavelength FAF imaging and electrophysiology may have application to disorders other than AIM.
KeywordsAcute idiopathic maculopathy Autofluorescence imaging Electro-oculogram Electroretinogram
The research was supported by grants from the Foundation Fighting Blindness (USA) and from the National Institute for Health Research UK to the Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital and Institute of Ophthalmology, London. Roland Consult are thanked for mfERG facilities.
Conflict of interest statement
No authors have any financial/conflicting interests to disclose.
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