Electrodiagnostic and two-wavelength fundus autofluorescence imaging investigations in acute idiopathic maculopathy
- 127 Downloads
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.
- 3.Beck AP, Jampol LM, Glaser DA, Pollack JS (1996) Is coxsackievirus the cause of unilateral acute idiopathic maculopathy? Arch Ophthalmol 114(5):555–559Google Scholar
- 9.Gass JD (1997) Stereoscopic atlas of macular diseases, 4th edn. Mosby-Year Book, St. Louis, p 676Google Scholar
- 10.Macular pigment optical density measurements V220.127.116.11 (2005) Heidelberg Engineering GmbH. Gerhart Hauptmann Strasse 30, 69221 DossenheimGoogle Scholar
- 11.Wolf S, Wolf-Schnurrbusch UEK (2007) Macular pigment measurement—theoretical background. In: Holz FG, Schmitz-Valckenberg S, Spaide RF, Bird AC (eds) Atlas of fundus autofluorescence imaging. Springer, New YorkGoogle Scholar
- 19.Robson AG, Michaelides M, Saihan Z, Bird AC, Webster AR, Moore AT, Fitzke FW, Holder GE (2008) Functional characteristics of patients with retinal dystrophy that manifest abnormal parafoveal annuli of high density fundus autofluorescence; a review and update. Doc Ophthalmol 116(2):79–89CrossRefPubMedGoogle Scholar