Multifocal electroretinograms in patients with branch retinal artery occlusion

PURPOSE. To investigate the usefulness of second-order multifocal electroretinograms (MERGs) for detecting inner retinal disorders. METHODS. The MERG from 5 patients with branch retinal artery occlusion (BRAO) was recorded. Twelve eyes of 12 normal subjects were also tested. MERGs were recorded using 61 hexagons. Bright flash ERGs were also recorded to measure the oscillatory potentials (OP). Root mean square (RMS) measures of the local first- and second-order MERGs (fMERG and sMERG) were compared in the affected and unaffected areas. The first negative trough (N1) and first positive peal; (P1) were also used for measuring the amplitudes and latencies of the fMERG. RESULTS. The fMERG RMS-amplitudes decreased significantly (r = 0.56, P < 0.05) in the affected area compared with normal values. The fMERG latencies of N1 and P1 increased significantly (P < 0.05) in the affected area. Furthermore, the sMERG RMS-amplitudes decreased almost to the noise level (r = 0.28, p < 0.001) in the affected areas. The interocular ratio of the sMERG RMS-amplitudes (affected/normal) significantly correlated with that of the fMERC (r = 0.69, P < 0.001). The fMERG latencies significantly correlated with the sMERG RMS-amplitude (r = 0.37 similar to 0.69, P < 0.05 <similar to> 0.001), but only began to increase after a 30% to 50% loss of the sMERG amplitude. The summed OP amplitude decreased to the same extent as the sMERG in the affected eye (0.5 of the normal eye). CONCLUSIONS. Although the fMERG amplitude and latency were significantly changed, the sMERG was much more affected by BRAO. The marked reduction of the sMERG in the affected area strongly suggested its main source was from the more inner layers of the retina compared to the fMERG. The sMERG appeared to be a sensitive indicator of inner retinal dysfunction.