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From the Department of Ophthalmology, Niigata University School of Medicine, Niigata, Japan.
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 peak (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 fMERG
(r = 0.69, P < 0.001). The fMERG
latencies significantly correlated with the sMERG RMS-amplitude
(r = 0.37 
0.69, P < 0.05 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.
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