title: Foveal outer retinal function in eyes with unexplained visual symptoms or acuity loss.
abstract: OBJECTIVE
  To determine whether foveal outer retinal dysfunction is common in eyes with unexplained visual symptoms or acuity loss.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Seventy-three eyes of 44 consecutive patients with unexplained visual symptoms or acuity loss, 39 eyes of 39 control subjects, and 12 eyes of 7 patients with known maculopathy.
  
  
  METHODS
  Foveal cone electroretinography (ERG) and letter recognition perimetry.
  
  
  METHODS
  Foveal cone ERG data.
  
  
  RESULTS
  Abnormal foveal cone ERG data were recorded in 35 (48%) of 73 eyes (23 [52%] of 44 patients). Among these 35 eyes, amplitude was lower than in normal controls (P<.001) and was correlated with visual acuity and the number of letter recognition perimetry errors (P<.05 for both). The latter was higher in eyes with abnormal retinal responses than in symptomatic eyes with normal responses (P<.01). However, initial symptoms, visual acuity, and macular appearance did not differentiate between these 2 groups. Foveal cone ERG test vs retest data showed consistent results.
  
  
  CONCLUSIONS
  Foveal outer retinal dysfunction is a common underlying mechanism of previously unexplained visual symptoms or acuity loss. Foveal cone ERG testing should be considered early in the evaluation of eyes with this presentation.
authors.affiliation: Division of Ophthalmology, Saint Luke's Medical Center, Cleveland, Ohio 44104, USA. aweinerbo@aol.com
authors.forename: A
authors.initials: A
authors.lastname: Weiner
authors.forename: M E
authors.initials: ME
authors.lastname: Schmidt
authors.forename: S
authors.initials: S
authors.lastname: Patel
authors.forename: C H
authors.initials: CH
authors.lastname: Gussler
authors.forename: B F
authors.initials: BF
authors.lastname: Remler
authors.forename: S R
authors.initials: SR
authors.lastname: Kaufman
authors.forename: H D
authors.initials: HD
authors.lastname: Kohn
authors.forename: D T
authors.initials: DT
authors.lastname: Weidenthal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004596:Electroretinography; D005260:Female; D005584:Fovea Centralis / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012160:Retina / Q000503:physiopathology*; D017949:Retinal Cone Photoreceptor Cells / Q000503:physiopathology; D012164:Retinal Diseases / Q000175:diagnosis / Q000503:physiopathology*; D014786:Vision Disorders / Q000175:diagnosis / Q000503:physiopathology*; D014792:Visual Acuity; D058609:Visual Field Tests