title: Electrodiagnostic and two-wavelength fundus autofluorescence imaging investigations in acute idiopathic maculopathy.
abstract: 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.
authors.affiliation: Moorfields Eye Hospital, 162 City Road, London, EC1V 2PD, UK. alex@1780.com
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Day
authors.forename: Tryfon
authors.initials: T
authors.lastname: Rotsos
authors.forename: Graham E
authors.initials: GE
authors.lastname: Holder
authors.forename: Adnan
authors.initials: A
authors.lastname: Tufail
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Robson
mesh_terms: D000208:Acute Disease; D000328:Adult; D004396:Coloring Agents; D004585:Electrooculography; D004596:Electroretinography; D005260:Female; D005451:Fluorescein Angiography; D005583:Fourier Analysis; D006801:Humans; D007208:Indocyanine Green; D008266:Macula Lutea / Q000473:pathology*; D012164:Retinal Diseases / Q000175:diagnosis*; D055213:Retinal Pigment Epithelium / Q000473:pathology*; D041623:Tomography, Optical Coherence
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green