title: Idiopathic, isolated fovea plana with bilateral off-centre multifocal ERGs.
abstract: BACKGROUND
  The purpose of this paper is to report a case of idiopathic isolated fovea plana showing asymmetry in the multifocal electroretinogram (mfERG).
  
  
  METHODS
  We carried out optical coherence tomography (OCT) imaging, macular pigment density measurement, genetic testing and electrophysiological testing with visual evoked potentials and mfERGs on a young, highly myopic female of Pakistani origin, who had good visual acuity and no nystagmus.
  
  
  RESULTS
  OCT imaging revealed a complete absence of any foveal pit in either eye. Macular pigment density was normal and visual evoked potentials indicated normal chiasmal crossings, excluding albinism. Genetic testing revealed normal PAX6 coding data, excluding aniridia as a cause. mfERGs showed asymmetry consistent with off-centre fixation to the temporal side of the fovea in both eyes, but were otherwise normal.
  
  
  CONCLUSIONS
  Lack of a foveal pit is a well-known finding in conditions such as oculocutaneous albinism and PAX6 gene-related aniridia. Isolated fovea plana is less common, and this case illustrates that the absence of a foveal pit does not necessarily result in a poor visual outcome. The finding of asymmetry in the mfERG in such a case is novel, and may indicate a functional adaptation to the structure of the fovea.
authors: Department of Life Sciences, Glasgow Caledonian University, Glasgow, UK.
authors: Alice D
authors: AD
authors: McTrusty
authors: Daphne L
authors: DL
authors: McCulloch
authors: Niall C
authors: NC
authors: Strang
authors: Angela
authors: A
authors: McCall
authors: Stuart
authors: S
authors: Parks
authors: Alison
authors: A
authors: Brown
authors: Graeme J
authors: GJ
authors: Kennedy
mesh_terms: D016115:Albinism, Oculocutaneous / Q000175:diagnosis / Q000503:physiopathology*; D004596:Electroretinography / Q000379:methods*; D005074:Evoked Potentials, Visual / Q000502:physiology*; D005260:Female; D005584:Fovea Centralis / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D009897:Optic Chiasm / Q000503:physiopathology*; D041623:Tomography, Optical Coherence; D055815:Young Adult