Central Retinal Function as Measured by the Multifocal Electroretinogram and Flicker Perimetry in Early Age-Related Macular Degeneration

PURPOSE. To determine the retinal function in early age-related macular degeneration (AMD) assessed by the multifocal electroretinogram (mfERG) and flicker perimetry and to seek a relationship between local objective mfERG parameters and subjective flicker perimetry thresholds. METHODS. mfERG and flicker perimetry were performed in 15 patients (15 eyes) with early AMD and 14 controls (14 eyes) of similar age. The mfERG P1 response amplitude density (nV/deg(2)) and P1 implicit time of the first-order kernel and the flicker thresholds of each concentric ring were analyzed. The relationship between individual mfERG responses and the corresponding individual flicker sensitivity outcomes was determined. RESULTS. The mfERG response amplitude of the central ring (ring 1) was significantly reduced in early AMD eyes compared with the controls (P = 0.009). No significant difference in mfERG amplitude between early AMD and control eyes was detected in the other rings. The mfERG implicit time was significantly increased in the early AMD eyes but only within the central four rings of 12 degrees. A significant reduction in flicker sensitivity was also detected in early AMD eyes but only within the central 6 degrees. There was a significant, moderate correlation (r = -0.477; P < 0.001) between local mfERG latency and flicker sensitivity from the same tested locations within the central 6 degrees. There was a weak correlation (r = 0.200; P < 0.014) between mfERG amplitude and flicker sensitivity. CONCLUSIONS. Both mfERG and flicker perimetry show abnormal retinal function, but only in the very central macula, in early AMD. A novel relationship between mfERG and flicker sensitivity should enhance the clinical monitoring of disease progression. (Invest Ophthalmol Vis Sci. 2011;52:9267-9274) DOI: 10.1167/iovs.11-8517