Adaptation responses in early age-related maculopathy

PURPOSE. To investigate the global-flash multifocal electroretinogram (mfERG) in early age-related maculopathy ( ARM). METHODS. Thirty-two eyes from 20 healthy control subjects and 12 age-matched subjects with early ARM were investigated with the conventional and the global-flash mfERG. Early ARM subjects were graded according to an international grading system. The conventional mfERG consisted of 103 hexagons flickering according to a pseudorandom m-sequence. The global-flash mfERG paradigm used four frames starting with the conventional m-sequence stimulation, followed by a dark frame, a global flash, and another dark frame. The responses include a direct response (DR) and a later induced component (IC). The first-order kernel peak-to-trough response densities of the conventional mfERG (N1P1), the global-flash DR and IC, and the implicit times of the conventional P1, global-flash DR, and IC peak were analyzed after averaging the results into five groups according to five field locations: a central area and four quadrants. RESULTS. There was a significant reduction of the global-flash mfERG DR response density ( P <= 0.05) in the early ARM group compared with the control group. Neither the IC response density nor DR and IC implicit times were significantly impaired. However, the superior retina showed longer implicit times than did the inferior retina for the DR in the early ARM group. There was no significant correlation between funduscopic features and the central averaged responses of the global-flash mfERG ( for the DR response density: r = - 0.19, P = 0.3, or for the DR implicit time: r = - 0.18, P = 0.3). None of the conventional mfERG parameters was significantly different between the two groups. CONCLUSIONS. The global-flash mfERG detects deficits in early ARM before the conventional mfERG. Retinal ischemia may play a role in producing function impairment in ARM.