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Br J Ophthalmol 2004;88:1223-1224 doi:10.1136/bjo.2003.040584
  • Letter

Potential diagnostic dilemmas using the multifocal electroretinogram in intermittent exotropia

  1. C Bellmann,
  2. M M Neveu,
  3. L Kousoulides,
  4. J J Sloper,
  5. A C Bird,
  6. G E Holder
  1. Moorfields Eye Hospital, London, UK
  1. Correspondence to: G Holder PhD Department of Electrophysiology, Moorfields Eye Hospital, City Road, London EC1V 2PD, UK; graham.holdermoorfields.nhs.uk
  • Accepted 31 January 2004

Multifocal electroretinography (mfERG) is a valuable technique in assessing macular function in retinal disease objectively as it provides spatial information. Altered responses give an estimate of the extent of central retinal dysfunction.1–4 Fixation is known to be an important technical factor in mfERG recording.5–7 We present findings in a patient with asymptomatic intermittent exotropia that reinforce the importance of adequate consideration of potential fixation errors.

Case report

The patient was a 52 year old man with maternally inherited diabetes and deafness (MIDD) consequent upon a mitochondrial DNA nucleotide A3243G point mutation, and examined as part of a series of patients with MIDD.8 Visual acuity was 20/20 (ETDRS chart) bilaterally. Fundi showed symmetrical bilateral irregular patches of retinal pigment epithelium atrophy at the posterior poles. The foveas were …

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