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Transient macular dysfunction determined by focal macular electroretinogram
  1. Naoki Terauchi1,
  2. Kaoru Fujinami1,
  3. Kei Shinoda1,
  4. Kazushige Tsunoda1,
  5. Gen Hanazono1,
  6. Yozo Miyake1,
  7. Koichi Inomata3
  1. 1
    Laboratory of Visual Physiology, National Institute of Sensory Organs, National Hospital Organization, Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo 152-8902, Japan
  2. 3
    Department of Ophthalmology, School of Medicine, Nihon University, 1-8-13 Surugadai, Kanda, Chiyoda-ku, Tokyo 101-8309, Japan
  1. Dr Kei Shinoda, Laboratory of Visual Physiology, National Institute of Sensory Organs, National Hospital Organization, Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo 152-8902, Japan; shinodakei{at}kankakuki.go.jp

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Rapid diagnosis of patients with acute visual loss is critical1 but is difficult if the retina appears normal ophthalmoscopically. We report the case of a patient who presented with acute unilateral visual loss and a central scotoma.

Case report

A 75-year-old man complained of a sudden and painless decrease of vision in his left eye. He had undergone surgery for an unruptured intracranial aneurysm 20 years earlier and was taking 7 mg/day of systemic prednisolone for rheumatoid arthritis. He had also had diabetic mellitus without retinopathy for 5 years. He was being followed for a left hemianopsia and normal tension glaucoma for the previous 3 years.

On examination, a left relative afferent papillary defect (RAPD) was observed, and visual acuity (VA) was 20/30 OD and 20/2000 OS. All …

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