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Effect of inner retinal dysfunction on slow double-stimulation multifocal electroretinogram
  1. Patrick H W Chu1,
  2. Yiu-Fai Ng1,
  3. Patrick W K Ting1,
  4. Jenny C Y Lung1,
  5. Wing-Cheung Ho1,
  6. Kwok-Fai So2,
  7. Chi-Ho To1,
  8. Henry H L Chan1
  1. 1Laboratory of Experimental Optometry (Neuroscience), School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
  2. 2Department of Anatomy, Research Centre of Heart, Brain, Hormone and Healthy Aging, The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China
  1. Correspondence to Dr Henry H L Chan, School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China; henryhl.chan{at}


Purpose This study investigated the retinal adaptive mechanism in inner retinal dysfunction using the slow double-stimulation multifocal electroretinogram (mfERG) paradigm.

Methods Slow double-stimulation mfERG responses were recorded from 15 eyes of 15 4-month-old Mongolian gerbils in control conditions and after suppression of inner retinal responses with injections of tetrodotoxin (TTX) and N-methyl-d-aspartic acid (NMDA). The stimulation consisted of five video frames: the two initial frames with multifocal flashes were triggered by two independent m-sequences, followed by three dark video frames. The results were compared with findings in humans: 7 subjects with glaucoma and 31 age-matched normal subjects were measured using the same mfERG protocol.

Results The stimulation generates two responses (M1 and M2) from the two independent multifocal frames. The M1:M2 ratio showed a significant reduction after administration of TTX+NMDA in the animal study. This matched with the human glaucoma findings. Glaucoma subjects generally have a reduced M1:M2 ratio; this ratio showed a sensitivity of 86%, with a specificity of 84% for differentiating normal eyes from glaucomatous eyes.

Conclusion This stimulation paradigm provides a method of measuring temporal visual characteristics. The M1:M2 ratio acts as an indirect functional indicator of retinal adaptation, which may be abnormal in the diseased retina. Further development of this method may help to describe the functional variation in the diseased retina and to predict the occurrence of a range of retinopathies.

  • Multifocal electroretinogram
  • double flash
  • glaucoma
  • gerbil
  • inner retina
  • electrophysiology
  • experimental and animal models
  • psychophysics
  • vision
  • degeneration
  • inflammation
  • medical education
  • wound healing
  • eye (tissue) banking
  • choroid
  • diagnostic tests/investigation
  • treatment surgery
  • treatment medical
  • retina
  • glaucoma

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  • Funding This study was supported by the Departmental General Research Fund (GU585, GU858), the Grants for Post-Doctoral Fellowship (G-YX3C) and the Niche Areas Glaucoma Research (J-BB76) from The Hong Kong Polytechnic University.

  • Competing interests None.

  • Ethics approval This study was approved by the ethics committee of The Hong Kong Polytechnic University.

  • Provenance and peer review Not commissioned; externally peer reviewed.