Canadian Journal of Ophthalmology

The official journal of the Canadian Ophthalmological Society
Volume 36, no.5, August 2001
  
Editorial
“The only difference between men and boys is the price of their toys”
I.M. MacDonald

Ophthalmology has some very sophisticated toys. They help us diagnose and treat eye diseases. In this issue of the Journal Marc Hébert1 provides a look at a new technology — multifocal electroretinography (mfERG) — certain to take its place in the inventory of neat ophthalmic gadgetry (see page 293). How we acquire these new toys is a real challenge, as many do not generate revenue that will offset their cost. How we can train and keep the personnel to run them is another challenge. The mfERG unit comes with a hefty price tag in the $70000-plus range and needs a good electrophysiology lab to run it. Ideally, it should be available to ophthalmologists through a regional ERG lab as part of its inventory of test equipment.

Some clinicians will remember electrophysiology equipment that took a photograph of an oscilloscope. The current technology of ERG has improved dramatically and provides good-quality results. Electrophysiology truly aids the clinician in providing objective data on retinal and optic nerve function. The mfERG will not replace the full-field ERG, which is still needed to determine whether rod and cone function are normal. mfERG tests the central 40° to 50° of the visual field, providing the opportunity of primarily assessing macular function. It will likely replace the focal or pattern ERG, which was designed to test macular function but proved to be less reliable than predicted.

Research is bringing forward new treatments for macular degeneration. mfERG will become an important clinical research tool to monitor the effect of treatment on macular function. Other uses will undoubtedly be found. One good example of its potential use is in monitoring the effects of chloroquine on the retina.2 Although the equipment is extremely sophisticated, its results can be quickly interpreted as a three-dimensional map of macular function and easily understood by patients.

Ian M. MacDonald, MD, CM
Editor-in-Chief


References

1. Hébert M. Multifocal electroretinography: introduction to the technique and its clinical application. Can J Ophthalmol 2001;36:293–7.
2. Kellner U, Kraus H, Foerster MH. Multifocal ERG in chloroquine retinopathy: regional variance of retinal dysfunction. Graefes Arch Clin Exp Ophthalmol 2000;238: 94–7.