Br J Ophthalmol 1998;82:650-654 ( June )
Electrophysiological evaluation of visual loss in Müller cell
sheen dystrophy
Ulrich Kellner,
Hannelore Kraus,
Heinrich Heimann,
Horst Helbig,
Norbert Bornfeld,
Michael H Foerster
Department of Ophthalmology, Universitäts-Klinikum
Benjamin Franklin, Freie Universität Berlin, Germany
Correspondence to: Ulrich Kellner, MD, Augenklinik, Universitäts-Klinikum
Benjamin Franklin, Freie Universität Berlin, Hindenburgdamm 30, 12200 Berlin, Germany.
Accepted for publication 9
December 1997
AIMS
To describe the clinical picture and
electrophysiological findings in Müller cell sheen dystrophy, a
recently reported retinal dystrophy.
METHOD
A basic ophthalmological evaluation as well
as recording of standard electro-oculography and
electroretinography were performed in one patient at the onset of
visual loss and after 1 year of follow up.
RESULTS
A 61 year old woman presented with visual
loss in the right eye. Multiple folds at the level of the internal
limiting membrane were seen at the posterior pole in both eyes. Macular
oedema was present in the right eye. The visual acuity of the right eye
was 6/30 and of the left 6/9. A paracentral scotoma was found in the right eye. Electro-oculographic examination of both eyes gave normal
results. Electroretinography (ERG) revealed reduced b-wave and flicker
amplitudes in the right eye; these potentials were normal for the left
eye. The ON response in the right eye was reduced and delayed; it was
normal in the left eye. A further loss of visual function was noted 1 year later in the right eye, but the ophthalmoscopic findings were
unchanged. The ERG of the right eye had a negative waveform when dark
adapted. Light adapted responses showed an unusual delayed b-wave,
broad and delayed ON and OFF responses and a missing flicker response,
suggesting a Müller cell dysfunction. Light adapted responses were
slightly reduced in the left eye.
CONCLUSIONS
Electrophysiological data indicate
Müller cell dysfunction as a background of functional loss in Müller
cell sheen dystrophy. This is in agreement with previously reported
histological findings in this disorder.
Keywords:
internal limiting membrane;
electroretinography;
retinal degeneration;
Müller cells
© 1998 by British Journal of Ophthalmology