Study on macular blue-cone using multifocal blue-cone electroretinogram

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Diabetic retinopathy can be accurately diagnosed by fluorescein angiogram(FA). However, FA cannot be frequently repeated. Electroretinogram may be a useful tool for diagnosis of diabetic retinopathy. Since the diabetic change starts from local area of the ocular fundus and its severity varies from area to area, full-field ERG is not suited for study of diabetic retinopathy. Focal ERG is needed. Multifocal ERG(mfERG) can record focal ERG from many areas of the fundus simultaneously and is suited for diagnosis of diabetic retinopathy. We studied patients with diabetic retinopathy using blue cone mfERG that is recorded by silent substitution of color ORT monitor. Blue cone System is more vulnerable than red and green cone systems. Blue cone focal ERG (first order kernel), was abnormal in the area without visible abnormality of the retina, indicating that it is very sensitive to diabetic change. However, our study revealed that white lesions, such as hard or soft exudates, causes stray light effect on the focal responses. Our experiments also showed that the second order kernel is free from stray light effect. Therefore, we tried to extract the second order kernel of blue cone mfERG but were not successful because of its small amplitude. Our conclusion in this study is that the first order kernel of blue cone mfERG is very sensitive to diabetic change but is affected by white lesions, and the second order kernel of blue cone mfERG should be investigated.