case_images: PMC4129142_01
case_images: Visual field of the patient's right eye demonstrating a generalized depression.
case_images: CRIM2014-290696.001.jpg
case_images: PMC4129142_01_CRIM2014-290696.001.jpg
case_images: fig1
case_images: The patient underwent visual field testing that revealed a large central scotoma in the right eye and was normal in the left eye (Figure 1).
case_images: Optical coherence tomography of the macula without any abnormal findings.
case_images: CRIM2014-290696.002.jpg
case_images: PMC4129142_01_CRIM2014-290696.002.jpg
case_images: fig2
case_images: Optical coherence tomography (OCT) (Spectralis SD-OCT, Heidelberg Engineering, Inc., Germany) also revealed no macular pathology (Figure 2).
case_images: (a) Pattern electroretinogram (PERG) showing reduction of the P50 amplitude in the right eye. (b) Bright flash dark adapted ERGs (DA 11.0) demonstrating a "negative" ERG in the right eye, as b-wave is of a lower amplitude than a-wave. (c) Photopic single flash ERGs (LA 3.0) responses were subnormal in the right eye. (d) Light adapted 30 Hz flicker ERG (LA 30 Hz) demonstrating implicit time delay in the right eye.
case_images: CRIM2014-290696.003.jpg
case_images: PMC4129142_01_CRIM2014-290696.003.jpg
case_images: fig3
case_images: According to the results, PERG P50 amplitude as an index of macular function was reduced in the right eye but was within normal limits in the left eye indicating right eye macular dysfunction (Figure 3(a)). Bright flash dark adapted ERGs (DA 11.0) were of normal a-wave amplitude bilaterally, while b-wave was of reduced amplitude in the right eye and subnormal in the left eye, indicating a "negative ERG" in the right eye (a-wave amplitudes: 302 muV and 305 muV in the right and left eye, resp.; b-wave amplitudes: 276 muV and 345 muV in the right and left eye, resp.) (Figure 3(b)). Photopic single flash ERGs (LA 3.0) responses were subnormal in the right eye only (a-wave amplitudes: 25 muV and 38.5 muV in the right and left eye, resp.; b-wave amplitudes: 115 muV and 200 muV in the right and left eye (Figure 3(c)). ERG (LA 30 Hz) was delayed in the right eye but within normal limits in the left eye (implicit time of 31 msec and 26 msec in the right and left eyes, resp.) (Figure 3(d)). EOG light rise and the Arden ratio were within normal limits bilaterally (Arden ratio: 4.2 and 3.9 in the right and left eyes, resp.) (Figure 4).
case_images: EOG recordings demonstrating a normal light rise and Arden ratio bilaterally.
case_images: CRIM2014-290696.004.jpg
case_images: PMC4129142_01_CRIM2014-290696.004.jpg
case_images: fig4
case_images: ERG (LA 30 Hz) was delayed in the right eye but within normal limits in the left eye (implicit time of 31 msec and 26 msec in the right and left eyes, resp.) (Figure 3(d)). EOG light rise and the Arden ratio were within normal limits bilaterally (Arden ratio: 4.2 and 3.9 in the right and left eyes, resp.) (Figure 4).
case_images: Visual field of right eye (a) and left eye (b) demonstrating deterioration of the right eye and involvement of the left.
case_images: CRIM2014-290696.005.jpg
case_images: PMC4129142_01_CRIM2014-290696.005.jpg
case_images: fig5
case_images: Visual field testing was also repeated and revealed further depression of sensitivity in the right eye and involvement of the left eye (Figure 5).