Multifocal electroretinogram in desferrioxamine-related macular toxicity

The purpose of the study was to evaluate focal macular function by using multifocal electroretinography in a patient presenting with features of desferrioxamine maculopathy.

This is an observational case-control study of a 74-year-old man taking desferrioxamine mesylate 40 mg/kg/d 4 to 5 times a week as an iron-chelating agent for 5 years. Desferrioxamine-related ocular toxicity presenting as bilaterally symmetrical pigmentary maculopathy was diagnosed by clinical examination and relevant history. Retinopathy was further corroborated with full-field electroretinography and multifocal electroretinography using VERIS Science 5.1 with Burian-Allen bipolar contact lens electrodes. First-order kernels were calculated and analyzed from six zones at different retinal eccentricities around the fovea.

Clinical and electrophysiological investigations showed a bilaterally symmetric picture of desferrioxamine maculopathy, with P1 and N1 on multifocal electroretinography showing significantly reduced amplitudes and prolonged implicit times in both the eyes as compared with age-matched controls.

Maculotoxicity may be the presenting feature of desferrioxamine toxicity, and multifocal electroretinography allows simultaneous measurements of multiple focal macular responses in these cases.