Electroretinographic findings in transplant chorioretinopathy

Brian T Chan-Kai¹, Steven Yeh², Richard G Weleber², Peter J Francis², Grazyna Adamus², S Robert Witherspoon³, Andreas K Lauer<sup>1

1</sup>Cullen Eye Institute, Baylor College of Medicine, Houston, Texas; ²Casey Eye Institute, Oregon Health and Science University, Portland, Oregon; ³Retina Institute of Texas, Dallas, Texas, USA

Aim: Transplant chorioretinopathy is a rare complication following solid organ or bone ­marrow transplantation and can result in severe vision loss. This series presents electroretinogram (ERG) results in patients with this condition.

Methods: Patients who presented with bilateral vision loss following bone marrow or solid organ transplantation were identified. A complete ophthalmologic examination, fundus ­photography, and fluorescein angiography (FA) were performed. Full-field ERG was obtained in all patients and a multifocal ERG (mfERG) was obtained in two patients.

Results: Four patients were identified. All patients had bilateral vision loss and displayed a characteristic pattern of mottled hyperfluorescence on FA. Three patients developed ­progressive vision loss ranging from 20/60 to hand motions whereas one retained 20/40 vision. All patients exhibited moderate to severe cone dysfunction, while the degree of rod abnormalities was varied. Two patients with severe cone dysfunction showed mild clinical changes initially, but later developed progressive vision loss and chorioretinal atrophy.

Conclusion: Transplant chorioretinopathy patients undergoing ERG testing show cone ­dysfunction with a variable degree of rod dysfunction. ERG abnormalities preceded the visual acuity and clinical changes in two patients, suggesting that ERG may be a helpful predictor of the clinical course in this rare disease.

Keywords: transplant, chorioretinopathy, electroretinogram, ERG, mfERG

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