Open AccessReduced full‐field electroretinogram (ERG) in a patient treated with methotrexate
Author(s) -
Ponjavic Vesna,
Gränse Lotta,
Stigmar Elisabeth Bengtsson,
Andréasson Sten
Publication year - 2004
Publication title -
acta ophthalmologica scandinavica
Language(s) - English
Resource type - Journals
eISSN - 1600-0420
pISSN - 1395-3907
DOI - 10.1046/j.1600-0420.2003.00181.x
Subject(s) - medicine , electroretinography , ophthalmology , erg , fundus (uterus) , fundus photography , visual field , visual acuity , retinal , optometry , retina , fluorescein angiography , optics , physics
. Purpose: To examine retinal function in a patient with decreased vision possibly due to treatment with methotrexate. Methods: Ophthalmological examination included testing of visual acuity (VA), fundus inspection, fundus photography and kinetic perimetry. Retinal function was tested objectively with three electrophysiological methods: full‐field electroretinography (ERG), multifocal electroretinography (mfERG) and electro‐oculography (EOG). Results: A 13‐year‐old boy with psoriasis arthritis had been treated with methotrexate on a weekly basis for 8.5 years. After terminating treatment, his VA, which was reduced to 0.3 in both eyes initially, improved during the following 3 years but did not return to normal. No visual field defects were found with kinetic perimetry. The rod and cone responses in the full‐field ERG were markedly reduced in b‐wave amplitude initially, but grew slowly to nearly normal values 3 years later. After withdrawal of the drug, the mfERG demonstrated normal responses in the macular region. The Arden index in the EOG was normal. Conclusion: Chronic treatment with methotrexate may affect VA, and may reversibly reduce rod and cone function. In patients who use systemic medication and whose vision is reduced, objective evaluation of retinal function with electrophysiological methods is recommended.