Purpose: To investigate localized retinal dysfunction in hypertensive patients using multifocal electroretinogram (mfERG) and to assess its sensitivity as an early predictor for the development of retinopathy in hypertensive patients. Methods: Ninety-eight eyes were included in this case-control study. Twenty-eight eyes of healthy subjects served as a control group (group I). Seventy eyes belonged to patients with systemic hypertension assigned into two groups; group II including 39 eyes of hypertensive patients with normal fundus and group III including 31 eyes of patients with signs of hypertensive retinopathy. All participants were subjected to complete ophthalmic and electrophysiological examination using mfERG. N1 and P1 wave amplitudes and implicit times from the central hexagon and four concentric rings across the visual field were analyzed. Results: mfERG amplitudes were significantly reduced in hypertensive group with retinopathy than in controls. N1 amplitude was significantly reduced in the most eccentric ring in eyes of hypertensive patients with normal fundus. Conclusion: mfERG is a sensitive objective tool for assessment of retinal dysfunction in hypertensive patients. mfERG amplitude is a promising predictor for early development of retinopathy in systemic hypertension.

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