Comparing the RETeval® portable ERG device with more traditional tabletop ERG systems in normal subjects and selected retinopathies

Abstract

Purpose Our study aimed to determine if ISCEV standard-like ERGs recorded with the LKC RETeval® portable ERG unit compared to those obtained using the more traditional tabletop unit. Methods ERGs recorded from normal subjects and patients affected with retinal ON and OFF pathway anomalies were compared. Analysis included peak time and amplitude measurements as well as time–frequency domain analysis with the discrete wavelet transform of waveforms obtained with the two systems. Results Although both systems were similarly able to record reliable and highly reproducible ERG responses, there were major discrepancies in ERG responses between the portable and tabletop units, pointing toward a weaker stimulation of the retinal OFF pathway with the portable RETeval® unit. Conclusion The portable RETeval® unit appears to be able to record highly reproducible and diagnostically useful clinical ERGs, albeit with some significant differences in waveform composition compared to those obtained with more standard tabletop systems. Given the unknown origin of these waveform discrepancies, if left uncorrected, these differences could potentially lead to erroneous interpretation when used in the clinical context and/or compared to ERGs recorded using more traditional table top units. Clearly, more research is warranted before handheld devices, such as the RETeval®, can be homologated as a diagnostically sound ERG devices.

The Value of Electroretinography in Identifying Candidate Genes for Inherited Retinal Dystrophies: A Diagnostic Guide

“…This technology has produced results consistent with standard systems in pediatric patients [102]. Additionally, reports of handheld ERG devices are being used to diagnose specific IRDs [103].…”

The Use of the RETeval Portable Electroretinography Device for Low-Cost Screening: A Mini-Review

“…The portable ERG approach may provide reliable and low-cost biomarkers within the framework of oculomics for population-wide screening programs. Therefore, further investigations are warranted to assess its reproducibility and the expected inter-individual variations in elderly populations, as reported in young people [9].…”

“…Nevertheless, challenges persist regarding interpretation, seamless clinical integration, and widespread accessibility [8], as ERG assessments classically require a more complex technical background with costly equipment and welltrained personnel. A commercially available option for portable ERG has emerged as a feasible and cost-effective alternative for research and clinical applications [9]. To use the system, it is necessary to assess institutional normal reference data obtained from healthy individuals.…”

“…The comparison of human ERGs recorded with the portable handheld RETeval system (▶ Fig. 1) and standard tabletop devices shows certain similarities (e.g., times and amplitudes of the photopic hill peak) and discrepancies (e.g., morphology and frequency composition of the photopic OFF responses) [9]. However, the reasons underlying asymmetric ON and OFF contributions to the photopic ERGs recorded with the RETeval are not known.…”

Visual electrophysiology and “the potential of the potentials”

“…Figure 2 illustrates the device and example waveforms. Many publications have emerged reporting its use in diverse conditions including diabetic retinopathy, a range of inherited retinal diseases, birdshot chorioretinopathy, glaucoma, idiopathic intracranial hypertension, and others [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47].…”