Flash electroretinography: normative values with surface skin electrodes and no pupil dilation using a standard stimulation protocol

Papathanasiou, Eleftherios S.; Papacostas, Savvas

doi:10.1007/s10633-007-9065-x

Cited by 19 publications

(21 citation statements)

References 35 publications

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“…The conjunctival DTL electrode is widely used clinically as it provides good patient comfort and obviates the need for corneal anaesthesia [25][26][27]. However, the non-invasive skin electrode is often used in recording ERG responses from children [28][29][30][31], and there has been growing interest in extending its use to other patient groups [32,33]. Colotto et al [8] were able to obtain measurable focal PhNR responses using a skin active electrode.…”

Section: Introductionmentioning

confidence: 99%

Inter-subject, inter-ocular and inter-session repeatability of the photopic negative response of the electroretinogram recorded using DTL and skin electrodes

et al. 2010

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The photopic negative response (PhNR) has attracted interest as a flash ERG component reflecting inner retinal activity, with investigators adopting various approaches to analysing the response. This study has two principal aims: first to determine the most reliable technique for assessing the PhNR amplitude; secondly to compare the repeatability characteristics of the PhNR recorded using DTL and skin active electrodes. Electroretinograms were recorded in 31 subjects, using both electrode types, in response to a Ganzfeld red stimulus (Lee filter "bright red"; 1.76 log phot td.s; 4 Hz) presented over a steady blue background (Schott glass filter BG28; 3.9 log scot td). Sixteen subjects returned to assess repeatability. PhNR amplitude was measured from b-wave peak-to-PhNR trough, pre-stimulus baseline to trough, and from peak and baseline to a fixed time-point; a ratio of b-wave/PhNR amplitude was also calculated. Coefficients of variation (CoV), and inter-ocular and inter-session limits of agreement (LoA) were calculated for all measures. The ratio of b-wave/PhNR amplitude showed the lowest CoV (14.3% DTL; 23.2% skin), inter-ocular LoA (22.2% DTL; 25.0% skin), and inter-session LoA (22.8% DTL; 20.3% skin). The peak-to-trough and peak-to-fixed-time measurements were also consistently reliable. Least reliable measures were those measured from baseline. While skin electrode responses were significantly smaller than DTL responses (P < 0.0001), the variability was only slightly increased. This study suggests that peak-to-trough measurements are the most reliable means of measuring the PhNR and ratio calculation further improves repeatability. Skin electrodes provided a viable alternative to DTL electrodes for recording the PhNR.

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Section: Introductionmentioning

confidence: 99%

Inter-subject, inter-ocular and inter-session repeatability of the photopic negative response of the electroretinogram recorded using DTL and skin electrodes

et al. 2010

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“…ERG responses are said to achieve adult levels by the fourth year of life; therefore, separate pediatric normative values evaluation would be necessary for children aged <4 years (6) . Previous studies with skin electrodes have demonstrated that peak-to-peak amplitude can show variability as the skin electrode can move during the exam, reducing the amplitudes on the final steps as the electrodes lose adherence to the skin (11) .…”

Section: Discussionmentioning

confidence: 99%

“…Different types of electrodes can be used for ERG recording, and those that contact the cornea or nearby bulbar conjunctiva during the procedure are most strongly suggested for full-field ERG recording. These electrodes include conductive fibers and foils, bipolar contact lenses, conjunctival loop electrodes, and corneal wicks (6) . ERG recording in uncooperative patients and/or patients with palpebral alterations is a challenge because of the difficulty of appropriate placement of the conventional active electrodes.…”

Section: Introductionmentioning

confidence: 99%

Full-field electroretinogram recorded with skin electrodes in normal adults

Salomão¹,

Pereira²,

Berezovsky³

2016

Arquivos Brasileiros De Oftalmologia

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Approved by the following research ethics committee: Universidade Federal de São Paulo UNIFESP (#0174/04). ABSTRACT Purpose:Alternative recording methods have been tested to allow the electroretinogram (ERG) recording in uncooperative patients and/or patients with palpebral alterations, including recordings with skin electrodes. The purpose of this study was to compare ERG recorded with skin electrodes and well-established microfiber electrodes and to determine normative values of ERG parameters for recording with skin electrodes. Methods: Fifty healthy volunteers (17-26 years; mean 20.63 ± 2.01 years) participated in the study. A gold disk skin electrode was placed on the lower orbital rim of a randomly chosen eye. On the contralateral eye, a microfiber electrode was positioned in the lower conjunctival sac. Gold disc electrodes were positioned at the ipsilateral outer canthus of both eyes acting as reference electrodes for the creation of a potential difference. Two ground electrodes were placed on the lobe of each ear. ERGs were recorded according to the International Society of Clinical Electrophysiology Visual (ISCEV) protocol using the VERIS 5.1.9 system for data acquisition and analysis. Results: Both types of electrodes showed similar wave response morphologies. The implicit time of responses between the two electrodes was comparable. On peak-to-peak amplitude, skin electrode recordings showed an amplitude reduction of 61.4% for rod responses, 61.5% for maximal responses, 46.2% for oscillatory potentials, 57.4% for cone responses, and 54.4% for 30Hz-flicker responses, when compared with microfiber electrode recordings. Based on these findings, normative values for peak-to-peak amplitude and implicit time to be used as a reference for ERGs recorded with skin electrodes were determined. Conclusions: ERGs recorded with skin electrodes presented lower peak-to-peak amplitude compared with microfiber electrodes. However, using appropriate normative values, skin electrodes may be useful for specific target populations such as uncooperative infants and/or patients with ocular surface alterations.

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“…Aunque hay estudios realizados con electrodos de superficie y sin dilatación pupilar 9 , el protocolo ISCEV exige dilatación para estimular toda la retina y, preferentemente, electrodo de lentilla corneal desechable con referencia al canto externo del ojo. Se realiza adaptación previa a la oscuridad y se estimula mediante una campana «ganzfeld» con un flash de 0,01 cd.s.m , que activa bastones y conos obteniendo una onda «a» negativa, seguida de la «b» positiva de mucha mayor amplitud y una «c» negativa lenta.…”

Section: Electrorretinograma-flash (Erg-f)unclassified

Electrophysiological tests in the assessment of visual disorders

Iragui-Madoz

2010

An Sist Sanit Navar

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RESUMENLos tests electrofisiológicos ayudan al estudio de la función visual. El objetivo de este trabajo es presentar las bases fisiológicas, aspectos técnicos e indicaciones generales de los tests que se practican de forma habitual en nuestro medio.El electorretinograma-flash refleja la función de los fotorreceptores y de capas más externas de la retina. El electrorretinograma-patrón informa de las células ganglionares retinianas y puede identificar alteraciones maculares que simulan neuropatías ópticas. El electrooculograma valora la función del epitelio pigmentario y capas externas de la retina y diferencia la enfermedad de Best de otras bestrofinopatías. Los potenciales evocados visuales informan de las vías ópticas y son, sobre todo, útiles en la valoración del nervio óptico.Palabras clave. Electrorretinograma-flash. Electrorretinograma-patrón. Electrooculograma. Potenciales evocados visuals. ABSTRACTSome electrophysiological tests are helpful in the assessment of visual disorders. The physiological basis, technical aspects and general indications of those available at most neurophysiology services are reviewed.The Full-Field electroretinogram reflects photoreceptor and outer retinal function. The Pattern electroretinogram assesses retinal ganglion cell function and can identify macular dysfunction mimicking optic nerve disease. The electro-oculogram is a test of function of the outer retina and retinal pigment epithelium; it differentiates Best's disease from all other bestrophinopathies. Visual evoked potentials evaluate the visual pathway and are especially helpful in the evaluation of the optic nerve.

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Flash electroretinography: normative values with surface skin electrodes and no pupil dilation using a standard stimulation protocol

Abstract: This study has established the clinical feasibility of performing flash ERG using surface skin electrodes, with no pupillary dilation and using the stimulation standards of the ISCEV.

Cited by 19 publications

References 35 publications

Inter-subject, inter-ocular and inter-session repeatability of the photopic negative response of the electroretinogram recorded using DTL and skin electrodes

Inter-subject, inter-ocular and inter-session repeatability of the photopic negative response of the electroretinogram recorded using DTL and skin electrodes

Full-field electroretinogram recorded with skin electrodes in normal adults

Electrophysiological tests in the assessment of visual disorders

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