A corneal electrode for patterned stimulus electroretinography

Obtaining a contact lens acquired electroretinogram in the presence of topical anesthetic hypersensitivity

Clinical circumstances often demand flexibility in electrodiagnostic procedures. We present a clinical case that required alteration of our routine full-field electroretinography technique. The patient presented with reports of allergy to Xylocaine (lidocaine) and refused the use of any type of topical anesthetic drops. This conflicted with our routine ERG method that combines the use of the Henkes Lovac hard contact lens and the topical anesthetic Alcaine (proparacaine hydrochloride). We acquired a successful electroretinogram without topical anesthesia by using a "piggy-back" system involving the interposition of a soft hydrophilic contact lens between the cornea and the recording hard lens. The procedure yielded excellent ERG recordings and was well tolerated. This non-routine technique was also compared to our standard ERG technique using a normal volunteer. It appears that this proposed "piggy-back" technique is a useful alternative to routine ERG procedure in cases of refusal/allergy to ophthalmic solutions and also potentially in cases where additional corneal protection is needed.

Clinical application of the pattern electroretinogram with lid skin electrode

Pattern evoked potentials were recorded simultaneously with an electrode placed on the skin of the lower eyelid, gold foil electrodes hooked on the right and left eyelids, and a skin electrode at Oz in normal subjects and in patients with optic nerve and macular diseases. Peak latencies and amplitudes of the pattern electroretinogram (PERG) were compared between the two electrodes. In both records, the peak latency showed no difference at 56.7 +/- 2.9 ms (mean +/- S.D.), while the amplitude of the PERG with the lid skin electrode was at 1.2 +/- 0.3 microV, approximately one-third of that obtained with the gold foil electrode. Although the skin electrode did not always record responses as well as the gold foil, its advantages recommend its use in clinical cases.

Comparison of the spatial response properties of the human retina and cortex as measured by simultaneously recorded pattern ERGs and VEPs

Electroretinograms and visual evoked potentials were simultaneously recorded from adult subjects using a checkerboard pattern stimulus reversing at 0.94, 3.75 and 7.5 Hz. Two contrast levels were used: 30 and 85%. The data obtained from the cortex (VEPs) show spatial tuning properties for all temporal frequencies at both contrast levels, with the peak of the amplitude-check size function occurring between 15 and 30 min. Tuning properties were found at the retina but only at the high contrast level and for the faster (3.75 and 7.5 Hz) temporal frequencies. The results demonstrate that spatial tuning is present in the human retina but not under as wide a range of conditions as found at the cortex.

Electroretinographic testing in diabetics: a comparison study of the Burian-Allen and the Henkes corneal electrodes

A series of 57 diabetics underwent standard electroretinographic recordings for the purpose of testing the effect of insulin on the electroretinograms in diabetes mellitus, specifically on the oscillatory potential changes (Kozak et al., Jap. J. Ophthal. Suppl., 1979). Use of the speculum-type corneal electrode (Burian-Allen, Hansen Labs.,) produced 9 corneal abrasions in the first 28 patients in this series. However, when the technique of examination was altered by use of the Henkes-type bipolar electrode, only 2 abrasions were produced in the last 29 patients. These frequencies of abrasions are statistically different. The suggestion is made that electroretinographic tracings in diabetics the performed with the use of the Henkes bipolar low-vacuum corneal electrode (Medical Workshops, Holland).