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Regenold J, Doan HL, Ghoraba H, Khojasteh H, Jaclyn Hwang JJ, Yavari N, Akhavanrezayat A, Than NTT, Le AHD, Halim MS, Nguyen QD. Evaluation of correlation between Diopsys® NOVA™ fixed-luminance flicker ERG and Diagnosys® Espion 2™ flicker ERG parameters. Doc Ophthalmol 2023:10.1007/s10633-023-09934-x. [PMID: 37219642 DOI: 10.1007/s10633-023-09934-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 04/07/2023] [Indexed: 05/24/2023]
Abstract
PURPOSE Diopsys® NOVA™ is a novel full-field electroretinography (ffERG) device that can make rapid measurements of retinal electrophysiologic function. Diagnosys® Espion 2™ is a clinical gold-standard ERG device. This study aimed to investigate whether light-adapted Diopsys® NOVA™ fixed-luminance flicker ffERG magnitude and implicit time (converted from phase) measurements correlate with light-adapted Diagnosys® Espion 2™ flicker ffERG amplitude and implicit time measurements, respectively. METHODS Twelve patients (22 eyes) with various retinal and uveitic diseases underwent light-adapted Diagnosys® Espion 2™ and Diopsys® NOVA™ fixed-luminance flicker testing. Diopsys® magnitude and implicit time (converted from phase) measurements were compared to Diagnosys® amplitude and implicit time measurements, and a Pearson correlation was used to evaluate any existing correlation. Groups were also compared using generalized estimating equations. Bland-Altman plots were utilized to determine agreement between the comparison groups. RESULTS Age of patients ranged from 14 to 87 years. 58% (n = 7/12) of patients were female. A significant, positive correlation (r = 0.880, P < 0.001) was observed between magnitude (Diopsys®) and amplitude (Diagnosys®) measurements. Amplitude increases by 6.69 µV for each 1 µV increase in Magnitude (p-value < 0.001). A statistically significant, strong positive correlation was observed between Diopsys® implicit time measurements (converted from phase) and Diagnosys® implicit time measurements (r = 0.814, p-value < 0.001). For each 1 ms increase in Diopsys® implicit time, Diagnosys® implicit time increases by 1.13 ms (p-value < 0.001). CONCLUSIONS There is a statistically significant positive correlation between light-adapted Diopsys® NOVA™ fixed-luminance flicker amplitude and Diagnosys® flicker magnitude values. Additionally, there is a statistically significant positive correlation between Diopsys® NOVA™ fixed-luminance flicker implicit time (converted from phase) and Diagnosys® flicker implicit time values. These results imply that the Diopsys® NOVA™ module, which utilizes the nonstandard shortened International Society for Clinical Electrophysiology of Vision (ISCEV) ERG protocol, can produce reliable light-adapted flicker ffERG measurements.
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Affiliation(s)
- Jonathan Regenold
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, 2452 Watson Court, Suite 200, Palo Alto, CA, 94303, USA
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Hien Luong Doan
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, 2452 Watson Court, Suite 200, Palo Alto, CA, 94303, USA
- Pham Ngoc Thach University of Medicine, Saigon, Vietnam
| | - Hashem Ghoraba
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, 2452 Watson Court, Suite 200, Palo Alto, CA, 94303, USA
| | - Hassan Khojasteh
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, 2452 Watson Court, Suite 200, Palo Alto, CA, 94303, USA
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Jaclyn Joyce Jaclyn Hwang
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, 2452 Watson Court, Suite 200, Palo Alto, CA, 94303, USA
| | - Negin Yavari
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, 2452 Watson Court, Suite 200, Palo Alto, CA, 94303, USA
| | - Amir Akhavanrezayat
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, 2452 Watson Court, Suite 200, Palo Alto, CA, 94303, USA
| | - Ngoc Trong Tuong Than
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, 2452 Watson Court, Suite 200, Palo Alto, CA, 94303, USA
| | - Anthony Huy Dinh Le
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, 2452 Watson Court, Suite 200, Palo Alto, CA, 94303, USA
- University of Missouri - Kansas City School of Medicine, Kansas City, Missouri, USA
| | - Muhammad Sohail Halim
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, 2452 Watson Court, Suite 200, Palo Alto, CA, 94303, USA
- Ocular Imaging Research and Reading Center, Sunnyvale, CA, USA
| | - Quan Dong Nguyen
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University School of Medicine, 2452 Watson Court, Suite 200, Palo Alto, CA, 94303, USA.
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Comparison of DTL and gold cup skin electrodes for recordings of the multifocal electroretinogram. Doc Ophthalmol 2023; 146:67-78. [PMID: 36536110 PMCID: PMC9911471 DOI: 10.1007/s10633-022-09912-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/11/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To compare mfERG recordings with the Dawson-Trick-Litzkow (DTL) and gold cup skin electrode in healthy young and old adults and to test the sensitivity of both electrodes to age-related changes in the responses. METHODS Twenty participants aged 20-27 years ("young") and 20 participants aged 60-75 ("old") with a visual acuity of ≤ 0 logMAR were included. The mfERG responses were recorded simultaneously using DTL and skin electrodes. P1 amplitudes, peak times and signal-to-noise ratios (SNRs) were compared between both electrodes and across age groups, and correlation analyses were performed. The electrode's performance in discriminating between age groups was assessed via area under curve (AUC) of receiver operating characteristics. RESULTS Both electrodes reflected the typical waveform of mfERG recordings. For the skin electrode, however, P1 amplitudes were significantly reduced (p < 0.001; reduction by over 70%), P1 peak times were significantly shorter (p < 0.001; by approx. 1.5 ms), and SNRs were reduced [(p < 0.001; logSNR ± SEM DTL young (old) vs gold cup: 0.79 ± 0.13 (0.71 ± 0.15) vs 0.37 ± 0.15 (0.34 ± 0.13)]. All mfERG components showed strong significant correlations (R2 ≥ 0.253, p < 0.001) between both electrodes for all eccentricities. Both electrodes allowed for the identification of age-related P1 changes, i.e., P1-amplitude reduction and peak-time delay in the older group. There was a trend to higher AUC for the DTL electrode to delineate these differences between age groups, which, however, failed to reach statistical significance. CONCLUSIONS Both electrode types enable successful mfERG recordings. However, in compliant patients, the use of the DTL electrode appears preferable due to the larger amplitudes, higher signal-to-noise ratio and its better reflection of physiological changes, i.e., age effects. Nevertheless, skin electrodes appear a viable alternative for mfERG recordings in patients in whom the use of corneal electrodes is precluded, e.g., children and disabled patients.
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Qualitative and quantitative comparison of ERGs with contact lens and adhesive skin electrodes. Doc Ophthalmol 2022; 144:203-215. [PMID: 35304683 DOI: 10.1007/s10633-022-09868-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 02/23/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Traditional ERGs recorded using corneal electrodes can be difficult for some patients to tolerate. In the last several years, adhesive skin electrodes have gained in acceptance. In this report we present a qualitative comparison of waveforms as well as a quantitative analysis of correlation of amplitudes and implicit times of simultaneous ERG recordings using contact lens and skin electrodes. METHODS 89 subjects were included; all were referred for full-field ERG testing for multiple indications. ERGs (obtained according to ISCEV standards) were recorded simultaneously from both eyes with ERG-jet corneal contact lens electrodes and LKC Technologies Sensor Strip adhesive skin electrodes using multi-channel instrumentation (Diagnosys LLC, Espion3). Waveforms, a-wave and b-wave amplitudes and implicit times were compared. RESULTS Waveform morphologies were similar between electrode types. Regression coefficients (conversion factors) for a-wave and b-wave amplitudes under both photopic and scotopic conditions were tightly clustered. Regression coefficients for implicit times were nearly equal to 1.0. The regression coefficient for the entire amplitude dataset was 0.349, with an overall correlation of 0. 869 between amplitude recorded with skin and contact lens electrodes. The regression coefficient for the entire implicit time dataset was 0.967, with an overall correlation of 0.964 between skin and contact lens electrodes. CONCLUSIONS Our best estimate for the conversion factor between ERG amplitudes recorded with adhesive skin electrodes and contact lens electrodes is 0.349-amplitudes with skin electrodes are about 1/3 the amplitudes recorded simultaneously from the same eyes with contact lens electrodes, with a high correlation. Implicit times are nearly identical for the two electrode types.
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Ozaki K, Yoshikawa Y, Ishikawa S, Katsumoto T, Shibuya M, Shoji T, Kondo H, Matsumoto S, Shinoda K. Electroretinograms recorded with skin electrodes in silicone oil-filled eyes. PLoS One 2019; 14:e0216823. [PMID: 31150414 PMCID: PMC6544342 DOI: 10.1371/journal.pone.0216823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 04/29/2019] [Indexed: 11/19/2022] Open
Abstract
Purpose To assess the physiology of the retina by electroretinography (ERG) with skin electrodes in eyes that had undergone vitrectomy with silicone oil (SO) tamponade. Design Retrospective case series. Method ERGs were recorded from eleven eyes with complex vitreoretinal disorders and from the normal fellow eyes. The affected eyes underwent pars plana vitrectomy (PPV) with SO tamponade. ERGs were recorded before and after the SO was removed. The amplitudes and implicit times of the a- and b-waves of the affected eyes were compared to those of the normal fellow eyes. In addition, the ratios of the amplitudes of the b-waves of the affected eyes to those of the fellow eyes were compared before and after the SO was removed. Results ERGs were recordable from 7 eyes (63.6%) before the SO was removed and 11 eyes (100%) after the SO was removed. The a- and b-wave amplitudes were significantly smaller in the affected eyes than those of the fellow eyes at the baseline. The b-wave amplitude before the removal of the SO was significantly and positively correlated with that after the SO removal. The ratios of the b-waves of the affected/normal fellow eye significantly increased after the SO was removed. Conclusion The results indicate that ERGs picked up by skin electrode can be used to assess the physiology of the retina in eyes with a SO tamponade. The amplitude of the b-waves of the ERGs in silicone-filled eyes can be used to predict the amplitude after the silicone is removed.
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Affiliation(s)
- Kimitake Ozaki
- Department of Ophthalmology, Saitama Medical University, Iruma-gun, Saitama, Japan
| | - Yuji Yoshikawa
- Department of Ophthalmology, Saitama Medical University, Iruma-gun, Saitama, Japan
| | - Sho Ishikawa
- Department of Ophthalmology, Saitama Medical University, Iruma-gun, Saitama, Japan
| | - Takeshi Katsumoto
- Department of Ophthalmology, Saitama Medical University, Iruma-gun, Saitama, Japan
| | - Masayuki Shibuya
- Department of Ophthalmology, Saitama Medical University, Iruma-gun, Saitama, Japan
| | - Takuhei Shoji
- Department of Ophthalmology, Saitama Medical University, Iruma-gun, Saitama, Japan
| | - Hiromi Kondo
- Department of Ophthalmology, Saitama Medical University, Iruma-gun, Saitama, Japan
| | - Soiti Matsumoto
- Department of Ophthalmology, Saitama Medical University, Iruma-gun, Saitama, Japan
- Matsumoto Eye Clinic, Awa City, Tokushima, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Saitama Medical University, Iruma-gun, Saitama, Japan
- * E-mail:
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Kim BG, Chang IB, Jeong KD, Park JY, Kim JS, Hwang JH. Comparison of electroretinographic measurements between tabletop and handheld stimulators in healthy subjects. Doc Ophthalmol 2019; 139:1-9. [PMID: 30887263 DOI: 10.1007/s10633-019-09686-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 03/12/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE To compare full-field electroretinography (ffERG) parameters obtained from handheld and tabletop electroretinography (ERG) devices in normal subjects. METHODS Twenty volunteers underwent ffERG using a tabletop and handheld stimulator. The responses obtained from the right eyes were compared. The coefficient of variation and intraclass correlation coefficient (ICC) were derived to assess inter- and intra-individual reliability. RESULTS The b-wave in the rod response, a- and b-waves in the maximal combined response, a-wave in the cone response, and the 30-Hz flicker response showed significantly greater amplitudes when recorded with the tabletop stimulator than with the handheld stimulator. The implicit time of response (ITR) in the 30-Hz flicker response was longer when recorded with the handheld stimulator than when recorded with the tabletop stimulator. With regard to amplitude, the ICC indicated moderate-to-high reliability in the measurement of the b-wave in the rod response, and a- and b-waves in the maximal combined response. With regard to ITR, measurement of the b-wave in the rod response and a-wave in the maximal combined response showed moderate-to-high reliability. CONCLUSION Despite the significantly lower ERG amplitude measurements recorded by the handheld stimulator, there were no significant differences in variability between the two stimulators.
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Affiliation(s)
- Bum G Kim
- Department of Ophthalmology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - In B Chang
- Department of Ophthalmology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Kyeong D Jeong
- Asan-si Healthcare Center, Asan-si, Chungcheongnam-do, Korea
| | - Jae Y Park
- Department of Ophthalmology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Jae S Kim
- Department of Ophthalmology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Je Hyung Hwang
- Department of Ophthalmology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
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