Abstract
The International Society for Clinical Electrophysiology of Vision (ISCEV) standard for full-field electroretinography (ERG) describes a minimum procedure, but encourages more extensive testing. This ISCEV extended protocol describes an extension to the ERG standard, namely the photopic On–Off ERG, and outlines common clinical applications. A light stimulus duration of 150–200 ms is used in the presence of a rod-suppressing background to elicit cone-driven On- and Off-system ERG components. The On-response occurs after the stimulus onset and has a negative a-wave and positive b-wave. The Off d-wave is a positive component evoked by stimulus offset. Common diagnoses that may benefit from additional photopic On–Off ERG testing include retinal dystrophies and retinal disorders that cause dysfunction at a level that is post-phototransduction or post-receptoral. On–Off ERGs assess the relative involvement of On- and Off-systems and may be of use in the diagnosis of disorders such as complete and incomplete congenital stationary night blindness (complete and incomplete CSNB), melanoma-associated retinopathy, and some forms of autoimmune retinopathy. The photopic On–Off ERGs may also be useful in X-linked retinoschisis, Batten disease, Duchenne muscular dystrophy, spinocerebellar degeneration, quinine toxicity, and other retinal disorders.
Highlights
The International Society for Clinical Electrophysiology of Vision (ISCEV) standard for full-field electroretinography (ERG) describes a minimum set of tests but encourages the use of additional ERG protocols for clinical ERG testing [1]
The protocol was prepared by the authors in accordance with ISCEV procedures http://www.iscev.org/standards/ index.html), and was approved by the ISCEV Board of Directors on 25th March 2018
The standard light-adapted (LA) 3.0 ERG b-wave is evoked with flashes of a short duration (\ 5 ms) on a rod-saturating background and largely reflects overlapping contributions from the On- and Off-bipolar cell pathways
Summary
The International Society for Clinical Electrophysiology of Vision (ISCEV) standard for full-field electroretinography (ERG) describes a minimum set of tests but encourages the use of additional ERG protocols for clinical ERG testing [1]. The standard light-adapted (LA) 3.0 ERG b-wave is evoked with flashes of a short duration (\ 5 ms) on a rod-saturating background and largely reflects overlapping contributions from the On- and Off-bipolar cell pathways. The flash and background wavelength for the ISCEV standard ERG are defined as visibly white, with CIE coordinates near x = 0.31, y = 0.32 Both white and chromatic (blue and green) stimuli have been used to elicit On–Off ERGs of similar waveform [18]. Peak times of On-response components are measured from the beginning of the stimulus to the This protocol is intended to be used for routine applications as an extension to the standard ERG protocol, and reporting should follow the latest ISCEV standard for ERG [1]. It is acknowledged that in diagnostic studies involving ISCEV standard ERGs, it may be sufficiently informative to describe the relative involvement of On–Off ERG a-, b-, and d-waves qualitatively
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