Electroretinography System Research Articles

USING RETeval SYSTEM FLICKER ELECTRORETINOGRAPHY FOR EVALUATION OF DENSE VITREOUS HEMORRHAGE.

To determine whether the RETeval electroretinography (ERG) system can be used to evaluate eyes with dense vitreous hemorrhage (VH). This retrospective case series study included 69 eyes of 69 patients with acute dense VH. Flicker ERGs were recorded by the RETeval system, an ERG device with adhesive skin electrodes. We evaluated the flicker ERG amplitudes in eyes with VH and the ratio of the VH eye amplitudes compared with the fellow eye amplitudes for each VH cause. In patients with rhegmatogenous retinal detachment, the amplitude ratios were extremely low (0.08 ± 0.03). To detect rhegmatogenous retinal detachment, the area under the receiver operating characteristic curve was 0.977 (95% confidence interval, 0.943-1.000) (best rhegmatogenous retinal detachment cutoff value, 0.14; sensitivity, 100.0%; and specificity, 95.4%). The flicker ERG amplitude was not significantly correlated with the initial visual acuity (ρ = -0.189, P = 0.120) but was positively correlated with the postoperative visual acuity in eyes with VH (ρ = -0.328, P = 0.006). The RETeval ERG system was found to be a useful diagnostic option in situations where dense VH precluded fundus examination or posterior vitreous detachment was indistinguishable from rhegmatogenous retinal detachment.

Electroretinography (ERG) in the wild giant panda (Ailuropoda melanoleuca)

Using a quick electroretinography (ERG) protocol for rapid assessment of the retinal function of wild giant pandas (Ailuropoda melanoleuca) performed in field conditions to demonstrate the range of ERG recordings in giant pandas of unknown retinal status. Nine free range giant pandas. All the giant pandas were anesthetized using an intramuscular dexMTZ injection, which is a combination of dexmedetomidine and tiletamine-zolazepam. After 20 mins of dark adaptation, scotopic ERGs were obtained by using three flash intensities: -25dB (0.0087cd·s/m2 ), 0dB (2.75cd·s/m2 ), and +5dB (8.7cd·s/m2 ). Next, photopic ERGs were acquired using a single flash protocol with a flash intensity of 3.0cd·s/m2 after 10minutes of light adaptation. In scotopic ERG at 0.0087cd·s/m2 , mean b-wave amplitude and peak time were 82.26µV (SD±16.65 and 95% CI 68.33-96.18) and 66.97ms (SD±10.86 and 95% CI 57.90-76.05), respectively. This flash intensity was below a-wave threshold and resulted in b waves with greater peak times compared to those with higher intensities. At 2.75cd·s/m2 , the mean a-wave amplitude and peak time were 53.95µV (SD±11.63 and 95% CI 44.23-63.67) and 16.13ms (SD±2.62 and 95% CI 13.94-18.31), and mean b-wave amplitude and peak time were 119.57µV (SD±15.54 and 95% CI 106.57-132.56) and 32.00ms (SD±6.47 and 95% CI 26.59-37.41). At 8.7cd·s/m2 , the mean a-wave amplitude and peak time were 58.85µV (SD±14.90 and 95% CI 46.39-71.31) and 15.59ms (SD±2.63 and 95% CI 13.40-17.79), and the mean b-wave amplitude and peak time were 132.97µV (SD±22.11 and 95% CI 114.48-151.46) and 32.66ms (SD±6.87 and 95% CI 26.91-38.40). In photopic ERG at 2.75cd·s/m2 , the mean a-wave amplitude and peak time were 62.08µV (SD±16.61 and 95% CI 48.19-75.97) and 16.28ms (SD±0.90 and 95% CI 15.53-17.03), and the mean b-wave amplitude and peak time were 214.93µV (SD±70.41 and 95% CI 156.07-273.80) and 33.09ms (SD±1.27 and 95% CI 32.03-34.15). Using a portable ERG system with a brief ERG protocol to perform electroretinographies in wild giant pandas is a practical, useful, and reliable method for the rapid assessment of their retinal function.

Novel Detection and Restorative Levodopa Treatment for Preclinical Diabetic Retinopathy.

Diabetic retinopathy (DR) is diagnosed clinically by directly viewing retinal vascular changes during ophthalmoscopy or through fundus photographs. However, electroretinography (ERG) studies in humans and rodents have revealed that retinal dysfunction is demonstrable prior to the development of visible vascular defects. Specifically, delays in dark-adapted ERG oscillatory potential (OP) implicit times in response to dim-flash stimuli (<−1.8 log cd · s/m2) occur prior to clinically recognized DR. Animal studies suggest that retinal dopamine deficiency underlies these early functional deficits. In this study, we randomized individuals with diabetes, without clinically detectable retinopathy, to treatment with either low- or high-dose Sinemet (levodopa plus carbidopa) for 2 weeks and compared their ERG findings with those of control subjects (no diabetes). We assessed dim-flash–stimulated OP delays using a novel handheld ERG system (RETeval) at baseline and 2 and 4 weeks. RETeval recordings identified significant OP implicit time delays in individuals with diabetes without retinopathy compared with age-matched control subjects (P < 0.001). After 2 weeks of Sinemet treatment, OP implicit times were restored to control values, and these improvements persisted even after a 2-week washout. We conclude that detection of dim-flash OP delays could provide early detection of DR and that Sinemet treatment may reverse retinal dysfunction.

Electroretinogram Recording in Larval Zebrafish using A Novel Cone-Shaped Sponge-tip Electrode.

The zebrafish (Danio rerio) is commonly used as a vertebrate model in developmental studies and is particularly suitable for visual neuroscience. For functional measurements of visual performance, electroretinography (ERG) is an ideal non-invasive method, which has been well established in higher vertebrate species. This approach is increasingly being used for examining the visual function in zebrafish, including during the early developmental larval stages. However, the most commonly used recording electrode for larval zebrafish ERG to date is the glass micropipette electrode, which requires specialized equipment for its manufacture, presenting a challenge for laboratories with limited resources. Here, we present a larval zebrafish ERG protocol using a cone-shaped sponge-tip electrode. The novel electrode is easier to manufacture and handle, more economical, and less likely to damage the larval eye than the glass micropipette. Like previously published ERG methods, the current protocol can assess outer retinal function through photoreceptor and bipolar cell responses, the a- and b-wave, respectively. The protocol can clearly illustrate the refinement of visual function throughout the early development of zebrafish larvae, supporting the utility, sensitivity, and reliability of the novel electrode. The simplified electrode is particularly useful when establishing a new ERG system or modifying existing small-animal ERG apparatus for zebrafish measurement, aiding researchers in the visual neurosciences to use the zebrafish model organism.

Electroretinography in eight species of neotropical deer

ABSTRACT The aim of this study was to establish normal baseline ERG values of 23 anesthetized deer belonging to 8 neotropical species (Mazama americana, Mazama nemorivaga, Mazama gouazoubira, Mazama nana, Mazama bororo, Ozotocerus bezoarticus, Odocoileus virginianus and Blastocerus dichotomus). Only right eyes were studied. Chemical restraint was performed using xylazine associated with ketamine, IM, for M. americana, M. gouazoubira, M. nemorivaga, M. nana, M. bororo, O. bezoarticus and O. virginianus. A combination of tiletamine/zolazepam diluted in xylazine 2% was used for B. dichotomus individuals. After 20min of dark adaptation, electroretinograms were obtained using a handheld electroretinography (ERG) machine using the QuickRetCheck Protocol at three different light intensities: 0.01cd.s/m2, 3cd.s/m2, and 10cd.s/m2. After light adaptation, photopic phase was recorded. A-wave amplitude recorded during pattern mixed rod/cone response in M. americana was significantly lower when compared to B. dichotomus. No other differences were observed between the species studied. ERG in Neotropical deer is applicable using a portable ERG system and did not show differences among species in relation to the retinal response at different light intensities. Therefore, the lifestyle of the species is more dictated by the selection pressure of the environment than by physiological factors.

Electroretinography using the RetEval ERG system in healthy children

Recent innovation has led to the development of the hand-held RetEval™ ERG system (LKC Technologies, Gaithersburg, MD) which utilizes skin electrodes and can be performed without anesthesia. The purpose of this study is to determine reference range values for electroretinography (ERG) in healthy children using the RetEval ERG system.

Correlation of Visually Evoked Functional and Blood Flow Changes in the Rat Retina Measured With a Combined OCT+ERG System.

To correlate visually evoked functional and blood flow changes in the rat retina measured simultaneously with a combined optical coherence tomography and electroretinography system (OCT+ERG). Male Brown Norway (n = 6) rats were dark adapted and anesthetized with ketamine/xylazine. Visually evoked changes in the retinal blood flow (RBF) and functional response were measured simultaneously with an OCT+ERG system with 3-μm axial resolution in retinal tissue and 47-kHz image acquisition rate. Both single flash (10 and 200 ms) and flicker (10 Hz, 20% duty cycle, 1- and 2-second duration) stimuli were projected onto the retina with a custom visual stimulator, integrated into the OCT imaging probe. Total axial RBF was calculated from circular Doppler OCT scans by integrating over the arterial and venal flow. Temporary increase in the RBF was observed with the 10- and 200-ms continuous stimuli (∼1% and ∼4% maximum RBF change, respectively) and the 10-Hz flicker stimuli (∼8% for 1-second duration and ∼10% for 2-second duration). Doubling the flicker stimulus duration resulted in ∼25% increase in the RBF peak magnitude with no significant change in the peak latency. Single flash (200 ms) and flicker (10 Hz, 1 second) stimuli of the same illumination intensity and photon flux resulted in ∼2× larger peak RBF magnitude and ∼25% larger RBF peak latency for the flicker stimulus. Short, single flash and flicker stimuli evoked measureable RBF changes with larger RBF magnitude and peak latency observed for the flicker stimuli.

Comparison between fullfield electroretinography obtained from handheld and tabletop devices in normal subjects

ObjectiveTo compare full-field electroretinography (ERG) parameters obtained from Ephios handheld and VERIS tabletop ERG devices in normal subjects for interchangeable usability and reliability. DesignComparison study. ParticipantsComparison of full-field ERG between two devices for 57 normal subjects. MethodsERG was recorded for 57 normal subjects using tabletop device (VERIS 5.2.2X; Electro-Diagnostic Imaging Inc, San Mateo, Calif.) and handheld ERG device (Ephios handheld portable ERG system; ephios ab; Teknikringen, Linkoping, Sweden). Bland–Altman plot was done to measure the agreement between the 2 devices. Intraclass correlation coefficient (ICC) was calculated for amplitudes, implicit times, and b/a ratio to assess the reliability. Coefficient of variation (CV = 100 × [standard deviation/mean]) with 95% CI was calculated to measure the variability between the devices. Wilcoxon sign rank test was used to assess the repeatability of the Ephios handheld device. ResultsThe mean a-wave and b-wave amplitudes of dark-adapted 3.0 ERG for the tabletop were 220.3 ± 52.6 and 471.5 ± 84.3 μV, respectively, whereas the mean a-wave and b-wave amplitudes in the same scotopic setting for the handheld device were 152.6 ± 34.2 and 379.7 ± 75.9 μV, respectively. The values represent mean ± standard deviation. The ICC of b/a ratio was 0.660 between the devices. The amplitudes CV of tabletop and handheld ERG devices ranged from 17.9% to 29.1% and from 22.4% to 30.1%, respectively. ConclusionsThe pattern of waveform of the Ephios handheld device is similar to the VERIS tabletop device. The ERG parameters showed variability between the 2 devices. Hence Ephios handheld ERG device can be used along with its normative data for measuring ERG. Because of variability, the devices cannot be used interchangeably.

Electroretinography in the normal koala (Phascolarctos cinereus)

To perform electroretinography on normal anesthetized koalas (Phascolarctos cinereus). Six hospitalized koalas. The koalas were anesthetized using alfaxalone intramuscularly and isoflurane via face mask, then maintained on isoflurane after endotracheal intubation. After 20 min of dark adaptation, electroretinograms were obtained using a handheld electroretinography (ERG) machine using a single flash protocol at three light intensities: 10 mcd s/m(2) , 3000 mcd s/m(2) , and 10,000 mcd s/m(2) . At 10 mcd s/m(2) , the mean b-wave amplitude and implicit time were 49.5 μV (SD ± 33.1 and 95% CI 29.9-69.0) and 87.4 ms (SD ± 6.5 and 95% CI 83.6-91.2). At 3000 mcd s/m(2) , the mean a-wave amplitude and implicit time were 70.5 μV (SD ± 30.7 and 95% CI 52.3-88.7) and 20.6 ms (SD ± 3.1 and 95% CI 18.7-22.4), and the mean b-wave amplitude and implicit time were 122.8 μV (SD ± 49.3 and 95% CI 93.7-151.9) and 63.1 ms (SD ± 13.2 and 95% CI 55.3-71.0). At 10,000 mcd sm(2) , the mean a-wave amplitude and implicit time were 90.8 μV (SD ± 37.2 and 95% CI 68.8-112.8) and 16.1 ms (SD ± 3.1 and 95% CI 14.3-18.0), and the mean b-wave amplitude and implicit time were 148.3 μV (SD ± 54.9 and 95% CI 115.9-180.8) and 67.4 ms (SD ± 8.4 and 95% CI 62.5-72.3). Electroretinography in koalas is practical using a portable ERG system and a DTL thread electrode and allows for rapid assessment of retinal function.

Electroretinography in dogs using a fiber electrode prototype

We compared two electroretinography (ERG) electrodes in dogs using ERG standards of the International Society for Clinical Electrophysiology of Vision (ISCEV). Ten healthy Yorkshire terrier dogs (mean age, 2.80 ± 1.42 years; 6 females) weighing 5.20 ± 1.56 kg were evaluated using an ERG system for veterinary use. Dark- and light-adapted ERG responses were recorded using an ERG-Jet electrode and a fiber electrode prototype. The examinations were performed during 2 visits, 3 weeks apart. Both electrodes (ERG-Jet or fiber prototype) were used on each animal and the first eye to be recorded (OD × OS) was selected randomly. Three weeks later the examination was repeated on the same animal switching the type of electrode to be used that day and the first eye to be examined. The magnitude and waveform quality obtained with the two electrode types were similar for all ERG responses. ERG amplitudes and implicit times obtained from dogs using the fiber electrode prototype were comparable to those obtained with the ERG-Jet electrode for rod, maximal rod-cone summed, cone, and 30-Hz flicker responses. The fiber electrode prototype is a low-cost device, available as an alternative instrument for clinical veterinary ERG recording for retinal function assessment.

Full-field electroretinography under general anesthesia in retinoblastoma

To investigate the electrical responses of the retina in retinoblastoma (RB), by recording full-field electroretinography (ERG) under general anesthesia. The ERG was recorded using Ephios hand-held portable ERG system, according to International Standards for Clinical Electrophysiology of Vision. Forty-eight eyes of 43 cases and 33 eyes of 33 controls were enrolled. The cases were classified based on international intraocular retinoblastoma classification (IIRC). Forty-eight eyes of cases were divided into 30 cases with active RB and 18 cases with regressed RB. The amplitudes of a- and b-waves were decreased as compared to controls in all subgroups. The implicit times of all RB patients from group A to C differed statistically from controls (p value < 0.05) except for single-flash rod response. The ERG waveforms in group E eyes were non-recordable. The comparison of ERG parameters between active and regressed groups (IIRC groups A and B) was statistically insignificant. Single case follow-up of unilateral RB after systemic chemotherapy showed improvement in amplitudes compared to baseline parameters. Reduced amplitudes and delayed implicit times were noted in advanced disease. The ERG of RB cases did not follow any specific pattern of waveform. ERG appears to be a dynamic parameter to observe changes following treatment for RB. Although ERG is not a diagnostic test for RB, it can be used as a complementary test to assess the residual retinal function in RB eyes.

Correlation of visually evoked intrinsic optical signals and electroretinograms recorded from chicken retina with a combined functional optical coherence tomography and electroretinography system

Visually evoked fast intrinsic optical signals (IOSs) were recorded for the first time in vivo from all layers of healthy chicken retina by using a combined functional optical coherence tomography (fOCT) and electroretinography (ERG) system. The fast IOSs were observed to develop within ∼5 ms from the on-set of the visual stimulus, whereas slow IOSs were measured up to 1 s later. The visually evoked IOSs and ERG traces were recorded simultaneously, and a clear correlation was observed between them. The ability to measure visually evoked fast IOSs non-invasively and in vivo from individual retinal layers could significantly improve the understanding of the complex communication between different retinal cell types in healthy and diseased retinas.

Electroretinography in the western gray kangaroo (Macropus fuliginosus)

To perform electroretinography on normal anesthetized western gray kangaroos (Macropus fuliginosus). Animals studied Six captive western gray kangaroos. The kangaroos were anesthetized using a combination of ketamine and medetomidine via a remote drug delivery system, then were maintained on isoflurane after endotracheal intubation and reversal of the medetomidine with atipamazole. After a minimum of 20 min of dark adaptation, electroretinograms were obtained using a handheld electroretinography (ERG) machine using a single flash protocol at three light intensities: 10 mcd.s/m(2), 3000 mcd.s/m(2), 10 000 mcd.s/m(2). At 10 mcd.s/m(2) the mean b-wave amplitude and implicit time was 102.0 μV (SD ± 41.3 and 95% CI 68.9-135.1) and 78.4 ms (SD ± 8.3 and 95% CI 71.8-85.0). At 3000 mcd.s/m(2) the mean a-wave amplitude and implicit time was 69.9 μV (SD ± 20.5 and 95% CI 53.5-86.3) and 17.6 ms (SD ± 1.5 and 95% CI 16.4-18.8) and the mean b-wave amplitude and implicit time was 175.4 μV (SD ± 35.9 and 95% CI 146.7-204.1) and 74.1 ms (SD ± 3.5 and 95% CI 71.2-76.9). At 10 000 mcd.s/m(2) the mean a-wave amplitude and implicit time was 89.1 μV (SD ± 27.1 and 95% CI 67.5-110.8) and 16.8 ms (SD ± 1.0 and 95% CI 16.0-17.0) and the mean b-wave amplitude and implicit time was 203.7 μV (SD ± 41.4 and 95% CI 170.6-236.8) and 75.4 ms (SD ± 3.3 and 95% CI 72.8-78.1). Electroretinography outside of the typical clinical setting is feasible using a portable ERG system and allows for quick analysis of retinal function in exotic species.