ISCEV guide to visual electrodiagnostic procedures

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Abstract

Clinical electrophysiological testing of the visual system incorporates a range of noninvasive tests and provides an objective indication of function relating to different locations and cell types within the visual system. This document developed by the International Society for Clinical Electrophysiology of Vision provides an introduction to standard visual electrodiagnostic procedures in widespread use including the full-field electroretinogram (ERG), the pattern electroretinogram (pattern ERG or PERG), the multifocal electroretinogram (multifocal ERG or mfERG), the electrooculogram (EOG) and the cortical-derived visual evoked potential (VEP). The guideline outlines the basic principles of testing. Common clinical presentations and symptoms are described with illustrative examples and suggested investigation strategies.

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Most cited references 4

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Pattern electroretinography (PERG) and an integrated approach to visual pathway diagnosis.

Graham E. Holder (2001)

The pattern electroretinogram (PERG) provides an objective measure of central retinal function, and has become an important element of the author's clinical visual electrophysiological practice. The PERG contains two main components, a positivity at approximately 50ms (P50) and a larger negativity at approximately 95ms (N95). The P50 component is affected by macular dysfunction with concomitant reduction in N95. The PERG therefore complements the Ganzfeld ERG in the assessment of patients with retinal disease. In contrast, the ganglion cell origins of the N95 component allow electrophysiological evaluation of ganglion cell function both in primary disease and in dysfunction secondary to optic nerve disease, where selective loss of N95 can be observed. Both macular dysfunction and optic nerve disease can give abnormalities in the visual evoked cortical potential (VEP), and the PERG thus facilitates more meaningful VEP interpretation. This review addresses the origins and recording of the PERG, and then draws on extensive clinical data from patients with genetically determined retinal and macular dystrophies, other retinal diseases and a variety of optic nerve disorders, to present an integrated approach to diagnosis.

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ISCEV Standard for clinical electro-oculography (2017 update)

Paul A. Constable, Michael Bach, Laura Frishman … (2017)

The clinical electro-oculogram (EOG) is an electrophysiological test of the outer retina and retinal pigment epithelium (RPE) in which changes in the electrical potential across the RPE are recorded during successive periods of dark and light adaptation. This document presents the 2017 EOG Standard from the International Society for Clinical Electrophysiology of Vision (ISCEV: www.iscev.org). This standard has been reorganized and updated to include an explanation of the mechanism of the EOG, but without substantive changes to the testing protocol from the previous version published in 2011. It describes methods for recording the EOG in clinical applications and gives detailed guidance on technical requirements, practical issues and reporting of results with the main clinical measure (the Arden ratio) now termed the light peak:dark trough ratio. The standard is intended to promote consistent quality of testing and reporting within and between clinical centers.

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Pattern electroretinography(PERG) and an integrated approach to visual pathway diagnosis.progress in retinal and eye research

GE Holder (2001)

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Author and article information

Contributors

Anthony G. Robson: 020 7566 2554 , anthony.robson@moorfields.nhs.uk

Journal

Journal ID (nlm-ta): Doc Ophthalmol

Journal ID (iso-abbrev): Doc Ophthalmol

Title: Documenta Ophthalmologica. Advances in Ophthalmology

Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )

ISSN (Print): 0012-4486

ISSN (Electronic): 1573-2622

Publication date (Electronic): 3 February 2018

Publication date PMC-release: 3 February 2018

Publication date (Print): 2018

Volume: 136

Issue: 1

Pages: 1-26

Affiliations

[1 ]ISNI 0000 0000 8726 5837, GRID grid.439257.e, Department of Electrophysiology, , Moorfields Eye Hospital, ; 162 City Road, London, UK

[2 ]ISNI 0000000121901201, GRID grid.83440.3b, Institute of Ophthalmology, , University College London, ; London, UK

[3 ]ISNI 000000009445082X, GRID grid.1649.a, Department of Clinical Neurophysiology, , Sahlgrenska University Hospital, ; Göteborg, Sweden

[4 ]Southwest Hospital, Southwest Eye Hospital, Third Military Medical University, Chongqing Institute of Retina, Chongqing, China

[5 ]ISNI 0000 0004 1767 1636, GRID grid.417748.9, Srimati Kanuri Santhamma Centre for Vitreoretinal Diseases, Jasti V. Ramanamma Childrens’ Eye Care Centre, , L V Prasad Eye Institute, ; Hyderabad, India

[6 ]ISNI 0000 0004 0378 8438, GRID grid.2515.3, Department of Ophthalmology, , Boston Children’s Hospital, ; Boston, USA

[7 ]ISNI 0000 0004 1757 3470, GRID grid.5608.b, Department of Neurosciences, Ophthalmic Clinic, , Padova University, ; Padova, Italy

[8 ]ISNI 0000 0004 0621 9599, GRID grid.412106.0, National University of Singapore, , National University Hospital, ; Singapore City, Singapore

[9 ]GRID grid.416167.3, The Mount Sinai Hospital, New York Eye and Ear Infirmary of Mount Sinai, ; New York, USA

Article

Publisher ID: 9621

DOI: 10.1007/s10633-017-9621-y

PMC ID: 5811581

PubMed ID: 29397523

SO-VID: 4c76031d-1c40-444a-8cde-a100dcb9624d

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

History

Date received : 15 December 2017

Date accepted : 18 December 2017

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ScienceOpen disciplines: Ophthalmology & Optometry

Keywords: iscev standards,clinical electrophysiology,electrooculogram (eog),electroretinogram (erg),pattern erg,multifocal erg (mferg),visual evoked potential (vep),optic neuropathy,maculopathy,retinopathy

Data availability:

ScienceOpen disciplines: Ophthalmology & Optometry

Keywords: iscev standards, clinical electrophysiology, electrooculogram (eog), electroretinogram (erg), pattern erg, multifocal erg (mferg), visual evoked potential (vep), optic neuropathy, maculopathy, retinopathy

ISCEV guide to visual electrodiagnostic procedures

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Most cited references 4

Pattern electroretinography (PERG) and an integrated approach to visual pathway diagnosis.

ISCEV Standard for clinical electro-oculography (2017 update)

Pattern electroretinography(PERG) and an integrated approach to visual pathway diagnosis.progress in retinal and eye research

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