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. 2019 Jun;138(3):217-227.
doi: 10.1007/s10633-019-09687-6. Epub 2019 Mar 30.

ISCEV extended protocol for the stimulus-response series for the dark-adapted full-field ERG b-wave

Mary A Johnson  1 , Brett G Jeffrey  2 , André M V Messias  3 , Anthony G Robson  4   5
Affiliations

ISCEV extended protocol for the stimulus-response series for the dark-adapted full-field ERG b-wave

Mary A Johnson et al. Doc Ophthalmol. 2019 Jun.

Abstract

The International Society for Clinical Electrophysiology of Vision (ISCEV) standard for full-field electroretinography (ERG) describes a minimum protocol for clinical testing but encourages more extensive testing where appropriate. This ISCEV extended protocol describes an extension of the ISCEV full-field ERG standard, in which methods to record and evaluate the growth of the dark-adapted (DA) ERG b-wave with increasing stimulus energy are described. The flashes span a range that includes the weakest flash required to generate a reliable DA ERG b-wave and that required to generate a maximal b-wave amplitude. The DA ERG b-wave stimulus-response series (also known historically as the "intensity-response" or "luminance-response" series) can more comprehensively characterize generalized rod system function than the ISCEV standard ERG protocol and may be of diagnostic or prognostic value in disorders that cause generalized rod system dysfunction.

Keywords: Clinical standards; Electroretinogram (ERG); Intensity–response; International Society for Clinical Electrophysiology of Vision (ISCEV); Naka–Rushton; Retinopathy.

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Conflict of interest statement

Conflict of interest None of the authors has a conflict of interest with the information presented in this manuscript.

Figures

Fig. 1
Fig. 1
Human DA ERG waveforms recorded to flashes of increasing strength (intensity). After: Johnson (1991) in Heckenlively and Arden [2]
Fig. 2
Fig. 2
An example of flash stimulus–response amplitude data for DA ERG b-waves recorded from a healthy subject to flashes of increasing strength (intensity, I)
Fig. 3
Fig. 3
DA ERG b-wave stimulus–response functions in the affected and clinically normal eyes of a patient with venous stasis retinopathy (VSR), compared to an age-similar healthy subject
Fig. 4
Fig. 4
An example of flash stimulus–response amplitude data for DA ERG b-waves averaged from 85 healthy subjects to flashes of increasing strength (intensity). Circles are averages, error bars the 95% confidence limits, and the line a mathematical model that includes the second limb, seen in all normal subjects tested above flash strengths of approximately 0.1 cd·s/m2
Fig. 5
Fig. 5
Example of ERG b-wave stimulus–response data, fit by single Naka–Rushton equations to all of the data (dashed line) and to just the first limb (solid line). Figure reprinted with permission of Springer Nature (Documenta Ophthalmologica 85 [2] pp. 135–150). The care and fitting of Naka–Rushton functions to electroretinographic intensity–response data (Severns ML, Johnson, MA, Copyright 1993) [42]
Fig. 6
Fig. 6
Flash strength step sizes (increments) used for collection of ERG “intensity–response” data
See this image and copyright information in PMC

References

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    1. Heckenlively JR, Arden GB (eds) (1991) Principles and practice of clinical electrophysiology of vision, 1st edn. Mosby Year Book, St. Louis
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    1. Massof RW, Johnson MA (1981) Prereceptor light absorption in setters with neuronal ceroid lipofuscinosis. Investig Ophthalmol Vis Sci 20(1):134–136 - PubMed

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