ISCEV standard for clinical pattern electroretinography (2024 update)

Abstract

The pattern electroretinogram (PERG) is a localized retinal response evoked by a contrast-reversing pattern, usually a black and white checkerboard, which provides information about macular and retinal ganglion cell function. This document, from the International Society for Clinical Electrophysiology of Vision (ISCEV; www.iscev.org ) presents an updated and revised Standard for clinical PERG testing. This replaces the 2013 and all earlier versions. Minimum protocols for basic PERG stimuli, recording methods and reporting are specified, to promote consistency of methods for diagnosis and monitoring purposes, while responding to evolving clinical practices and technology. The main changes in the updated ISCEV Standard for clinical PERG include expanded guidance about large stimulus fields, stimulus parameters for simultaneous PERG and pattern visual evoked potential recording, baseline drift correction, and use of consistent ambient room lighting. These changes aim to provide a clinically relevant document about current practice which will facilitate good quality recordings and inter-laboratory comparisons.

Keywords: Clinical electrophysiology; Clinical standards; Electroretinogram; International society for clinical electrophysiology of vision (ISCEV); PERG; Pattern electroretinogram; Retina; Retinal ganglion cells; Visual evoked potential.

Fig. 1

Pattern ERG waveforms. Pattern ERGs recorded to 50’ check widths presented in standard 15-degree and 30-degree fields. P50 and N95 peak to trough amplitude and peak time measures are arrowed. The PERG P50 peak times from the 30- and 15-degree fields are the same, but P50 amplitude is larger from the 30-degree field in a healthy individual

Fig. 2

Baseline drift. Pattern ERG showing the effect of baseline drift on P50 and N95 measurements and the ratio of N95 to P50 amplitude, (see Sect. "Averaging and signal analysis" Averaging and signal analysis). The arrow shows the result of removing the linear trend (detrending)