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Updated: May 31, 2026
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Published on: September 3, 2020
Accuracy and results of photopic flash electroretinogram performed with skin electrodes in infants
Emmanuel Bui Quoc1, Eliane Albuisson, Isabelle Ingster-Moati
1Service d'Ophtalmologie Pédiatrique, Hôpital Robert Debré, AP-HP, Paris, France. emmanuel.bui_quoc@aliceadsl.fr
Insights
This study demonstrates the feasibility of using skin electrodes for electroretinograms (ERG) in children, establishing crucial normative data for this accessible method. The findings support its clinical utility for assessing visual function in pediatric patients.
Area of Science:
- Ophthalmology
- Neuroscience
- Pediatric Medicine
Background:
- Corneal electrodes for electroretinograms (ERG) can be challenging in pediatric patients.
- Alternative methods for ERG recording are needed to establish normative data in children.
Purpose of the Study:
- To assess the feasibility of performing ERG using skin electrodes in children.
- To establish normative electroretinogram data using skin electrodes for pediatric populations.
Main Methods:
- Fifty-one healthy children (7-11 years) underwent cone ERG and 30-Hz flicker ERG recordings.
- Active skin electrodes were placed on the lower eyelid with a reference electrode at the outer canthus.
- Responses were compared to existing normative data obtained with corneal electrodes.
Main Results:
- Cone ERG was successfully recorded in 100/102 eyes, and flicker ERG in 88/102 eyes.
- No significant correlation was found between the results of the two eyes for specific wave parameters.
- Median amplitudes for cone ERG b-wave and flicker ERG were 10.0 µV and 12.55 µV, respectively.
Conclusions:
- Skin electrode ERG amplitudes are reduced compared to corneal electrodes, requiring specific scaling factors for interpretation.
- This method is feasible and accurate for establishing normative ERG data in children.
- Skin electrode ERG is valuable for clinical assessment in conditions like nystagmus and suspected delayed visual maturation.
Purpose:
As it is not always possible to use corneal electrodes for recording electroretinograms (ERG) in children, it is necessary to check the feasibility of performing ERG with skin electrodes and to try to establish normative data.
Methods:
Fifty-one healthy children (aged 7-11 years) were recruited. Cone ERG and 30-Hz flicker ERG were recorded with one active skin electrode positioned over the lower eyelid and a reference electrode at the outer canthus of the eye. Responses were recorded to full-field stimuli. Correlations between results of both eyes were studied. Results were compared to normative data obtained with corneal electrodes.
Results:
Cone ERG response was obtained in 100/102 eyes. Flicker ERG was obtained in 88/102 eyes. No correlation between eyes was found for the a-wave latency, the a-wave amplitude, and the latency of the flicker. Mean b-wave implicit time of the cone ERG was 38.71 ± 1.6 ms; the median of its amplitude was 10.0 µV. The median of the amplitude of the flicker ERG was 12.55 µV.
Conclusions:
Amplitudes are significantly reduced, with a scaling factor of 8.75 for the b-wave amplitude of the cone ERG compared to corneal electrodes (9.6 for the a-wave amplitude and 8.87 for the flicker amplitude). Our study contributes to the establishment of normative data for skin electrode ERG. It emphasizes the feasibility and accuracy of this method. It is very useful to assess the normality of the ERG in many clinical situations, such as nystagmus and suspicion of delayed visual maturation.
