ISCEV standard full-field ERG reference limits from 407 healthy subjects, derived from transference and validation of...

Area of Science:

• Ophthalmology
• Neurophysiology
• Medical Imaging

Background:

• The International Society for Clinical Electrophysiology of Vision (ISCEV) provides standards for full-field electroretinogram (ERG) testing.
• Establishing reliable, age-adjusted reference intervals is crucial for accurate clinical interpretation of ERG data.
• Previous studies have used various electrode types, necessitating data harmonization.

Purpose of the Study:

• To establish age-adjusted reference intervals for the ISCEV standard full-field electroretinogram (ERG) using silver thread electrodes.
• To determine the comparability of ERG data recorded with silver thread and gold foil electrodes.
• To develop methods for pooling reference data from multiple centers and electrode types.

Main Methods:

• Collected and verified silver thread lower fornix ERG reference data from two centers (n=251).
• Compared ERG recordings using silver thread, gold foil, and skin electrodes (n=53 and n=41, respectively).
• Utilized a linear model to transform gold foil ERG data for inclusion in the silver thread reference range, creating a combined sample (n=407).

Main Results:

• Silver thread ERG data were consistent across two centers, supporting data pooling.
• Peak times for gold foil and silver thread ERGs showed high comparability (r²=0.75-0.98).
• Silver thread ERGs had amplitudes 55-65% of gold foil ERGs, and skin ERGs 35-38% of silver thread ERGs.

Conclusions:

• ISCEV standard silver thread ERG data are consistent across centers, enabling data transference.
• Gold foil ERG data can be adjusted for inclusion in silver thread reference ranges.
• The study provides a robust method for pooling reference data, beneficial for standardization and multi-center studies.