Diagnostic Performance of a Handheld Electroretinography Test for Glaucoma

Area of Science:

• Ophthalmology
• Neuroscience
• Medical Devices

Background:

• Glaucoma is a progressive optic neuropathy often diagnosed late.
• Early detection of glaucoma is crucial for preserving vision.
• Current diagnostic tools may have limitations in sensitivity and accessibility.

Purpose of the Study:

• To assess the diagnostic accuracy of a handheld electroretinography (ERG) device using sinusoidal flicker stimuli at various frequencies.
• To compare the performance of the ERG device in differentiating between glaucoma patients and healthy controls.

Main Methods:

• A cross-sectional study involved 72 participants (54 glaucoma, 18 control).
• A handheld ERG device (RETeval) delivered sinusoidal flicker stimuli from 1 to 50 Hz.
• Logistic regression models were trained and tested to predict glaucoma diagnosis based on ERG amplitude responses.

Main Results:

• A model using all frequencies yielded an Area Under the Curve (AUC) of 0.57.
• A model focusing on higher frequencies (≥30 Hz) significantly improved diagnostic performance with an AUC of 0.81.
• At ≥30 Hz, the model achieved 80% sensitivity and 74% specificity.

Conclusions:

• Handheld ERG with high-frequency flicker stimuli (30-50 Hz) shows potential for glaucoma diagnosis.
• This approach may help identify vulnerability in the retinal OFF pathway, which is implicated in glaucoma.
• The findings support the utility of accessible ERG devices for glaucoma screening and diagnosis.