The Mydriasis-Free Handheld ERG Device and Its Utility in Clinical Practice: A Review.

Area of Science:

• Ophthalmology
• Medical Devices
• Diagnostic Technology

Background:

• Full field electroretinography (ERG) is crucial for diagnosing retinal diseases.
• Mydriasis-free handheld ERG devices offer portable, non-invasive retinal function assessment.
• These devices are particularly useful for screening diabetic retinopathy (DR) and in pediatric populations.

Purpose of the Study:

• To review the current evidence on handheld ERG devices in ocular diseases.
• To evaluate their reliability, diagnostic accuracy, and limitations.
• To assess their utility in diverse clinical settings, including retinal diseases, DR, glaucoma, and pediatric cohorts.

Main Methods:

• A comprehensive literature search of Pubmed and Embase databases up to December 2024.
• Inclusion of studies evaluating handheld ERG devices in various ocular conditions and populations.
• Exclusion of case reports, abstracts, non-human studies, and letters; narrative synthesis of findings due to heterogeneity.

Main Results:

• 57 studies were included, evaluating handheld ERG in healthy subjects, DR, retinopathies, glaucoma, and pediatric cohorts.
• Handheld ERG devices provide rapid, non-invasive retinal assessment, suitable for screening with good sensitivity and reasonable specificity.
• Limitations include reduced performance in early disease/cone dysfunction, potential false positives, and variability compared to traditional ERG, especially in pediatric patients.

Conclusions:

• Handheld ERG devices are rapid, accessible, and user-friendly complementary tools for retinal assessment.
• They are particularly valuable in early disease detection and in settings where conventional ERG is less feasible.
• Further research is needed to refine protocols, enhance diagnostic accuracy, and validate their use across a wider range of ocular diseases.