Comparison of the handheld RETeval ERG system with a routine ERG system in healthy adults and in paediatric patients

Abstract

Background: Electroretinograms (ERG) are necessary for the evaluation of retinal function, however testing children is challenging and only performed at a few specialised centres. The handheld RETeval ERG instrument could prove a valuable tool for clinicians in assessing retinal function. This study evaluates this device using an ISCEV approved modified paediatric protocol and compares it to standard methods using a photic stimulator.

Subjects and Method: Cone and rod ERGs were recorded using a standard photic stimulator (Grass) and the RETeval device. Both methods involve using skin electrodes, without mydriasis and under dark and light conditions. Two groups of participants were recruited: 44 healthy adult subjects (mean age =39 years) and 37 paediatric patients (mean=5 years). Three of the paediatric patients were not sufficiently compliant to undertake the RETeval recording.

Results: Adult ERG reference range data is presented for the RETeval and compared to the standard system. There is lack of absolute agreement in the measurements between the two devices, highlighting the need for device-specific reference data. In the paediatric group there is a high level of diagnostic agreement between both systems (Cohen’s Kappa k = 0.80). The relative sensitivity and specificity of the RETeval was 1.0 and 0.91. Qualitative patient and user feedback is discussed.

Conclusions: ERGs are similar between the two methodologies. This study demonstrates that the RETeval device is a useful tool for assessing retinal function in children. Importantly, it is quick, relatively easy to use and can potentially reduce the burden and costs of paediatric electrodiagnostic assessments.

A Correction was issued to figure 1 of this paper shortly after publication due to typographical error. The correction can be accessed at the original paper, the additional links on this record and the correction pdf. Pease use figure 1 in the correction not the Accepted Manuscript.

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Identifiers

ORCID for Jay E. Self: orcid.org/0000-0002-1030-9963

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