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PubMed1986

Components of the electroretinogram: a reappraisal.

During light adaptation a progressive increase in the intensity of a flash stimulus yields ERGs in which the a-wave shows a gradual reduction in peak time, while the b-wave appears to do the opposite. However, close inspection of the different ERG waveforms indicates that the wave identified as the b-wave for a threshold stimulus actually decreases in peak time with progressively stronger stimulus. Furthermore, what is identified as the b-wave for a threshold stimulus delivered in light adaptation will become a part of the a-wave complex if the same stimulus is used in dark adaptation. Data presented here indicate that the identification of the a- and b-waves of the ERG must be constantly revised according to the intensity of the stimulus and/or the level of retinal adaptation. These findings seriously challenge the validity of the a-b-wave nomenclature currently used in electroretinography. An alternative nomenclature, based on the first derivative (dv/dt) of the ERG wave, is proposed.

Adaptation, Ocular↗
PubMed1976

EOG: light test and dark test.

The EOG test is divided into two parts: a light and a dark test. The adaptation period is extended to 30 min. During this adaptation period the luminance in the cabin decreases (or increases) slowly to the starting value of the light or dark step. In a model, we studied the influence of this ramplike luminance course on the results. Standard values for the test were calculated with 30 test persons. Our test results show a lower relative standard deviation (V = 10%) compared with earlier published results.

Adaptation, Ocular↗
PubMed2006

Utility in clinical practice of standard vs. high-intensity ERG a-waves.

PURPOSE: Standard ERG a-waves represent contributions from both photoreceptor and inner retinal cells, while the leading edge of the high-intensity a-wave is produced only by photoreceptors. This has raised questions about the value of the a-wave as an indicator of photoreceptor disease, and has led to suggestions for standardizing higher-intensity stimuli. Our objective was to compare the behavior of standard and high-intensity a-waves in clinical practice. METHODS: Standard ISCEV (International Society for Clinical Electrophysiology of Vision) a-waves and high-intensity a-wave responses were recorded under scotopic and photopic conditions from normal subjects and from patients with photoreceptor dystrophies and other diseases. RESULTS: The standard scotopic a-wave amplitude followed the high-intensity a-wave closely among patients with different diagnoses, and the results did not change significantly when cone a-waves were subtracted to isolate rod signals. The only exception was one patient with the enhanced S cone syndrome (ESCS) whose dark-adapted responses were cone-driven. Initial peak times clustered in a small range for both standard and high-intensity responses, and were not very sensitive to disease. CONCLUSION: High-intensity a-waves can show photoreceptor characteristics directly, and may help analyze some rare disorders. However, in our study the amplitude of conventional scotopic a-waves mirrored that of the high-intensity responses quite closely over a wide range of patients. This suggests that for practical purposes even if it is not perfect, the standard ERG is an excellent indicator of photoreceptor disease.

Adaptation, Ocular↗