September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Towards rapid assessment of retinal function in clinic: comparison of implicit times of photopic flicker electroretinogram responses recorded using a conventional and a portable system in patients with Birdshot chorioretinopathy
Author Affiliations & Notes
  • Omar Abdul Rahman Mahroo
    King's College London, London, England, United Kingdom
    UCL Institute of Ophthalmology, London, United Kingdom
  • Angharad Elizabeth Hobby
    King's College London, London, England, United Kingdom
    City University, London, United Kingdom
  • Ekaterina Hristova Yonova
    King's College London, London, England, United Kingdom
  • Diana Kozareva
    King's College London, London, England, United Kingdom
  • Ibtesham Tausif Hossain
    King's College London, London, England, United Kingdom
  • Mohamed Katta
    King's College London, London, England, United Kingdom
  • Christopher J Hammond
    King's College London, London, England, United Kingdom
  • Miles R Stanford
    King's College London, London, England, United Kingdom
  • Footnotes
    Commercial Relationships   Omar Mahroo, None; Angharad Hobby, None; Ekaterina Yonova, None; Diana Kozareva, None; Ibtesham Hossain, None; Mohamed Katta, None; Christopher Hammond, None; Miles Stanford, None
  • Footnotes
    Support  Fight for Sight UK (Grant 1409/10); Fight for Sight UK & Birdshot Uveitis Society (24BU141)
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 3594. doi:
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      Omar Abdul Rahman Mahroo, Angharad Elizabeth Hobby, Ekaterina Hristova Yonova, Diana Kozareva, Ibtesham Tausif Hossain, Mohamed Katta, Christopher J Hammond, Miles R Stanford; Towards rapid assessment of retinal function in clinic: comparison of implicit times of photopic flicker electroretinogram responses recorded using a conventional and a portable system in patients with Birdshot chorioretinopathy. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3594.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Birdshot chorioretinopathy (BCR) is a chronic inflammatory disease which follows a variable course. Disease activity can be difficult to assess objectively. The implicit time of the 30 Hz photopic flicker electroretinogram (ERG) has been shown to be a sensitive parameter in these patients. Electroretinography is not universally available, limiting its utility in guiding treatment decisions in many settings. A portable device allowing rapid measurements in clinic could be transformational in this regard, but such devices require validation.

Methods : A hand-held device with skin electrodes (RETeval, LKC Technologies, Inc., Gaithersburg, MD, USA) and a more conventional full-field device with a conductive fibre recording electrode (Diagnosys ColorDome, Diagnosys, Lowell, MA, USA) were used to record photopic flicker ERGs in Birdshot patients attending a single eye service. For portable recordings, pupils were undilated (stimuli aimed to deliver similar retinal illuminances to international standard stimuli); pupils were dilated for conventional recordings. Implicit times were compared. Also, recordings made from over 300 healthy subjects provided control data.

Results : Recordings were made from 11 patients (21 eyes). Mean (SD) age was 60.9 (7.5) years. Implicit times ranged from 24.4 to 35.2 ms and from 24.5 to 37 ms for portable and conventional devices respectively. Mean (SD) implicit times were 29.1 (3.7) ms and 30.3 (4.2) ms respectively. Implicit times were slightly but significantly shorter with the hand-held device (p =0.0003). The correlation coefficient between the devices was 0.96 overall (0.98 and 0.96 for right and left eye recordings). Using the control data from healthy subjects, upper cut-off values (mean plus 2SD) of 28.6 ms and 29.1 ms were set for the two devices for designating times as “prolonged”. Agreement was quantified with a kappa of 0.81 (95% CI, 0.56 to 1.0)

Conclusions : Although implicit times differ between the two systems, highlighting the importance of control data, the correlation is extremely high, with very strong agreement. The portable device holds promise in providing reliable flicker time measurements, undilated, within minutes potentially at every clinic visit.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

Figure 1. 30 Hz ERG implicit times in patients.

Figure 1. 30 Hz ERG implicit times in patients.

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