Henrike Marie Nowitzki, Michael B Hoffmann, Khaldoon O Al-Nosairy
{"title":"DTL versus skin electrodes in recording of multifocal pattern electroretinogram and multifocal photopic negative response.","authors":"Henrike Marie Nowitzki, Michael B Hoffmann, Khaldoon O Al-Nosairy","doi":"10.1007/s10633-025-10014-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To compare the photopic negative response of the multifocal ERG (mfERG<sub>PhNR</sub>) and the multifocal pattern electroretinogram (mfPERG) using DTL electrode (E<sub>DTL</sub>) vs skin electrode (E<sub>SKIN</sub>) in healthy young and old adults.</p><p><strong>Methods: </strong>Ten \"Young\" [20-27 years] and eight \"Old\" [60-72 years] participants took part in this study. The electrophysiological responses were recorded binocularly using E<sub>DTL</sub> and E<sub>SKIN</sub>. 5-way ANOVAs were applied to investigate the following factors on mfERG<sub>PhNR</sub>: i) ELECTRODE, ii) DILATATION, iii) AGE, iv) EYE, and v) ECCENTRICITY. For mfPERG, the same factors, except dilatation, were investigated applying 4-way ANOVAs. These were conducted for amplitude and peak time of different components as well as signal-to-noise-ratio (SNR).</p><p><strong>Results: </strong>Amplitudes of mfERG<sub>PhNR</sub> [mfPERG]-based E<sub>SKIN</sub> recording were reduced to 32-38% [37-38%] compared to E<sub>DTL</sub>, <math><mrow><mi>p</mi> <mo><</mo> <mn>0.001</mn></mrow> </math> . This corresponded to SNR reduction to 80% [60%], <math><mrow><mi>p</mi> <mo><</mo> <mn>0.001</mn></mrow> </math> . E<sub>SKIN</sub> based responses had shorter peak times, by 0.2-0.5 ms for N1 and P1, <math><mrow><mi>p</mi> <mo><</mo> <mn>0.05</mn></mrow> </math> , [P1: 1.5 ms, <math><mrow><mi>p</mi> <mo><</mo> <mn>0.001</mn></mrow> </math> ]. Both age groups had comparable amplitudes and SNRs, but Young had shorter peak times, by 1.5-2.2 ms for N1 and P1, <math><mrow><mi>p</mi> <mo><</mo> <mn>0.05</mn></mrow> </math> [3.7-4.2 ms for N1, P1, N2, <math><mrow><mi>p</mi> <mo><</mo> <mn>0.05</mn></mrow> </math> ]. Compared to dilated recordings, undilated mfERG<sub>PhNR</sub> amplitudes were reduced to 47-87%, <math><mrow><mi>p</mi> <mo><</mo> <mn>0.01</mn></mrow> </math> , and peak times were delayed by 2.0-11.8 ms, <math><mrow><mi>p</mi> <mo><</mo> <mn>0.001</mn></mrow> </math> .</p><p><strong>Conclusions: </strong>mfPERG & mfERG<sub>PhNR</sub> traces were similar for E<sub>DTL</sub> and E<sub>SKIN</sub>. However, for skin electrodes, amplitudes and SNRs were lower and peak times shorter. E<sub>SKIN</sub> thus seem to be a viable alternative in patients in whom the use of corneal electrodes is precluded, e.g., children and disabled patients, but at the expense of SNR and with reference to E<sub>SKIN</sub> normative data.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":"137-153"},"PeriodicalIF":2.6000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12137451/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Documenta Ophthalmologica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10633-025-10014-5","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/9 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To compare the photopic negative response of the multifocal ERG (mfERGPhNR) and the multifocal pattern electroretinogram (mfPERG) using DTL electrode (EDTL) vs skin electrode (ESKIN) in healthy young and old adults.
Methods: Ten "Young" [20-27 years] and eight "Old" [60-72 years] participants took part in this study. The electrophysiological responses were recorded binocularly using EDTL and ESKIN. 5-way ANOVAs were applied to investigate the following factors on mfERGPhNR: i) ELECTRODE, ii) DILATATION, iii) AGE, iv) EYE, and v) ECCENTRICITY. For mfPERG, the same factors, except dilatation, were investigated applying 4-way ANOVAs. These were conducted for amplitude and peak time of different components as well as signal-to-noise-ratio (SNR).
Results: Amplitudes of mfERGPhNR [mfPERG]-based ESKIN recording were reduced to 32-38% [37-38%] compared to EDTL, . This corresponded to SNR reduction to 80% [60%], . ESKIN based responses had shorter peak times, by 0.2-0.5 ms for N1 and P1, , [P1: 1.5 ms, ]. Both age groups had comparable amplitudes and SNRs, but Young had shorter peak times, by 1.5-2.2 ms for N1 and P1, [3.7-4.2 ms for N1, P1, N2, ]. Compared to dilated recordings, undilated mfERGPhNR amplitudes were reduced to 47-87%, , and peak times were delayed by 2.0-11.8 ms, .
Conclusions: mfPERG & mfERGPhNR traces were similar for EDTL and ESKIN. However, for skin electrodes, amplitudes and SNRs were lower and peak times shorter. ESKIN thus seem to be a viable alternative in patients in whom the use of corneal electrodes is precluded, e.g., children and disabled patients, but at the expense of SNR and with reference to ESKIN normative data.
期刊介绍:
Documenta Ophthalmologica is an official publication of the International Society for Clinical Electrophysiology of Vision. The purpose of the journal is to promote the understanding and application of clinical electrophysiology of vision. Documenta Ophthalmologica will publish reviews, research articles, technical notes, brief reports and case studies which inform the readers about basic and clinical sciences related to visual electrodiagnosis and means to improve diagnosis and clinical management of patients using visual electrophysiology. Studies may involve animals or humans. In either case appropriate care must be taken to follow the Declaration of Helsinki for human subject or appropriate humane standards of animal care (e.g., the ARVO standards on Animal Care and Use).