OPHTHALMOLOGY DEPARTEMENT OF SRIWIJAYA UNIVERSITY

M. HOESIN HOSPITAL PALEMBANG

2014

dr. Ristania

Consultant
dr. H.A.K Ansyori,Spm. Mkes.
dr. Ramzi Amin, SpM.

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Electroretinogram
Literature review
Tuesday, Mei 30th 2014


Background
Holmgren (1865)
Karpe (1947)

Research and diagnostic of retinal
Diseases Record the Electroretino-graphy
ERG
Aim
To explain the function of ERG
and how it use for the diagnosis

Electroretinogram (ERG)
Electro
Part
Currents,
wires, voltage,
resistance

Cell types,
membrane
potential,
radial currents

Diagnostic test
of patient
retinal
diseases

Retino
Part
Gramo
Part
Electroretinogram (ERG)
the Record of retinal action
currents produce by the
retina response to light
stimulus.
measure the electrical response
of the light sensitive cells such as
rods & cones
ERG Machine
Physiological Basis
Human Eye
The Structure of Retina
Photoreceptors

Distribution of Rods and cones

The eye contains about 6.5 million cones and
120 million rods.
The density of the cones is greatest at the
fovea
Processing of signal in retina

Light
Transduction
Signal processing
Convergen and
divergen
Output
Ganglion
cell, Fire
Spikes
Wave Origin
Recording ERG
The Electroretinogram
The a wave is produced
due to photoreceptor
activity.
The b wave originates due
to retinal inner nuclear
layer, from Bipolar &
Muller cells.
The c wave is produced by
pigmented epithelial cells.
Recording and Interpretation ERG
The ISCEV Standard species ve responses

(1) Dark-adapted 0.01 ERG
(2) Dark-adapted 3.0 ERG
(3) Dark-adapted 3.0
(4) Light-adapted 3.0 ERG
(5) Light-adapted 3.0 icker

Recording and Interpretation ERG
Pre Adaptation of Dark

Dark Adapted 0,01 ERG
(Rod Response)

Dark Adapted 3,0 ERG
(Combine Rod-Cone Response)

Dark Adapted 3,0
Oscillatory potentials
Pre Adaptation of Light

Light Adapted 3,0 ERG
(Single Flash Cone Response)

Light Adapted 3,0 Flicker ERG
(30 Hz Flicker)
Dark-adapted 0.01 ERG
(rod response)
The Dark-adapted 0.01 ERG is
normally the rst signal measured
after dark adaptation

The stimulus is a dim white ash of
0.01 cd.s.m
-2
; with a minimum
interval of 2 s between ashes.

Dark-adapted 3.0 ERG (combined rod
cone response)
This is produced by a white 3.0 cd.s.m
-2
ash
in the dark-adapted eye. There should be an
interval of at least 10 s between stimuli.

Dark-adapted 3.0 oscillatory potentials
Dark-adapted oscillatory potentials should be
obtained from the dark-adapted eye, using
the 3.0 cd.s.m
-2
flash stimulus.

The high-pass filter must be set at 75100 Hz,
and the low pass filter set at 300 Hz or above.

Light-adapted 3.0 ERG
(single-flash cone response)
Use a 3.0-cd.s.m
-2
stimulus, with
at least 0.5 s between flashes.

To achieve stable and
reproducible cone ERGs, a
minimum of 10 min light
adaptation is required,

The background luminance should
be 30 cd.m
-2

Light-adapted 3.0 flicker ERG (30 Hz
flicker)
Flicker ERGs also reflect activity of the cone
system, and should be obtained with 3.0-
cdsm
-2
stimuli,
Flashes should be presented at a rate of
approximately 30 stimuli per second (30 Hz),
and the rate that is chosen should be constant
for the laboratory.
Interpretation eletroretinography
Abnormal ERG
Abnormal ERG
ERG Function
Retinitis pigmentosa
choroideremia,
gyrate atrophy of the retina,
Goldman-Favre syndrome,
congenital stationary night blindness
X-linked juvenile retinoschisis
Achromatopsia
cone dystrophies
Usher syndrome

Multifocal Electro retinography
(mfERG)
Recording of multiple spatially resolved ERG
responses from the retina over a central area
of abt 25 degrees.
Multifocal Electro retinography
(mfERG)
The stimulus consists of
an array of 61/102/241
hexagonal elements of
black &white color

Multifocal Electro retinography
(mfERG)

N1 response off
bipolar cells. P1
response on bipolar
peak. N2 response on
bipolar cells recovery.
Multifocal Electro retinography
(mfERG)

Clinical application of mfERG It can point out
local alterations which cannot be detected by
standard ERG.
Excluding outer retinal diseases.
Maculopathies.
Vascular disorders.
Following disease progression.
CONCLUSION
ERG is a tool to measure electrical signals
issued by the retina and photoreceptor cells
(rods and cones)

ERG is used to check there are abnormalities in
the retina of the eye and photoreceptor cells

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YOU