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The value of two-field pattern electroretinogram in routine clinical electrophysiologic practice
Lenassi, Eva ...
Purpose:: To investigate the clinical use of the large-field pattern electroretinogram (PERG) as an adjunct test to the International-standard PERGin an unselected sequential cohort of patients ...referred for routine electrophysiologic assessment. Methods:: Pattern electroretinograms to both 15degrees x 11 degrees (International Society for Clinical Electrophysiology of Vision Standard) and 30 degrees x 22 degrees (large field) checkerboard field sizes were recorded in 277 consecutive electrophysiology patients, aged 10-79 years. Most patients had additional tests including full-field electroretinogram, electrooculogram, multifocal electroretinograms, or cortical visual evoked potential. Patient data were compared with data from 27control subjects. Results:: Satisfactory 2-field PERG data were obtained in 91% (N = 253) of patients; data from 24 patients (9%) were excluded because ofpoor compliance (n = 17) or nystagmus (n = 7). Standard PERGs were consistent with macular dysfunction in 44% of cases; large-field PERG revealedmacular dysfunction in an additional 8% of eyes and helped to distinguish between localized central, predominantly paracentral, and widespread macular dysfunction. The results were consistent with multifocal electroretinogram and/or imaging studies on the same patients. In some patients with optic nerve disease, the large-field PERG provided clearer evidence of normal macular function than the standard PERG. Conclusion:: Routine use of the large-field PERG is a valuable complement to standard-fieldPERG testing in the evaluation and management of patients with different forms of macular or generalized retinal dysfunction and can be useful in patients with optic nerve disease.
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