Abstract
Purpose To assess the feasibility, sensitivity, and specificity of nonsedated handheld cone flicker electroretinogram (ERG) as a screening tool to detect retinal dysfunction in children with nystagmus. Methods Pediatric patients at a tertiary referral center from December 2015 to July 2016 were enrolled and placed into three age-matched groups: normal, nystagmus with a retinal dystrophy, and nystagmus without a retinal dystrophy. Unsedated 30 Hz cone flicker ERG responses were obtained using a handheld device (RETeval) from both eyes of each patient using skin electrode sensors after pupillary dilation. Results A total of 71 children were enrolled; amplitudes and implicit times were successfully obtained in 65 (92%): 31 (mean age ± SD, 5.6 ± 2.7 years; range, 1-12 years) without nystagmus and 34 with nystagmus. Nystagmus patients were grouped by those with (n = 15; mean age, 8.5 ± 4.5 [range, 2-17 years) and without (n = 19; mean age, 4.3 ± 3.0 [range, 6 months-10 years]) a retinal dystrophy. The patients with retinal dystrophies had significantly smaller amplitudes and prolonged or nonmeasurable implicit times than the other two groups (P < 0.001). Among nystagmus patients, amplitude was able to discriminate between those with and without retinal dystrophies with area under curve of 0.986 (SE = 0.016; P < 0.001). An amplitude <5 μV in combination with an implicit time of >33 ms warrants further evaluation. Conclusions Unsedated handheld cone flicker ERG is a feasible screening test that effectively detects retinal dysfunction in children with nystagmus. In conjunction with clinical findings, the test helps reduce the need for sedated ERG in children.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 384-388 |
| Number of pages | 5 |
| Journal | Journal of AAPOS |
| Volume | 21 |
| Issue number | 5 |
| DOIs | |
| State | Published - Oct 1 2017 |
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ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Ophthalmology
Cite this
Nonsedated handheld electroretinogram as a screening test of retinal dysfunction in pediatric patients with nystagmus. / Grace, Sara F.; Lam, Byron L; Feuer, William J; Osigian Probst, Carla; Cavuoto, Kara M; Capo, Hilda.
In: Journal of AAPOS, Vol. 21, No. 5, 01.10.2017, p. 384-388.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Nonsedated handheld electroretinogram as a screening test of retinal dysfunction in pediatric patients with nystagmus
AU - Grace, Sara F.
AU - Lam, Byron L
AU - Feuer, William J
AU - Osigian Probst, Carla
AU - Cavuoto, Kara M
AU - Capo, Hilda
PY - 2017/10/1
Y1 - 2017/10/1
N2 - Purpose To assess the feasibility, sensitivity, and specificity of nonsedated handheld cone flicker electroretinogram (ERG) as a screening tool to detect retinal dysfunction in children with nystagmus. Methods Pediatric patients at a tertiary referral center from December 2015 to July 2016 were enrolled and placed into three age-matched groups: normal, nystagmus with a retinal dystrophy, and nystagmus without a retinal dystrophy. Unsedated 30 Hz cone flicker ERG responses were obtained using a handheld device (RETeval) from both eyes of each patient using skin electrode sensors after pupillary dilation. Results A total of 71 children were enrolled; amplitudes and implicit times were successfully obtained in 65 (92%): 31 (mean age ± SD, 5.6 ± 2.7 years; range, 1-12 years) without nystagmus and 34 with nystagmus. Nystagmus patients were grouped by those with (n = 15; mean age, 8.5 ± 4.5 [range, 2-17 years) and without (n = 19; mean age, 4.3 ± 3.0 [range, 6 months-10 years]) a retinal dystrophy. The patients with retinal dystrophies had significantly smaller amplitudes and prolonged or nonmeasurable implicit times than the other two groups (P < 0.001). Among nystagmus patients, amplitude was able to discriminate between those with and without retinal dystrophies with area under curve of 0.986 (SE = 0.016; P < 0.001). An amplitude <5 μV in combination with an implicit time of >33 ms warrants further evaluation. Conclusions Unsedated handheld cone flicker ERG is a feasible screening test that effectively detects retinal dysfunction in children with nystagmus. In conjunction with clinical findings, the test helps reduce the need for sedated ERG in children.
AB - Purpose To assess the feasibility, sensitivity, and specificity of nonsedated handheld cone flicker electroretinogram (ERG) as a screening tool to detect retinal dysfunction in children with nystagmus. Methods Pediatric patients at a tertiary referral center from December 2015 to July 2016 were enrolled and placed into three age-matched groups: normal, nystagmus with a retinal dystrophy, and nystagmus without a retinal dystrophy. Unsedated 30 Hz cone flicker ERG responses were obtained using a handheld device (RETeval) from both eyes of each patient using skin electrode sensors after pupillary dilation. Results A total of 71 children were enrolled; amplitudes and implicit times were successfully obtained in 65 (92%): 31 (mean age ± SD, 5.6 ± 2.7 years; range, 1-12 years) without nystagmus and 34 with nystagmus. Nystagmus patients were grouped by those with (n = 15; mean age, 8.5 ± 4.5 [range, 2-17 years) and without (n = 19; mean age, 4.3 ± 3.0 [range, 6 months-10 years]) a retinal dystrophy. The patients with retinal dystrophies had significantly smaller amplitudes and prolonged or nonmeasurable implicit times than the other two groups (P < 0.001). Among nystagmus patients, amplitude was able to discriminate between those with and without retinal dystrophies with area under curve of 0.986 (SE = 0.016; P < 0.001). An amplitude <5 μV in combination with an implicit time of >33 ms warrants further evaluation. Conclusions Unsedated handheld cone flicker ERG is a feasible screening test that effectively detects retinal dysfunction in children with nystagmus. In conjunction with clinical findings, the test helps reduce the need for sedated ERG in children.
UR - http://www.scopus.com/inward/record.url?scp=85031898222&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85031898222&partnerID=8YFLogxK
U2 - 10.1016/j.jaapos.2017.06.022
DO - 10.1016/j.jaapos.2017.06.022
M3 - Article
C2 - 28917993
AN - SCOPUS:85031898222
VL - 21
SP - 384
EP - 388
JO - Journal of AAPOS
JF - Journal of AAPOS
SN - 1091-8531
IS - 5
ER -