ERG electrode in pediatric patients: comparison of DTL fiber, PVA-gel, and non-corneal skin electrodes.

Hard contact lens electrodes have been the type most frequently used in pediatric electroretinography but they are not well-tolerated by patients. The Dawson Trick Litzkow fiber electrode is better tolerated but it is fragile and difficult to sterilize. A new electrode made from anomalous polyvinyl alcohol gel is inexpensive, has stable electrical recording properties, and can be discarded after use. Dermal electrodes have been used for electroretinogram recording for some time; however, there are few reports that directly compare their performance against standard contact lens assemblies. We compared the DTL and the polyvinyl gel electrodes in the same group of subjects and investigated their recording characteristics along with non corneal skin electrodes placed on the infraorbital ridge. Signal-averaged electroretinogram were obtained under both scotopic and photopic stimulation conditions and the implicit time and amplitudes of the a- and b-waves were determined. Overall, dermal recordings generally had shorter implicit times and lower amplitudes than with the fiber or gel electrodes. The dermal electrodes were best tolerated and outlasted the corneal in repeated use. Since amplitude characteristics of the dermal electrodes were generally about 50% of that obtained with corneal electrodes, we feel that under standardized conditions they are acceptable for most clinical recording situations in infants and young children.