The Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Eye (Lond). 2021 Aug;35(8):2180-2189. doi: 10.1038/s41433-020-01221-2. Epub 2020 Oct 19.
Electroretinograms (ERG) are necessary for the evaluation of retinal function, however testing children is challenging and only performed at a few specialised centres. The handheld RETeval ERG instrument could prove a valuable tool for clinicians in assessing retinal function. This study evaluates this device using an ISCEV approved modified paediatric protocol and compares it to standard methods using a photic stimulator.
Cone and rod ERGs were recorded using a standard photic stimulator (Grass) and the RETeval device. Both methods involve using skin electrodes, without mydriasis and under dark and light conditions. Two groups of participants were recruited: 44 healthy adult subjects (mean age = 39 years) and 37 paediatric patients (mean = 5 years). Three of the paediatric patients were not sufficiently compliant to undertake the RETeval recording.
Adult ERG reference range data are presented for the RETeval and compared to the standard system. There is lack of absolute agreement in the measurements between the two devices, highlighting the need for device-specific reference data. In the paediatric group there is a high level of diagnostic agreement between both systems (Cohen's Kappa k = 0.80). The relative sensitivity and specificity of the RETeval was 1.0 and 0.91. Qualitative patient and user feedback is discussed.
ERGs are similar between the two methodologies. This study demonstrates that the RETeval device is a useful tool for assessing retinal function in children. Importantly, it is quick, relatively easy to use and can potentially reduce the burden and costs of paediatric electrodiagnostic assessments.
视网膜电图（ERG）是评估视网膜功能所必需的，然而，对儿童进行测试具有挑战性，且仅在少数几个专门中心进行。手持式 RETeval ERG 仪器可能是评估视网膜功能的临床医生的有价值工具。本研究使用经 ISCEV 批准的改良儿科方案评估该设备，并将其与使用光电刺激器的标准方法进行比较。
使用标准光电刺激器（Grass）和 RETeval 设备记录锥体细胞和杆体细胞 ERG。两种方法都涉及使用皮肤电极，无需散瞳，在暗室和亮室条件下进行。招募了两组参与者：44 名健康成年受试者（平均年龄 39 岁）和 37 名儿科患者（平均年龄 5 岁）。有 3 名儿科患者因不配合而无法进行 RETeval 记录。
为 RETeval 呈现了成人 ERG 参考范围数据，并与标准系统进行了比较。两种设备的测量值缺乏绝对一致性，这突出了需要设备特定的参考数据。在儿科组中，两种系统之间具有高度的诊断一致性（Cohen's Kappa k=0.80）。RETeval 的相对灵敏度和特异性分别为 1.0 和 0.91。讨论了患者和用户的定性反馈。
两种方法的 ERG 相似。本研究表明，RETeval 设备是评估儿童视网膜功能的有用工具。重要的是，它快速、相对容易使用，并且可以潜在地减少儿科电诊断评估的负担和成本。
