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Electrophysiological Assessment in Birdshot Chorioretinopathy: Flicker Electroretinograms Recorded With a Handheld Device

Waldie, A. M., Hobby, A. E., Chow, I. , Cornish, E. E., Indusegaran, M., Pekacka, A., Nguyen, P., Fraser, C., Binns, A. M. ORCID: 0000-0001-8621-498X, Stanford, M. R., Hammond, C. J., McCluskey, P. J., Grigg, J. R. & Mahroo, O. A. (2022). Electrophysiological Assessment in Birdshot Chorioretinopathy: Flicker Electroretinograms Recorded With a Handheld Device. Translational Vision Science and Technology, 11(5), article number 23. doi: 10.1167/tvst.11.5.23


Purpose: The flicker electroretinogram (ERG) is a sensitive indicator of retinal dysfunction in birdshot chorioretinopathy (BCR). We explored recordings from a handheld device in BCR, comparing these with conventional recordings in the same patients and with handheld ERGs from healthy individuals.

Methods: Non-mydriatic flicker ERGs, using the handheld RETeval system (LKC Technologies), were recorded with skin electrodes at two centers. At one center (group 1), the stimuli (85 Td·s, 850 Td background) delivered retinal illuminance equivalent to international standards; at the other center (group 2), a different protocol was used (32 Td·s, no background). Patients also underwent international standard flicker ERG recordings with conventional electrodes following mydriasis. Portable ERGs from patients were also compared with those from healthy individuals.

Results: Thirty-two patients with BCR (mean age ± SD, 56.4 ± 11.3 years) underwent recordings. Portable and standard ERG parameters correlated strongly (r > 0.75, P < 0.01) in both groups. Limits of agreement for peak times were tighter in group 1 (n = 21; −4.3 to+2.0ms [right eyes], −3.9to1.5ms [left eyes]) than in group 2(n=11;−3.4 to +6.9 ms [right eyes], −4.8 to +9.0 ms [left eyes]). Compared with healthy controls (n =66 and n =90 for groups 1 and 2, respectively), patients with BCR showed smaller mean amplitudes and longer peak times.

Conclusions: Portable ERGs correlated strongly with conventional recordings, suggesting potential in rapid assessment of cone system function in office settings.
Translational Relevance: Flicker ERGs, known to be useful in BCR, can be obtained rapidly with a portable device with skin electrodes and natural pupils.

Publication Type: Article
Additional Information: This work is licensed under a Creative Commons Attribution 4.0 International License.
Publisher Keywords: birdshot chorioretinopathy; electroretinography; retina; uveitis
Subjects: R Medicine > RE Ophthalmology
T Technology > TK Electrical engineering. Electronics Nuclear engineering
Departments: School of Health & Psychological Sciences > Optometry & Visual Sciences
SWORD Depositor:
[thumbnail of Waldie et al. birdshot 2022.pdf]
Text - Published Version
Available under License Creative Commons: Attribution International Public License 4.0.

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