ISCEV Standard for full-field clinical electroretinography (2022 update)

TLDR

The full‑field electroretinogram (ERG) is a mass electrophysiological response to diffuse flashes of light and is used widely to assess generalized retinal function. This document from the International Society for Clinical Electrophysiology of Vision (ISCEV) presents an updated and revised ISCEV Standard for clinical ERG testing. Minimum protocols for basic ERG stimuli, recording methods and reporting are specified to promote consistency of methods for diagnosis, monitoring and inter‑laboratory comparisons, while also responding to evolving clinical practices and technology, and a non‑standard abbreviated ERG protocol is described for use when patient age, compliance or other circumstances preclude ISCEV Standard ERG testing. The updated Standard allows ERGs to meet criteria without mydriasis, improves stimulus design for non‑dilated pupils, expands dark‑adapted oscillatory potential analysis, streamlines the document format, provides a detailed review of major ERG component origins, and reclassifies additional protocols as published ISCEV extended protocols.

Abstract

The full-field electroretinogram (ERG) is a mass electrophysiological response to diffuse flashes of light and is used widely to assess generalized retinal function. This document, from the International Society for Clinical Electrophysiology of Vision (ISCEV), presents an updated and revised ISCEV Standard for clinical ERG testing. Minimum protocols for basic ERG stimuli, recording methods and reporting are specified, to promote consistency of methods for diagnosis, monitoring and inter-laboratory comparisons, while also responding to evolving clinical practices and technology. The main changes in this updated ISCEV Standard for clinical ERGs include specifying that ERGs may meet the Standard without mydriasis, providing stimuli adequately compensate for non-dilated pupils. There is more detail about analysis of dark-adapted oscillatory potentials (OPs) and the document format has been updated and supplementary content reduced. There is a more detailed review of the origins of the major ERG components. Several tests previously tabulated as additional ERG protocols are now cited as published ISCEV extended protocols. A non-standard abbreviated ERG protocol is described, for use when patient age, compliance or other circumstances preclude ISCEV Standard ERG testing.