Alternative Electroretinography protocol for Children, finds
A Study was conducted to assess the diagnostic accuracy and agreement between a paediatric electroretinography protocol used at Great Ormond Street Hospital (GOSH-ERG) and the ‘gold standard’ international protocol (ISCEV-ERG) in health and disease.

Patient databases were screened to identify children with an ISCEV-ERG recorded within 4 years of a GOSH-ERG. Electroretinogram (ERG) component peak times and amplitudes were re-measured, and data were analysed in terms of absolute abnormality and proportional deviation from respective reference ranges. Abnormality was defined by the retinal system affected and by individual ERG a- and b-wave component analysis.

--A total of 59 patients were included: 38 patients had retinal disease defined by an abnormal ISCEV-ERG and 21 had normal ISCEV-ERGs.

--When absolute abnormality was defined by combined retinal systems, the GOSH-ERG showed an excellent overall sensitivity of 95%.

--Individual retinal systems showed good–excellent sensitivity and specificity.

--Electroretinogram (ERG) component sensitivities ranged between 60% and 97% and specificities between 79% and 97% dependent upon the protocol step. The proportional relationship appeared mostly linear between protocols.

--Electroretinogram (ERG) morphology was comparable for both protocols in a range of retinal diseases including those with pathognomonic ERGs.

Finally, a good diagnostic precision in relation to the ISCEV standard ERG was shown in a paediatric GOSH-ERG procedure. ERGs from each protocol are equally influenced by disease due to the closely proportioned deviation and similar waveform morphology. This promotes the use of the GOSH-ERG protocol in retinal disease screening, diagnostic and monitoring for children who cannot comply with the ISCEV-ERG stringent methodology.