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Documenta Ophthalmologica
Published in: Documenta Ophthalmologica 3/2018

Open Access 01-06-2018 | Technical Note

ERGs on the brain: the benefits of simultaneous flash retinal and cortical responses in paediatric cerebral visual impairment

Authors: Sian E. Handley, Dorothy A. Thompson, Katrina L. Prise, Alki Liasis

Published in: Documenta Ophthalmologica | Issue 3/2018

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Abstract

Purpose

To highlight the importance of simultaneous flash electroretinogram (ERG) and visual evoked potential (VEP) recording to differentiate a true flash VEP response from an artefact caused by the intrusion of the ERG on a mid-frontal reference electrode in cases of severe cerebral visual impairment (CVI).

Methods

We report an observational case series of four children with severe CVI who underwent simultaneous flash ERG and VEP recordings. Flash VEPs from Oz–Fz and lower lid skin ERGs referred to Fz were recorded simultaneously to Grass intensity setting 4 flash stimulation.

Results

In all cases, atypical, but reproducible VEPs were evident. Comparison of the timing and waveform of the VEPs and ERGs showed the occipital responses were inverted ERGs and no true flash VEP was evident.

Conclusions

While ISCEV and neurophysiology standards do not require the simultaneous recording of the flash ERG with the VEP, these cases highlight the usefulness of this non-invasive technique particularly in suspected paediatric cerebral visual impairment to differentiate a true VEP from an artefact caused by ERG contamination.
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Metadata
Title
ERGs on the brain: the benefits of simultaneous flash retinal and cortical responses in paediatric cerebral visual impairment
Authors
Sian E. Handley
Dorothy A. Thompson
Katrina L. Prise
Alki Liasis
Publication date
01-06-2018
Publisher
Springer Berlin Heidelberg
Published in
Documenta Ophthalmologica / Issue 3/2018
Print ISSN: 0012-4486
Electronic ISSN: 1573-2622
DOI
https://doi.org/10.1007/s10633-018-9631-4

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