Abstract
Introduction
Previous research suggests that the electroretinogram (ERG) is reduced and delayed in non-pathological myopia. However, the invasive nature of the electrode and cumbersome equipment required has prevented the widescale uptake of ERG measures. This study investigated whether previously reported changes to the ERG response in myopia are also observable when measured using non-invasive skin electrodes and a hand-held ERG device.
Method
Monocular flash ERGs were measured using the RETeval® device according to the ‘ISCEV 6 Step Dark First cd’ protocol in 46 participants with non-pathological myopia (spherical equivalent refraction [SER] −0.50 to −11.25 D, median −3.75 D, median axial length [AL] 25.4 mm) and 47 non-myopic controls (SER +2.00 to −0.25 D, median +1.00 D, median AL 23.6 mm). Measures were performed under pupil mydriasis with Sensor Strip skin electrodes.
Results
The median implicit time for all dark-adapted (DA) components was longer among myopes. Following Holm-Bonferroni correction, this difference reached statistical significance (p < 0.05) for the DA 3.0 A-wave, DA 10.0 A-wave and B-waves, and DA Oscillatory potentials 1 and 2. There were no significant differences between median light-adapted (LA) implicit times nor response amplitudes between refractive groups. For all DA components, there was a significant, positive correlation between AL and implicit time (all p < 0.05).
Conclusions
The RETeval®, used with skin electrodes, did not detect the reduction in ERG amplitude reported in myopic eyes using traditional ERG setups, potentially due to high inter-subject variability and/or anatomical confounders associated with the use of a skin electrode. The RETeval® with skin electrodes did detect subtle delays to DA implicit times previously reported in myopia, with a positive relationship observed between AL and implicit time for all DA components. In contrast, no significant differences were observed for LA implicit times, which may indicate underlying differences in the dark-adaptation process and/or scotopic visual pathways in myopia.
Previous research suggests that the electroretinogram (ERG) is reduced and delayed in non-pathological myopia. However, the invasive nature of the electrode and cumbersome equipment required has prevented the widescale uptake of ERG measures. This study investigated whether previously reported changes to the ERG response in myopia are also observable when measured using non-invasive skin electrodes and a hand-held ERG device.
Method
Monocular flash ERGs were measured using the RETeval® device according to the ‘ISCEV 6 Step Dark First cd’ protocol in 46 participants with non-pathological myopia (spherical equivalent refraction [SER] −0.50 to −11.25 D, median −3.75 D, median axial length [AL] 25.4 mm) and 47 non-myopic controls (SER +2.00 to −0.25 D, median +1.00 D, median AL 23.6 mm). Measures were performed under pupil mydriasis with Sensor Strip skin electrodes.
Results
The median implicit time for all dark-adapted (DA) components was longer among myopes. Following Holm-Bonferroni correction, this difference reached statistical significance (p < 0.05) for the DA 3.0 A-wave, DA 10.0 A-wave and B-waves, and DA Oscillatory potentials 1 and 2. There were no significant differences between median light-adapted (LA) implicit times nor response amplitudes between refractive groups. For all DA components, there was a significant, positive correlation between AL and implicit time (all p < 0.05).
Conclusions
The RETeval®, used with skin electrodes, did not detect the reduction in ERG amplitude reported in myopic eyes using traditional ERG setups, potentially due to high inter-subject variability and/or anatomical confounders associated with the use of a skin electrode. The RETeval® with skin electrodes did detect subtle delays to DA implicit times previously reported in myopia, with a positive relationship observed between AL and implicit time for all DA components. In contrast, no significant differences were observed for LA implicit times, which may indicate underlying differences in the dark-adaptation process and/or scotopic visual pathways in myopia.
| Original language | English |
|---|---|
| Pages (from-to) | 666-680 |
| Number of pages | 15 |
| Journal | Ophthalmic and Physiological Optics: the Journal of the College of Optometrists |
| Volume | 45 |
| Issue number | 3 |
| Early online date | 13 Feb 2025 |
| DOIs | |
| Publication status | Published (in print/issue) - 31 May 2025 |
Bibliographical note
Publisher Copyright:© 2025 The Author(s). Ophthalmic and Physiological Optics published by John Wiley & Sons Ltd on behalf of College of Optometrists.
Funding
This work was supported by a PhD studentship from the Department for the Economy, Northern Ireland (VS) and by the National Institute for Health and Care Research Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology (RSA, PJM). LKC Technologies provided a loan of the RETeval\u00AE for the duration of this study, and travel support to present the findings of this study at the EU-RETINA conference (VS). The views expressed are those of the authors and not necessarily those of the National Health Service, the National Institute for Health and Care Research or the Department of Health.
| Funders |
|---|
| Department for the Economy |
| University College London |
| Moorfields Eye Hospital NHS Foundation Trust |
| National Health Service |
UN SDGs
This output contributes to the following UN Sustainable Development Goals (SDGs)
-
SDG 3 Good Health and Well-being
Keywords
- electrophysiology
- myopia
- RETeval
- visual function
- Humans
- Middle Aged
- Male
- Electroretinography/instrumentation
- Electrodes
- Myopia/physiopathology
- Adult
- Female
- Dark Adaptation/physiology
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