Decades ago, electrophysiological testing was only conducted in research facilities and large medical centers, making them very inconvenient for all involved. However, in recent years the testing experience for doctors and patients alike has been vastly improved as visual evoked potential (VEP), pattern electroretinography (PERG), full field electroretinography (ffERG) and multifocal electroretinography (mfERG) are now available in an office setting with the Diopsys Nova ERG and VEP vision testing system.
Electrophysiological testing has the potential to determine treatment needs in patients much earlier than would happen otherwise. It has been proven to be safe, efficacious and very user- and patient-friendly, and presents remarkable possibilities from the sheer number of patients who can be helped. Not only can detecting abnormalities benefit glaucoma patients by determining dysfunction much earlier than other tests, but many other patients, including those with diabetes, those with abnormalities in the macula and even cataract patients, benefit. Premium cataract patients should definitely be tested with a ffERG before cataract surgery in order to detect any functional abnormalities that could affect their outcomes.
With the new testing systems, clinicians and technicians can easily set up the tests, administer them and decipher the results as they relate to documented reference ranges. The patient’s experience has likewise vastly improved as the testing is extremely patient-friendly, using Diopsys electrodes that sit comfortably on the patient’s head and lower eyelid.
The Diopsys machine is smaller than a visual field machine and works well placed in the same area. Some practices have dedicated testing days whereas others integrate these diagnostics with their patients’ annual or semiannual visits.
Banitt MR, et al. Invest Ophthalmol Vis Sci. 2013;doi:10.1167/iovs.12-11026.
Robert J. Noecker, MD, is a leading ophthalmologist with more than 15 years developing innovations in glaucoma surgery. He currently practices with Ophthalmic Consultants of Connecticut and is on the clinical faculty at Yale University. Noecker can be reached at email: firstname.lastname@example.org.
Disclosure: Noecker reports he is a consultant for Alcon, Aerie, Alimera, Beaver-Visitec, Diopsys, Ethis Communications, Glaukos, InnFocus, Inotek, Iridex, Novartis, Ocular Therapeutix, Omeros, PolyActiva, Santen, Shire, Solx and Sun Pharmaceuticals; is a speaker for Alcon, Allergan, Beaver-Visitec, Diopsys, Imprimis, Iridex, Novartis and Quantel; does research for AqueSys, Glaukos and InnFocus; and has an ownership interest in Ocular Therapeutix, Tula Medical and ISP Surgical.