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Negative electroretinograms in the pediatric and adult population

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Abstract

Objective To assess the frequency of negative waveform electroretinograms (ERGs) in a tertiary referral center. Design Retrospective chart review. Participants All patients who had an ERG performed at the electrophysiology clinic at Emory University from January 1999 through March 2008 were included in the study. Methods Patients with b-wave amplitude ≤ a-wave amplitude during the dark-adapted bright flash recording, in at least one eye, were identified as having a “negative ERG”. Clinical information, such as age, gender, symptoms, best corrected visual acuity, and diagnoses were recorded for these patients when available. Results A total of 1,837 patients underwent ERG testing during the study period. Of those, 73 patients had a negative ERG, for a frequency of 4.0%. Within the adult (≥18 years of age) and pediatric populations, the frequencies of a negative ERG were 2.5 and 7.2%, respectively. Among the 73 cases, negative ERGs were more common among male than female patients, 6.7% versus 1.8% (P < 0.0001). Negative ERGs were most common among male children and least common among female adults, 9.6% versus 1.1%, respectively, (P < 0.0001). Overall in this group of patients, the most common diagnoses associated with a negative ERG were congenital stationary night blindness (CSNB, n = 29) and X-linked retinoschisis (XLRS, n = 7). Conclusions The overall frequency of negative ERGs in this large retrospective review was 4.0%. Negative ERGs were most common among male children and least common among female adults. Despite the growing number of new diagnoses associated with negative ERGs, CSNB, and XLRS appear to be the most likely diagnoses for a pediatric patient who presents with a negative ERG.

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Acknowledgments

This study is supported in part by a grant to Emory University Eye Center from Research to Prevent Blindness (RPB). Partial salary support to CSB was provided by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Rehabilitation Research and Development Service, Career Development Award C4758W. The sponsors had no role in the design or conduct of this research.

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Authors and Affiliations

  1. Department of Ophthalmology, Emory University, Atlanta, GA, USA

    Johnstone M. Kim, John F. Payne, Jiong Yan & Claire S. Barnes

  2. Rehab R&D Center of Excellence, Veterans Affairs Medical Center, Decatur, GA, USA

    Claire S. Barnes

  3. VA Palo Alto HCS (154 U), 3801 Miranda Avenue, Palo Alto, CA, 94304, USA

    Claire S. Barnes

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  1. Johnstone M. Kim
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  2. John F. Payne
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  3. Jiong Yan
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  4. Claire S. Barnes
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Correspondence to Claire S. Barnes.

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Kim, J.M., Payne, J.F., Yan, J. et al. Negative electroretinograms in the pediatric and adult population. Doc Ophthalmol 124, 41–48 (2012). https://doi.org/10.1007/s10633-011-9301-2

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  • DOI: https://doi.org/10.1007/s10633-011-9301-2

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