Documenta Ophthalmologica

, Volume 139, Issue 3, pp 185–195 | Cite as

Test–retest repeatability of the pattern electroretinogram and flicker electroretinogram

  • Arthur F. Resende
  • Carina T. Sanvicente
  • Hamoon Eshraghi
  • Alberto Garcia
  • Kassandra Pickel
  • Qiang Zhang
  • Michael Waisbourd
  • L. Jay KatzEmail author
Original Research Article



To evaluate the repeatability of the steady-state pattern electroretinogram (PERG) and full-field flicker electroretinogram (Flicker ERG) protocols, delivered by the office-based Neuro Optic Vision Assessment (NOVA)™ testing platform, in healthy subjects.


Healthy individuals underwent PERG (16° and 24°) and Flicker ERG [fixed luminance (FL) and multi-luminance (ML)] testing protocols. Test–retest repeatability of protocols was calculated using intra-class correlation coefficients (ICC). Reference values of the parameters of the aforementioned tests were also calculated.


The ICCs for the PERG parameters ranged from 0.793 to 0.911 (p < 0.001). The ICCs for the Flicker ERG parameters ranged from 0.968 to 0.994 (p < 0.001). A linear regression analysis was applied to assess the impact of age on ERG responses. Age had a significant impact on all PERG parameters (16° or 24°). The phase response of the FL Flicker ERG significantly decreased with age (β = − 0.837, p ≤ 0.001). The FL Flicker ERG Magnitude was also impacted with a significant quadratic effect of age (β = − 0.0047, p = 0.0004). Similarly, the Phase Area Under the Curve (Phase AUC) of the ML Flicker ERG significantly declined with age (β = − 0.007, p = 0.009), and the impact on the Magnitude AUC was significant as well, with a negative quadratic age effect.


The PERG and Flicker ERG protocols, delivered by an office-based testing platform, were shown to have good-to-excellent test–retest repeatability when tests were performed in the same order and in immediate succession.


Steady-state pattern electroretinogram Flicker electroretinogram Repeatability Electrophysiology Reference database 



This study was funded by Dyopsis Inc. Dr. Alberto Garcia, MD works as Chief Medical Officer at Diopsys Inc. Ms. Kassandra Pickel, MPH worked as a Research Associate at Diopsys Inc. during this manuscript’s preparation. The Wills Eye Hospital Glaucoma Research Center has received funding from Diopsys Inc. to conduct this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Statement on the welfare of animals

This manuscript does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Arthur F. Resende
    • 1
  • Carina T. Sanvicente
    • 1
  • Hamoon Eshraghi
    • 2
  • Alberto Garcia
    • 3
  • Kassandra Pickel
    • 3
  • Qiang Zhang
    • 4
  • Michael Waisbourd
    • 5
  • L. Jay Katz
    • 1
    Email author
  1. 1.Glaucoma Research CenterWills Eye HospitalPhiladelphiaUSA
  2. 2.St. Luke’s University HospitalBethlehemUSA
  3. 3.Diopsys Inc.Pine BrookUSA
  4. 4.Vickie and Jack Farber Vision Research CenterWills Eye HospitalPhiladelphiaUSA
  5. 5.Division of Ophthalmology, Sackler Faculty of MedicineTel-Aviv Medical CenterTel-AvivIsrael

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