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Pattern-reversal electroretinogram (PERG): a normative study in adults

Purpose: To determine normative values for pattern-reversal electroretinogram (PERG) in healthy adult volunteers according to the standard protocol recommended by the International Society for Clinical Electrophysiology of Vision-ISCEV. Methods: Participants were 30 healthy volunteers (15 males) with ages from 18 to 61 years (mean= 30.8 ± 8.7 yrs.; median= 29.5 yrs). Inclusion criteria were: visual acuity of 0.0 logMAR (20/20 Snellen) in each eye, absence of visual complaints, absence of media opacities, negative history for ocular or neurological diseases, negative family history for ocular and informed consent. PERG was recorded from each eye in a darkened room at 1 m from a high resolution display monitor. Stimuli were monochromatic checkerboards subtending 60, 15 e 7.5 minutes of visual angle reversing at 1.9 Hz. Responses were obtained from modified disposable fiber electrodes developed at UNIFESP. Latency (ms) for N35, P50 and N95 components as well as peak-to-peak amplitudes (µV) for N35-P50 and P50-N95 were determined. For normative values only one randomly chosen eye was included. Normal limits were calculated as 97.5% percentiles for latency and 2.5% percentile for amplitudes for each stimulus size. Results: Normal limits for N35, P50 and N95 latencies for 60', 15' and 7.5' stimuli were respectively: N35 - 40.1; 39.9 and 41.3 ms; P50 - 60.5; 64.4 and 65.6 ms and N95 - 103.4; 104.6 and 104.6 ms. For amplitude the normative values for N35-P50 and P50-N95 for 60', 15' and 7.5' were respectively: N35-P50 - 1.7; 1.6 and 0.9 µV; P50-N95 - 3.8; 2.8 and 1.5 µV. No gender differences were found either for latency or for amplitude in the three stimulus sizes. There was no correlation between PERG latency and amplitude with age, except for P50 amplitude for stimulus 15'(r=0.39; P=0.035). Conclusions: Normative values were determined for PERG parameters of amplitude and latency for three stimulus sizes. These parameters are important for evaluating the normal functioning of retinal ganglion cells and the macula. The normative values obtained in this study are comparable to previous studies in the literature.

Reference values; Electroretinography; Electrophysiology; Retinal ganglion cells


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