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 Katz

Research output: Contribution to journalArticlepeer-review


Purpose: 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. Methods: 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. Results: 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. Conclusions: 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.

Original languageEnglish
Pages (from-to)185-195
Number of pages11
JournalDocumenta Ophthalmologica
Issue number3
StatePublished - 1 Dec 2019
Externally publishedYes


  • Electrophysiology
  • Flicker electroretinogram
  • Reference database
  • Repeatability
  • Steady-state pattern electroretinogram


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