Multi-centre variability of ISCEV standard ERGs in two normal adults
Multi-centre variability of ISCEV standard ERGs in two normal adults
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DOI：
10.1007/s10633-014-9471-9
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发表时间：
2015-04-01
影响因子：
1.4
通讯作者：
Thompson, D. A.
中科院分区：
文献类型：
--
作者：
Hamilton, R.;Al Abdlseaed, A.;Thompson, D. A.
个体在不同中心之间的全场ERG的重复性之前还没有被研究过。在英国的15个中心，用银线和皮肤电极记录相同的两个正常成人受试者的ERG，使用常规的、本地的协议和高度标准化的、与ISCEV标准中指定的值相匹配的ISCEV协议；当ISCEV标准允许选择时，只选择一个值。眼睛之间的差异很小，皮肤的幅度比银线电极小。没有一个中心产生离奇的数据点，所有15个中心的ERG都非常相似。与使用氙气闪光的ISCEV指定方案相比，局部方案(使用LED闪光)的幅度变异性较小(22%比24%，p=0.001)，但ISCEV指定方案的峰值时间变异性较小(6.1%比7.4%，p=0.001)。只有DA0.01ERG与光度变异性相关。与DA10a波相比，DA3a波的双峰时间变异性增加了一倍。中心间波幅变异性通常在临床显著阈值之内，这表明适当标准化的中心间变异性对总变异性的增加可能不会比受试者间变异性更多。由于氙气闪光管的不精确，ISCEV规定的协议的更严格的规范所获得的可变性改进可能超过了损失。峰值时间变异性远低于波幅变异性，符合生化分析的可接受变异性。这些结果证明了ERG标准的存在，并表明进一步标准化将有助于ERG在全球范围内更好地重现。
The reproducibility of an individual's full-field ERG between centres has not previously been investigated.ERGs were recorded using both silver thread and skin electrodes from the same two normal adult subjects at 15 UK centres using routine, local protocols and a highly standardised, 'ISCEV-specified' protocol matching the values specified in the ISCEV standard; where the ISCEV standard allows options, a single value was chosen.Inter-ocular differences were small, and amplitudes were smaller for skin than silver thread electrodes. No centre produced outlying data points, and ERGs across all 15 centres were remarkably similar. Amplitude variability was less for local protocols (using LED flashes) than for the ISCEV-specified protocol using xenon flashes (22 vs. 24 %, p = 0.01), but peak time variability was less for the ISCEV-specified protocol (6.1 vs. 7.4 %, p = 0.001). Only the DA 0.01 ERG correlated with photometric variability. The bifidity of the DA 3 a-wave doubled its peak time variability compared with the DA 10 a-wave.Inter-centre amplitude variability was typically within clinically significant thresholds, suggesting that inter-centre variability with suitable standardisation may not add more to total variability than inter-subject variability. Variability improvements gained by the tighter specifications of the ISCEV-specified protocol were possibly more than lost due to imprecisions of xenon flashtubes. Peak time variability was far lower than amplitude variability, corresponding with acceptable variability of biochemical assays. These results represent a vindication of the existence of an ERG standard and suggest that further standardisation would lend itself to greater reproducibility of ERGs worldwide.