研究目的
To compare baseline detrending methods to improve the photopic negative response (PhNR) repeatability without compromising its diagnostic ability in glaucoma.
研究成果
Baseline detrending, particularly using a whole signal polynomial of order 3, significantly improves the repeatability of the PhNR without compromising its diagnostic ability in glaucoma. This method reduces baseline drift and enhances clinical utility for diagnostics and longitudinal monitoring. Future research should explore more advanced processing techniques and validate findings in larger populations.
研究不足
The study used a portable ERG device which may have introduced more low-frequency artifacts compared to table-top systems. The sweep length of the ERG recording could influence trend estimation, and overprocessing (e.g., high polynomial orders or high-pass filters above certain thresholds) can cause waveform distortion and reduce diagnostic ability. The sample size was moderate (38 participants), and further studies with larger cohorts and more complex processing methods are needed.
1:Experimental Design and Method Selection:
The study compared two main baseline detrending approaches: increasing the high-pass filter cutoff from 1 to 10 Hz and estimating and removing the trend using polynomials of increasing order (1 to 10) applied to different parts of the ERG signal (prestimulus interval, prestimulus and postsignal interval, or whole signal). These were compared to the ISCEV recommended band-pass filter (0.3–300 Hz). Statistical methods included coefficient of repeatability (COR%), unpaired Student's t-test, and area under the receiver operating characteristic curve (AUC).
2:3–300 Hz). Statistical methods included coefficient of repeatability (COR%), unpaired Student's t-test, and area under the receiver operating characteristic curve (AUC). Sample Selection and Data Sources:
2. Sample Selection and Data Sources: Participants included 20 glaucoma patients and 18 age-matched healthy controls recruited from outpatient clinics. Exclusion criteria were visual acuity worse than 6/12, diabetes, recent ophthalmic surgery, and other eye conditions. Glaucoma patients had confirmed glaucomatous disc appearance and visual field defects.
3:List of Experimental Equipment and Materials:
Equipment used included the RETeval device for ERG recording, DTL-like electrode, gold-cup skin electrodes, tropicamide 0.5% for pupil dilation, and an International Light photometer for calibration. Software included Matlab for offline processing.
4:5% for pupil dilation, and an International Light photometer for calibration. Software included Matlab for offline processing. Experimental Procedures and Operational Workflow:
4. Experimental Procedures and Operational Workflow: Pupils were dilated, electrodes were placed, participants were light-adapted, and photopic ERGs were recorded using the RETeval device with 50 red flashes on a blue background. Signals were acquired at 2 kHz sampling frequency and processed offline. Detrending methods were applied, outlier traces were removed using robust principal component analysis, and ERG parameters (a-wave, b-wave, PhNR) were extracted from averaged traces.
5:Data Analysis Methods:
Data were analyzed using COR% for repeatability, unpaired t-tests for group comparisons, and AUC for diagnostic performance. Polynomial fitting and high-pass filtering were implemented in Matlab.
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Photometer
ILT-1700
International Light Technologies
Used to calibrate photopic luminance.
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Humphrey Field Analyzer
24-2
Carl Zeiss Meditec, Inc.
Used for visual field testing in glaucoma patients.
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RETeval
Not specified
LKC Technologies, Inc.
Used for recording photopic electroretinograms (ERGs) by delivering brief red flashes on a blue background.
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DTL-like electrode
22/1 dtex
Shieldex Trading
Placed along the lower lid margin to record ERG signals.
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Gold-cup skin electrode
Not specified
Grass Technologies, Astro-Med Inc.
Used as reference and ground electrodes placed on the temple and forehead for ERG recordings.
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Tropicamide
0.5%
Mydriacyl, Alcon Laboratories
Used for pupil dilation before ERG recordings.
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Matlab
R2016b
Mathworks
Used for offline processing of ERG signals, including detrending and data analysis.
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Spectral-domain optical coherence tomography
Spectralis or RS-3000 Advance
Heidelberg Engineering or NIDEK
Used to measure retinal nerve fiber layer thickness in participants.
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