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Predicting Outcome in Central Retinal Vein Occlusion Using the Flicker Electroretinogram

Predicting Outcome in Central Retinal Vein Occlusion Using the Flicker Electroretinogram Abstract Objective: To evaluate the usefulness of the 30-Hz flicker electroretinogram (ERG) in predicting outcome in patients with central retinal vein occlusion using an automated system previously developed to measure parameters of the flicker ERG and using information about the a priori probability of developing neovascularization of the iris in central retinal vein occlusion. Methods: Amplitude and timing were extracted from 30-Hz flicker ERGs of 76 patients with acute central retinal vein occlusion from a previous study. The ability of the ERG to predict the development of neovascularization of the iris based on derived parameters was measured using the area under the receiver operating characteristic curve. Results: The predictive ability of the 30-Hz ERG amplitude, as judged by a two-alternative forced-choice procedure, was 92%. The corresponding value for implicit time was 89%. Using Bayes' theorem, we computed the probability of developing neovascularization of the iris based on a single 30-Hz flicker ERG measurement at initial patient presentation. Conclusions: The 30-Hz flicker ERG provides useful information about the patients with central retinal vein occlusion. References 1. Swets JA, Picket RM. Evaluation of Diagnostic Systems . Orlando, Fla: Academic Press Inc; 1982. 2. Cornfield J, Dunn RA, Batchlor CD, Pipberger HV. Multigroup diagnosis of electrocardiograms . Comp Biomed Res . 1973;6:97-120.Crossref 3. Milliken JA, Pipberger H, Pipberger HV, et al. The impact of and ECG computer analysis program on the cardiologist's interpretation: a cooperative study . J Electrocardiol . 1983;16:141-150.Crossref 4. Henkes HE. Electroretinography in circulatory disturbances of the retina, I: electroretinogram in cases of occlusion of the central retinal vein or one of its branches . Arch Ophthalmol . 1953;49:190-201.Crossref 5. Karpe G, Uchermann A. The clinical electroretinogram, IV: the electroretinogram in circulatory disturbances of the retina . Acta Ophthalmol . 1955;33:493-516.Crossref 6. Sabates R, Hirose T, McMeel JW. Electroretinography in the prognosis and classification of central retinal vein occlusion . Arch Ophthalmol . 1983;101:232-235.Crossref 7. Kaye SB, Harding SP. Early electroretinography in unilateral central retinal vein occlusion as a predictor of rubeosis iridis . Arch Ophthalmol . 1988;106:353-356.Crossref 8. Johnson MA, Marcus S, Elman MJ, McPhee TJ. Neovascularization in central retinal vein occlusion: electroretinographic findings . Arch Ophthalmol . 1988;106:348-352.Crossref 9. Breton ME, Quinn GE, Keene SS, Dahmen JC, Brucker AJ. Electroretinogram parameters at presentation as predictors of rubeosis in central retinal vein occlusion patients . Ophthalmology . 1989;96:1343-1352.Crossref 10. Johnson MA, McPhee TJ. Electroretinographic findings in iris neovascularization due to acute central retinal vein occlusion . Arch Ophthalmol . 1993;111:806-814.Crossref 11. McDonald HR, Schatz H. Macular edema following panretinal photocoagulation . Retina . 1985;5:5-10.Crossref 12. Zweng HC, Little HL, Hammond AH. Complications of argon laser photocoagulation . Trans Am Acad Ophthalmol Otolaryngol . 1974;78:195-204. 13. Wepman B, Sokol S, Price J. The effects of photocoagulation on the electroretinogram and dark adaptation in diabetic retinopathy . Doc Ophthalmol Proc . 1977;25:139-147. 14. McPhee TJ, Johnson MA, Elman MJ, Finkelstein D. Electroretinographic findings in iris neovascularization due to acute central retinal vein occlusion. Presented as a poster at the Annual Meeting of the American Academy of Ophthalmology; November 8-12, 1987; Dallas, Tex. 15. Johnson MA, Massof RW. The photomyoclonic reflex: an artefact in the clinical electroretinogram . Br J Ophthalmol . 1981;66:368-372.Crossref 16. Severns ML, Johnson MA, Merritt SA. Automated estimation of implicit time and amplitude from the flicker electroretinogram . Appl Optics . 1991;30:2106-2112.Crossref 17. Anderson CM, Troelstra A, Garcia CA. Quantitative evaluation of photopic ERG waveforms . Invest Ophthalmol Vis Sci . 1979;18:26-43. 18. Green DM, Swets JA. Signal Detection Theory and Psychophysics . Melbourne, Fla: Robert E Krieger Publishing Co Inc; 1974:45-49. 19. Metz CE, Wang P-L, Kronman HB. A new approach for testing the significance of differences between ROC curves measured from correlated data . In: Deconinck F, ed. Information Processing in Medical Imaging . The Hague, the Netherlands: Martinus Nijhoff; 1984:432-445. 20. Birch DG, Anderson JL. Standardized full-field electroretinography: normal values and their variation with age . Arch Ophthalmol . 1992;110:1571-1576.Crossref 21. Johnson MA, Severns ML, Kelman SE. Using a neural network and the electroretinogram to classify central retinal vein occlusion . Perception . 1990;19:367. 22. Severns ML, Johnson MA. Automated implicit time and amplitude determination for the 30-Hz flicker electroretinogram: performance in the prediction of neovascularization in central retinal vein occlusion . In: Technical Digest on Noninvasive Assessment of the Visual System, 1991 . Washington, DC: Optical Society of America; 1991;1:10-13. 23. Hayreh SS, Rojas P, Podhajsky P, Montague P, Woolson RF. Ocular neovascularization with retinal vein occlusion, III: incidence of ocular neovascularization with retinal vein occlusion . Am J Ophthalmol . 1983;90:488-506. 24. Peachey NS, Alexander KR, Fishman GA. Visual adaptation and the cone flicker electroretinogram . Invest Ophthalmol Vis Sci . 1991;32:1517-1522. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Predicting Outcome in Central Retinal Vein Occlusion Using the Flicker Electroretinogram

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References (26)

Publisher
American Medical Association
Copyright
Copyright © 1993 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1993.01090080119027
Publisher site
See Article on Publisher Site

Abstract

Abstract Objective: To evaluate the usefulness of the 30-Hz flicker electroretinogram (ERG) in predicting outcome in patients with central retinal vein occlusion using an automated system previously developed to measure parameters of the flicker ERG and using information about the a priori probability of developing neovascularization of the iris in central retinal vein occlusion. Methods: Amplitude and timing were extracted from 30-Hz flicker ERGs of 76 patients with acute central retinal vein occlusion from a previous study. The ability of the ERG to predict the development of neovascularization of the iris based on derived parameters was measured using the area under the receiver operating characteristic curve. Results: The predictive ability of the 30-Hz ERG amplitude, as judged by a two-alternative forced-choice procedure, was 92%. The corresponding value for implicit time was 89%. Using Bayes' theorem, we computed the probability of developing neovascularization of the iris based on a single 30-Hz flicker ERG measurement at initial patient presentation. Conclusions: The 30-Hz flicker ERG provides useful information about the patients with central retinal vein occlusion. References 1. Swets JA, Picket RM. Evaluation of Diagnostic Systems . Orlando, Fla: Academic Press Inc; 1982. 2. Cornfield J, Dunn RA, Batchlor CD, Pipberger HV. Multigroup diagnosis of electrocardiograms . Comp Biomed Res . 1973;6:97-120.Crossref 3. Milliken JA, Pipberger H, Pipberger HV, et al. The impact of and ECG computer analysis program on the cardiologist's interpretation: a cooperative study . J Electrocardiol . 1983;16:141-150.Crossref 4. Henkes HE. Electroretinography in circulatory disturbances of the retina, I: electroretinogram in cases of occlusion of the central retinal vein or one of its branches . Arch Ophthalmol . 1953;49:190-201.Crossref 5. Karpe G, Uchermann A. The clinical electroretinogram, IV: the electroretinogram in circulatory disturbances of the retina . Acta Ophthalmol . 1955;33:493-516.Crossref 6. Sabates R, Hirose T, McMeel JW. Electroretinography in the prognosis and classification of central retinal vein occlusion . Arch Ophthalmol . 1983;101:232-235.Crossref 7. Kaye SB, Harding SP. Early electroretinography in unilateral central retinal vein occlusion as a predictor of rubeosis iridis . Arch Ophthalmol . 1988;106:353-356.Crossref 8. Johnson MA, Marcus S, Elman MJ, McPhee TJ. Neovascularization in central retinal vein occlusion: electroretinographic findings . Arch Ophthalmol . 1988;106:348-352.Crossref 9. Breton ME, Quinn GE, Keene SS, Dahmen JC, Brucker AJ. Electroretinogram parameters at presentation as predictors of rubeosis in central retinal vein occlusion patients . Ophthalmology . 1989;96:1343-1352.Crossref 10. Johnson MA, McPhee TJ. Electroretinographic findings in iris neovascularization due to acute central retinal vein occlusion . Arch Ophthalmol . 1993;111:806-814.Crossref 11. McDonald HR, Schatz H. Macular edema following panretinal photocoagulation . Retina . 1985;5:5-10.Crossref 12. Zweng HC, Little HL, Hammond AH. Complications of argon laser photocoagulation . Trans Am Acad Ophthalmol Otolaryngol . 1974;78:195-204. 13. Wepman B, Sokol S, Price J. The effects of photocoagulation on the electroretinogram and dark adaptation in diabetic retinopathy . Doc Ophthalmol Proc . 1977;25:139-147. 14. McPhee TJ, Johnson MA, Elman MJ, Finkelstein D. Electroretinographic findings in iris neovascularization due to acute central retinal vein occlusion. Presented as a poster at the Annual Meeting of the American Academy of Ophthalmology; November 8-12, 1987; Dallas, Tex. 15. Johnson MA, Massof RW. The photomyoclonic reflex: an artefact in the clinical electroretinogram . Br J Ophthalmol . 1981;66:368-372.Crossref 16. Severns ML, Johnson MA, Merritt SA. Automated estimation of implicit time and amplitude from the flicker electroretinogram . Appl Optics . 1991;30:2106-2112.Crossref 17. Anderson CM, Troelstra A, Garcia CA. Quantitative evaluation of photopic ERG waveforms . Invest Ophthalmol Vis Sci . 1979;18:26-43. 18. Green DM, Swets JA. Signal Detection Theory and Psychophysics . Melbourne, Fla: Robert E Krieger Publishing Co Inc; 1974:45-49. 19. Metz CE, Wang P-L, Kronman HB. A new approach for testing the significance of differences between ROC curves measured from correlated data . In: Deconinck F, ed. Information Processing in Medical Imaging . The Hague, the Netherlands: Martinus Nijhoff; 1984:432-445. 20. Birch DG, Anderson JL. Standardized full-field electroretinography: normal values and their variation with age . Arch Ophthalmol . 1992;110:1571-1576.Crossref 21. Johnson MA, Severns ML, Kelman SE. Using a neural network and the electroretinogram to classify central retinal vein occlusion . Perception . 1990;19:367. 22. Severns ML, Johnson MA. Automated implicit time and amplitude determination for the 30-Hz flicker electroretinogram: performance in the prediction of neovascularization in central retinal vein occlusion . In: Technical Digest on Noninvasive Assessment of the Visual System, 1991 . Washington, DC: Optical Society of America; 1991;1:10-13. 23. Hayreh SS, Rojas P, Podhajsky P, Montague P, Woolson RF. Ocular neovascularization with retinal vein occlusion, III: incidence of ocular neovascularization with retinal vein occlusion . Am J Ophthalmol . 1983;90:488-506. 24. Peachey NS, Alexander KR, Fishman GA. Visual adaptation and the cone flicker electroretinogram . Invest Ophthalmol Vis Sci . 1991;32:1517-1522.

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Aug 1, 1993

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