BriSCEV Survey ’08-09’ Ascertainment: all UK BriSCEV members (’07-’08) received survey (n=70) Follow up s and phone calls One response only requested / unit 15 units responded (no non - member response i.e. likely neurophysiology units) 83% response

responding centres routinely offer 15/15 ERG & pattern reversal VEP 14/15 PERG 13/15 pattern onset VEPs 12/15 EOGs 5/15 mfERGs, though number of respondents waiting kit 2/15 mfVEP 1/15 steady state step VEP Imaging: 6/15 centres acquire or access OCT, 2 of these 6 also do additional imaging BriSCEV Survey Results #0 available tests

Px numbers 8825 –2800 –1400 –700 (55% in 3 responding centres) BriSCEV Survey Results 1 px nos and staff number of people number of patients/annum 56 staff 24/56 PhD (42%) Nb number days testing vary 7/15 part time staff mix 5 medical physics 5 ophthalmology 2 optometry 1 clin neurophysiol 2 stand alone patients/annum number of staff involved nos tests/annum

Normative ERG data –13 centres provided Ganzfeld ERG data –2 centres have no data Of 13 giving data 1 centre purchased from Coupland 1 centre supplemented by crackERG 6 using median data 2 using mean data Rest not stated 8/13 using DTL, of these 5/9 sub-palpebral BriSCEV Survey Results # 2 mean & median data ERG norms

Range flash luminances: (blue & white) BriSCEV Survey Results # 2 mean & median data ERG norms: Rod driven b-wave Amplitude Flash luminance Time to peak rod driven b-wave amplitude (uV) rod driven flash luminance b time to peak ms DTL GF GF SKIN DTL DTL DTL GF GF DTL DTL GF DTL DTL

flash range , mode 3 scot standard flash b-wave amp amplitude (uV) scotopic standard flash scot b time to peak ms Amplitude Flash luminance Time to peak BriSCEV Survey Results # 2 mean & median data ERG norms: scot. Std flash b-wave DTL GF GF SKIN DTL DTL DTL GF GF DTL DTL GF DTL DTL

Amplitude Flash luminance Time to peak scot standard a-wave (uV) scotopic standard flash scot standard a time to peak ms BriSCEV Survey Results # 2 mean & median data ERG norms: scot. Std flash a-wave DTL GF GF SKIN DTL DTL DTL GF GF DTL DTL GF DTL DTL

flash range 1.5 – 8cd.s.m 2, background cd/m 2 phot b-wave amp amp (uV) phot flash luminance phot b time to peak ms Amplitude Flash luminance Time to peak BriSCEV Survey Results # 2 mean & median data ERG norms: phot std a-wave DTL GF GF SKIN DTL DTL DTL GF GF DTL DTL GF DTL DTL

phot a-wave amplitude amplitude (uV) phot flash luminance phot a time to peak ms Amplitude Flash luminance Time to peak BriSCEV Survey Results # 2 mean & median data ERG norms: phot std a-wave DTL GF GF SKIN DTL DTL DTL GF GF DTL DTL GF DTL DTL

Previous graphs for the mean and median, 8 centres also gave range and these data are plotted for each condition. BriSCEV Survey Results #3 range data rod driven Extreme range µV, ms nb age mix mean range amp: min 120 µ V mid 202µV max 361µV mean range time to peak min 71ms mid 86ms max 102ms gf sp sub-palpebral dtl gf gold foil sp

Scot std a-wave data BriSCEV Survey Results #3 range data scot standard flash Extreme range µV (400µV), 9-23ms nb age mix & flash luminance mean range amp: min 124µV mid 212µV max 287µV mean range time to peak min 13ms mid 15ms max 22ms sp gf

Scot std b-wave data BriSCEV Survey Results #3 range data scot standard flash Extreme range µV, 33-61ms nb age mix & flash luminance mean range amp: min 225µV mid 361µV max 545µV mean range time to peak min 39ms mid 47ms max 55ms sp gf

Phot a-wave data, one data set missing BriSCEV Survey Results #3 range data phot standard flash Extreme range 2-79µV, 11-17ms nb age mix mean range amp: min 16µV mid 33µV max 51µV mean range time to peak min 12ms mid 14ms max 16ms sp gf

Phot b-wave data, BriSCEV Survey Results #3 range data phot standard flash Extreme range µV, 22-34ms nb age mix mean range amp: min 70µV mid 129µV max 199µV mean range time to peak min 27ms mid 29ms max 32ms phot b-wave amplitude min mid max sp gf

µ V ms b-wave rod-driven µ V ms a-wave scot std µ V ms b-wave scot std µ V ms a-wave phot std µ V ms b-wave phot std There is concordance in skin ERG data between two centres nb std 3 vs 2.51cd.s.m 2 and phot background 70 vs 30 cd.m 2 Photopic ERGs Scotopic ERGs BriSCEV Survey Results #4 skin & ganzfeld data

14 respondents: 14/14 centres seen children 5-16yrs, range less 1/week – 8/week 13/14 centres see children 1-5yrs range 1/month -16/week 11/14 centres seen children 1yr and underrange 2/month – 11/week Under 1 yr – 11 centres 10/11 centres use skin ERGs and only rarely use sedation/ anaesthesia 1/11 uses routine anaesthesia and sedation 1yr and uses corneal electrodes. They see the smallest number under 1/ annum 2/12 centres see more than 4 children under 1yrs /wk (both children centres) 1-5yrs – 13 centres 12/13 centres seeing 1-5yr olds use skin electrodes mainly, but introduce corneal electrodes, 1/13 uses corneal electrodes only – smallest number of 1-5yr olds Aged 5-16yrs - 14 centres Corneal electrodes are mostly used, but 8/14 centres would occasionally use skin electrodes Sedation: very rare but occasionally used by 3/14 centres includes 2 responding children hospitals use under anaesthesia in theatre BriSCEV Survey Results #5 paediatric data

Duration of test typical ERG 60 minutes PERG 15 minutes VEPs minutes EOG minutes mfERG minutes mfVEP minutes Others many tests one session e.g. 105 minutes ERG PVEP mfERG and OCT 90 minutes to do all tests needed freq of appts /day number of appts/ day BriSCEV Survey Results #6 appointment times

Where next ? Can we combine data : no Can we use others data: mostly no Can we identify close data sets: yes Could national collaborations occur: yes With proviso than have common luminances to start with – calibration stimulators Investigate outliers, but outliers by definition are our normal limits!! –standardise eye OUTCOME UK TRAVELLING EYE PROJECT 2010 ISCEV small project grant funding