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Diopsys Insights

The Evolution of Objective, Functional Testing in Ophthalmic Practices

Posted by Diopsys, Inc. on September 22, 2018 at 3:29 PM


ERG Then and  NowDiopsys Turns 20!

INTRODUCTION:

Twenty years ago, visual electrophysiology testing was not widely used in the eye care office, and its importance to routine clinical practice was poorly understood. Diopsys has changed all that.

The early experience with visual electrophysiology is hardly reflective of how this testing is used in modern eye care today, especially with the advent of smaller platforms and streamlined protocols. Even as new diagnostic technology has entered the eye care space, electrophysiology testing has gained a more prominent role in evaluating patients, precisely because no other testing modality can deliver both objective and functional information about the health of retinal cells. For eye care specialists, that kind of data is indispensable for deciding who to treat and how to treat.

“It's another tool in the toolbox,” said Mark Latina, MD, “We think we understand a lot of diseases, we think we know what we are doing, but this testing gives us an objective functional approach to patients, and that is a huge benefit.”


Electrophysiology and Evolving Paradigms in Eye Care

Since its inception, Diopsys has been at the forefront of efforts to make electrophysiology testing more accessible and more relevant to everyday clinical practice. As the company marks this important milestone in its 20-year history, its mission has not changed.

Diopsys is an active supporter and leader in helping to educate eye care specialists about the vast indications for modern electrophysiology testing. In addition to its role in diagnosing common eye disease, electrophysiology testing can also demonstrate how treatment is affecting cell function at the retina and along the entire visual pathway.

Diopsys brand of electrophysiology testing provides the greatest benefit to the everyday practice in treating patients with eye disease. William Bond, MD, an anterior segment surgeon, said he routinely uses electrophysiology in cataract patients to evaluate whether the retina is healthy, which helps determine whether surgery is even viable, and if it is, what kind of lens is indicated for the patient.

“The role of electrophysiology is increasing because the profession has gained a greater understanding of how to interpret the test results and what the test can tell us that other tests don’t,” said Dr. Bond.

The Additive Value of Streamlined Testing

For Diopsys, it all started with the acquisition of a Visual Evoked Potential (VEP) system in 1998. The company then developed devices that have evolved into today’s advanced, easy-to-use platforms.  The first commercially available device, the Enfant® Pediatric VEP Vision Testing System, was introduced at the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) in 2004. 

Those early research and development efforts led to the advancement of other forms of electrophysiology testing. Collectively, the array of modules that Diopsys has developed helps clinicians hone in on exactly where pathology is affecting a patient’s visual system—information that is essential for making a diagnosis and for directing appropriate interventions.

“Accessible electrodiagnostic systems are powerful additional tools for a variety of ophthalmologic conditions from diagnosing optic neuritis to managing pre-perimetric glaucoma,” said William Ayliffe, FRCS, PhD. “I would recommend any colleague to invest in this equipment that we use every day to help us manage our patients in a more targeted and timely fashion.”

While there is a perception that electrophysiology testing is most applicable to esoteric eye disease, that is simply not the case, according to Jai G. Parekh, MD. Dr. Parekh said he routinely uses several forms of electrophysiology testing in his comprehensive ophthalmology practice.

“Not only would I recommend it, I would highly recommend it. I encourage my colleagues who are interested in glaucoma and retina diseases to go beyond the traditional tests and pursue obtaining VEP and ERG with the Diopsys system,” Dr. Parekh said.

ERG Lid Electrode DiopsysExpanding the Indications for Electrophysiology Testing

Diopsys has advanced electrophysiology testing significantly since it introduced its first testing platforms. Several new modules have been launched, including flicker, pattern, and multifocal electroretinography (ERG). Additionally, the company developed and patented, non-invasive, patient friendly, non-contact lid electrodes, which really opened up the ability for ERG testing in the practice.

“The most important thing to know about Diopsys modern visual electrophysiology is how easy and practical it is in a busy office. Our technicians can get reliable, informative results very efficiently, and the information you get you can’t get anywhere else,” said William Bond, MD.

Indeed, many eye care professionals employ Diopsys testing for common eye diseases seen in routine practice, including diabetic retinopathy, in cataract patients to evaluate retinal function, glaucoma, retinal vein occlusions, and uveitis. 

Steven Silverstein, MD has said, “With respect to the need for information that enables early detection and guides management decisions for diabetic retinopathy, ERG provides documentation of disease-related damage before retinopathy becomes clinically apparent using other diagnostic modalities. Measuring the function of living cells, ERG identifies cells that are stressed or dying, but are still viable and may have the potential for functional recovery with effective intervention."

Another example is in patients with suspected glaucoma, especially when other forms of diagnostic testing are inconclusive for making a diagnosis. With the availability of electrophysiology testing, clinicians can gain objective information regarding the viability of the ganglion cell layer, information that is often a tiebreaker in confirming the correct diagnosis.

“The holy grail for glaucoma, and really for all optic neuropathy, is to nail down whether the problem is in the retina or is the problem in the visual pathway behind the eye, and now there is a way of doing this,” said William E. Sponsel, MD.


20 Years Later:

Since Diopsys stepped onto the scene, visual electrophysiology testing in the eye care practice is now widely accepted and utilized. Accessible platforms, streamlined protocols, and a commitment to physician education and patient health has allowed eye care professionals around the globe get actionable results on retinal and visual pathway function. 

Diopsys is proud to help its customers with early diagnosis, tracking disease progression, and tailoring treatment. The company has a lot more in store for doctors and patients in the future, making the next 20 years at Diopsys even more exciting!

Diopsys 20th Anniversary - Modern Visual Electrophysiology


"A historical photo of a patient undergoing an electroretinogram" Image: By World Health Organisation photo by P. Almasy - http://ihm.nlm.nih.gov/images/A13870, Attribution, https://commons.wikimedia.org/w/index.php?curid=6657467

Topics: Visual Electrophysiology

Modern Visual Electrophysiology

World Leading Technology

As the world leader in modern visual electrophysiology, Diopsys, Inc. has done more than any other company to advance the use of ERG and VEP in the eye care practice. Read through our blog to gain valuable insights into the benefits and integration of this valuable technology.

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