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Verifying complaints of difficulties in night vision using electroretinography and dark adaptation tests

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Abstract

Purpose

To determine the electroretinographical and psychophysical parameters that can help to verify patients’ complaints of reduced night vision.

Methods

We tested 275 consecutive patients with normal appearing fundi, complaining of visual difficulties at night, using flash electroretinography (ERG) and dark adaptation (DA) test. Two ERG parameters were used to assess a scotopic retinal function: the amplitude of the response to dim blue flash (the rod response) and the b-wave ratio (measured/expected). Dark adaptation was measured with green- and red-light stimuli after exposure to a bright, bleaching light. The psychophysical parameter of night vision was defined as the threshold for detection of the blue-green stimulus that was measured after 40–45 min in complete darkness.

Results

Fifty-five patients were excluded from the analysis because of a discrepancy between the two ERG parameters in assessment of scotopic retinal function. The remaining 220 patients were divided into 4 groups: (1) normal ERG and normal DA, (2) subnormal ERG and subnormal DA, (3) normal ERG and subnormal DA and (4) subnormal ERG and normal DA. The ERG and DA tests supported the complaint of visual difficulties at night in 67 patients (group 2), while 34 patients were characterized as having normal scotopic visual function (group 1). The other 119 patients (groups 3 and 4) presented a diagnostic dilemma because one test (ERG or dark adaptation) showed normal scotopic function, while the other indicated subnormal scotopic function.

Conclusion

Our findings indicate that ERG is an essential, but not sufficient test for verifying patient’s complaint on visual difficulties in the dark. We suggest using both electroretinography and psychophysical dark adaptation to test patients complaining of reduced night vision.

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Funding

No funding was received for this work.

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Author notes

  1. Gilad Allon and Yolanda Friedrich have contributed equally to this work.

Authors and Affiliations

  1. Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel

    Gilad Allon, Eedy Mezer, Aviran Itzhaki & Ido Perlman

  2. Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel

    Gilad Allon, Eedy Mezer & Rina Leibu

  3. Leumit Health Care, Haifa, Israel

    Yolanda Friedrich

Authors
  1. Gilad Allon
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  2. Yolanda Friedrich
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  3. Eedy Mezer
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  4. Aviran Itzhaki
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  5. Rina Leibu
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  6. Ido Perlman
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Corresponding author

Correspondence to Ido Perlman.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Allon, G., Friedrich, Y., Mezer, E. et al. Verifying complaints of difficulties in night vision using electroretinography and dark adaptation tests. Doc Ophthalmol 140, 169–180 (2020). https://doi.org/10.1007/s10633-019-09729-z

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  • DOI: https://doi.org/10.1007/s10633-019-09729-z

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