Advanced CLAD PERG system with minimal patient preparation for clinical settings

AbstractGlaucoma is one of a number of optic nerve diseases which lead to retinal ganglion cellsRGCdegenerationultimately manifesting in a functional loss of vision if left untreatedThere exist a number of therapeutic approaches to treat these conditionsbut there are currently no clinical methods to detect the onset of RGC dysfunctionThe Pattern ElectroretinogramPERGis the only established tool to monitor RGC health in vivo in humans and experimental models of optic nerve diseasesThe monitoring of PERG responses can potentially provide earlier detection of degenerative retinal disorders such as glaucomaallowing for treatment paradigms to be initiated before irreversible functional vision loss has occurredA critical barrier to the widespread adoption of PERG for research and clinical use involves suboptimal characteristics of conventionally available displays for eliciting visual responsesThe goal of the proposed project is to produce commercially available device for use in both vision research and clinical applicationswhich is not only more compactfastercheaper and more user friendlybut also provides a higher quality of information through innovative display technology and processing techniquesDuring Phase Ithe following specific aims will be pursuedDevelop a next generation PERG stimulator for human subjectsPreviouslyour group developed a PERG device for animal studiesThe effort here will be miniaturizing and refining that technology to provide stimuli relevant for human subjects and achieve a form factor that will be suitable for clinical settingsInvestigate options for dry electrodes in PERGAnother limiting factor for clinical adoption of PERG and other electrophysiological techniques is time consuming patient preparationA dry electrode solution can streamline patient prep and increase ease of use and throughputCLAD in Glaucoma SubjectsCLAD is an analysis technique developed by our group which has the potential to increase the sensitivity of PERG for detecting RGC dysfunctionPilot data collected and presented in this submission strongly supports this increase in clinical utility Pattern ElectroretinographyPERGis an important indicator of Retinal Ganglion CellRGChealthand can be used to monitor the progression of degenerative retinal diseases such as glaucomaThe implementation of the proposed PERG device and analysis methods is expected to increase the accessibility of detection systems both clinically and in researchThe improved stimulator and analysis techniques are expected to increase the diagnostic value of the PERG response by increasing the quality and quantity of diagnostic measuresAs suchthe proposed work will greatly impact public health by improving screening measures for glaucoma and potentially other retinal disorders