Electroretinography (ERG) has been included in the 2024 update of the American Academy of Ophthalmology’s (AAO) Preferred Practice Pattern® (PPP) Guidelines for Diabetic Retinopathy (DR).1 The newly updated PPP, which serves as the gold standard for clinical decision-making, recognizes the value and role of ERG in both diagnosing and managing DR. This inclusion reflects the growing recognition that objective functional testing, alongside structural imaging, is critical for comprehensive DR assessment.
ERG has been used in research and academic settings for decades, but its adoption in everyday clinical practice has been limited. The RETeval® device, developed by LKC Technologies, revolutionized ERG by making it portable, easy to use and accessible in eye care clinics of any size. The FDA-cleared device allows for objective assessment of retinal function without the need for dilation, making functional testing a seamless part of virtually any clinical workflow.
“The inclusion of ERG in the AAO’s Preferred Practice Pattern® Guidelines is a pivotal moment in eye care history,” said Sruthi Arepalli, MD, Assistant Professor at Emory University School of Medicine. “As diagnosticians and treating physicians, we need an objective functional complement to structural imaging. ERG provides this, helping us detect early retinal dysfunction that may precede visible structural changes.2 This allows for earlier intervention and more personalized patient care.”
“ERG has been around for decades, but many of the early generation devices were not practical for routine clinical use,” says Nate Lighthizer, OD, Dean for the NSU Oklahoma College of Optometry. “The fact that ERG was added to the PPPs after all these years speaks volumes about how transformative the technology has become. RETeval is handheld, easy to use and provides objective, quantifiable data—something that had been missing in functional testing. Unlike visual acuity or visual fields, which rely on patient responses, the RETeval gives us a true physiological measurement of retinal function. That’s a game-changer.”
According to a recent report, 9.60 million people in the US had diabetic retinopathy and 1.84 million people had vision-threatening diabetic retinopathy in 2021.3 “The ability to accurately and efficiently predict risk of disease progression and manage disease in primary and specialty eye care practices is more important than ever,” says Dina Dubey, Chief Executive Officer, LKC Technologies. “The DR Score generated by the RETeval® device has demonstrated predictive value in assessing progression to vision threatening disease necessitating intervention.”4
References
1. Lim JI, Kim SJ, Bailey ST, et al. Diabetic Retinopathy Preferred Practice Pattern®. Ophthalmology. Published online February 7, 2025.
2. Ratra D, Nagarajan R, Dalan D, et al. Early structural and functional neurovascular changes in the retina in the prediabetic stage. Eye (Lond). 2021;35(3):858-867. doi:10.1038/s41433-020-0984-z
3. Lundeen EA, Burke-Conte Z, Rein DB, et al. Prevalence of diabetic retinopathy in the U.S. in 2021. JAMA Ophthalmol 2023;141:747-54.
4. Brigell M, Chiang B, Maa AY, Davis CQ. Enhancing Risk Assessment in Patients with Diabetic Retinopathy by Combining Measures of Retinal Function and Structure. Transl Vis Sci Technol. 2020;9(9):40. doi:10.1167/tvst.9.9.40
All photos courtesy of LKC Technologies
