Transcript Veris13 - Electro-Diagnostic Imaging, Inc.

VERIS
™
by
Electro-Diagnostic Imaging, Inc.
Redwood City, California, USA
Complete integrated System for
Visual Electrophysiology
First in Multifocal Electrophysiology
Comprehensive
Visual Electrodiagnostic Testing
Traditional (ISCEV Standard) Testing
• EOG, Full-Field ERG & Flash VEP, Pattern ERG & VEP
Multifocal Testing
• mfERG, mfVEP
• Automated Ring Ratio Analysis
• Optic Nervehead Component (Global Flash Paradigm)
...and more
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M-Sequence Full-Field ERG, Pattern VEP, Pattern ERG
Full Kernel Analysis ./ Synthesis capability
User-Defined Custom Recording and Analysis Protocols
Customizable Reports
Apple OS X Platform
• Exceptionally stable
• VERIS data can be stored automatically to any local, network,
or Internet-accessible storage device
• Choice of open or password-protected file locking of data,
analysis settings, and recording settings files
• Easy creation of pdf copies of reports for electronic medical
records or email communications without additional (3rd party)
software
• Easy to learn and fun to use!
FG1
FMS IV
VERIS Platform
Available Stimulators:
• FMS IV
• EMS IV (not shown)
• Fresnel Ganzfeld 1 (FG1)
• Flat panel displays
• Ganzfeld II (not shown)
Grass
Amplifier
Mac
Pro
VERIS
™
6 Software
Four Levels
1. Traditional
• Traditional ISCEV protocols only
2. CLINIC
• All Pre-programmed tests
• Creating and editing reports
3. SCIENCE
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All Pre-programmed tests,
Creating and editing reports
Creation of new stimulation modes
Creation of new analysis schemes
4. PRO
• All functions of SCIENCE
• Advanced kernel synthesis and modeling ability
Real-time Internet support
from EDI
• Available to all VERIS users by appointment
• Real-time monitoring and control of your VERIS system
from our California office for training and troubleshooting
at your location
• Fully encrypted with security controls to ensure privacy of
medical information
• Requires Internet connection
The Conventional Flash ERG Response
Response of the retina to a full-field
flash derived by means of an electrode
placed on or near the cornea of the eye.
The basic stimulator used for the
derivation of this response is
 The Ganzfeld Stimulator
ISCEV Standard
Ganzfeld Protocols
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The EDI Ganzfeld 2
Full-Size Ganzfeld Stimulator
Flash ERG
Flicker ERG
Flash VEP
EOG
The Fresnel Ganzfeld FG1
Supports all Ganzfeld functions
FG 1 in handheld use
FG 1 is the only handheld Ganzfeld
stimulator for binocular recording
The retina is not homogeneous in its
anatomy and physiology.
The distribution of dysfunction is
often characteristic for the disease
and helpful for diagnosis and
disease management.
 Response Mapping with Multifocal
Electrophysiology
mfVEP
mfERG
Hexagon array
Monitor screen
120 scaled sectors
stimulated with
contrast reversing
check patterns
~ 40°
Corneal Electrode
Amplifie
r
Typical electrode
placement
Computer
Minimum 2 channels:
1 midline
1 lateral
Trace array
Inion
120 focal VEPs
Right eye red
Left eye blue
Response
density
Inter-ocular differences
Fundus Monitoring Stimulator FMS IV
Permits monitoring the patient’s fixation during stimulation
Single know spherical refraction with range > 20 diopteer
For
PERG
PVEP
mfERG
mfVEP
Stimulator unit includes:
• High resolution color display
• Eye camera for patient alignment
• IR fundus camera for fixation monitoring
Eye Monitoring Stimulator EMS IV
Permits monitoring the patient’s eye during stimulation
Single know spherical refraction with range > 20 diopters
For
PERG
PVEP
mfERG
mfVEP
Stimulator unit includes:
• High resolution color display
• Eye camera for patient alignment
Clinical recording of multifocal
ERGs takes 2 to 7 minutes per eye.
The time depends on
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The spatial resolution (Veris offers
up to 509 stimulus areas within the
central 45 deg)
•
The electrode technique
Example from the Clinic:
Hydroxychloroquine Toxicity
Hydroxychloroquine Retinopathy
• A small percentage of patients who take this drug for
autoimmune disease develop a bullseye retinopathy.
• This retinopathy is, at best, only partially reversible when
the patient is taken off the drug.
• For disease prevention, the mfERG is now often used for
patient screening.
Para-central depression
Relative sparing of center
P1 implicit times are within normal range!
Plot is automatically
generated
red area between outside 30
Divided by total red area
Ring aveerages
The Multifocal VEP (mfVEP)
Placing recording electrodes on the scalp
over the visual cortex
A sensitive test in unilateral and asymmetric diseases
Normal mfVEP
200 nV
0
200 ms
Traces from the two eyes match well!
Red traces : right eye
Blue traces : left eye
Example from the Clinic:
Optic Neuritis
Optic Neuritis on right eye
acute phase
Record Dated: 03-26-2007
Red traces : right eye
Blue traces : left eye
Right eye amplitudes severely depressed in central area.
Optic Neuritis
Recovery 1
Record Dated: 05-19-2007
Red traces : right eye
Blue traces : left eye
Right eye amplitudes recovered but delayed in central area.
Optic Neuritis
Recovery 2
Record Dated: 07-23-2007
Red traces : right eye
Blue traces : left eye
Recovery of delays suggests re-myelination of fibers.