veris ™ by electro-diagnostic imaging, inc. redwood city, california, usa
DESCRIPTION
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 - PowerPoint PPT PresentationTRANSCRIPT
VERIS ™
by
Electro-Diagnostic Imaging, Inc.Redwood City, California, USA
First in Multifocal Electrophysiology
Complete integrated System for Visual Electrophysiology
ComprehensiveVisual 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• 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!
VERIS PlatformAvailable Stimulators:
• FMS IV
• EMS IV (not shown)
• Fresnel Ganzfeld 1 (FG1)
• Flat panel displays
• Ganzfeld II (not shown)
FG1
FMS IV
Mac ProGrass
Amplifier
VERIS ™ 6 SoftwareFour Levels
1. Traditional• Traditional ISCEV protocols only
2. CLINIC• All Pre-programmed tests• Creating and editing reports
3. SCIENCE• 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 supportfrom 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
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
The Conventional Flash ERG Response
ISCEV Standard
Ganzfeld Protocols
The EDI Ganzfeld 2Full-Size Ganzfeld Stimulator
• Flash ERG• Flicker ERG• Flash VEP• EOG
The Fresnel Ganzfeld FG1Supports 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 itsanatomy and physiology.
Response Mapping with Multifocal Electrophysiology
The distribution of dysfunction is often characteristic for the disease and helpful for diagnosis and disease management.
Monitor screen 120 scaled sectors stimulated with contrast reversing check patterns
~ 40°
Amplifier
Computer
Inion
Hexagon array
Corneal Electrode
Responsedensity
Trace array
mfERG mfVEP
120 focal VEPs
Right eye redLeft eye blue
Inter-ocular differences
Typical electrode placement
Minimum 2 channels: 1 midline 1 lateral
Stimulator unit includes:
• High resolution color display• Eye camera for patient alignment• IR fundus camera for fixation monitoring
Fundus Monitoring Stimulator FMS IVPermits monitoring the patient’s fixation during stimulationSingle know spherical refraction with range > 20 diopteer
ForPERGPVEPmfERGmfVEP
Stimulator unit includes:• High resolution color display• Eye camera for patient alignment
Eye Monitoring Stimulator EMS IVPermits monitoring the patient’s eye during stimulationSingle know spherical refraction with range > 20 diopters
ForPERGPVEPmfERGmfVEP
Clinical recording of multifocal ERGs takes 2 to 7 minutes per eye.
The time depends on
• 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 RetinopathyHydroxychloroquine 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!
red area between outside 30
Divided by total red area
Ring aveerages
Plot is automatically generated
The Multifocal VEP (mfVEP)
Placing recording electrodes on the scalp over the visual cortex
A sensitive test in unilateral and asymmetric diseases
200 nV
0 200 ms
Red traces : right eyeBlue traces : left eye
Normal mfVEP
Traces from the two eyes match well!
Example from the Clinic:
Optic Neuritis
Optic Neuritis on right eyeacute phase
Record Dated: 03-26-2007Red traces : right eyeBlue traces : left eye
Right eye amplitudes severely depressed in central area.
Record Dated: 05-19-2007 Red traces : right eyeBlue traces : left eye
Optic NeuritisRecovery 1
Right eye amplitudes recovered but delayed in central area.
Record Dated: 07-23-2007
Optic NeuritisRecovery 2 Red traces : right eye
Blue traces : left eye
Recovery of delays suggests re-myelination of fibers.