Electroretinography: A Comparative Study of Modalities and Analytical Approaches with Partial Integration of OCT Findings

Abstract

Electroretinography (ERG) is an essential tool for assessing retinal function, with responses from photoreceptors, ganglion cells, and inner layers. Clinical applications are often secondary to structural imaging, though dysfunction may appear before anatomical changes. This review compares three ERG types: full-field (ffERG), patterned (PERG), and multifocal (mfERG), highlighting differences in response, waveform components, and clinical uses. This review analyzes more than 60 studies (2014–2025). Advanced analyses in the time, frequency, and time–frequency domains demonstrated diagnostic accuracies between 85% and 97% for early detection of retinal dysfunctions such as glaucoma and retinitis pigmentosa. Integrating ERG with Optical Coherence Tomography (OCT) improved structure–function correlation by 15–25%. The findings highlight that combining ERG with quantitative feature extraction and OCT enhances early diagnosis and monitoring of retinal diseases and supports standardized clinical applications.