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.