RETeval Device for Electroretinography

Revolutionary ERG/VEP – Anywhere for Anyone.

Enhance your diagnostic capabilities or fuel your research with the RETeval® device — A powerful aid in the diagnosis and management of retina and optic nerve diseases such as diabetic retinopathy, glaucoma, and inherited retinal dystrophies.

Timothy Earley

The RETeval device is one of the most practical tools in my office.

Julie Rodman

The RETeval Device is the only FDA-cleared, portable, non-mydriatic electroretinography (ERG) testing instrument on the market in the US.

First Impressions
It is a major departure from traditional electroretinography and represents a technology that has evolved from large, expensive, and complicated to portable, affordable and easy-to-use and interpret. It allows us to confidently detect functional stress so that we can anticipate structural damage.
Structural testing is important, but it doesn’t tell us anything about how the patient feels or how a disease may be affecting a patient’s life. To understand this, we typically perform acuity checks and visual fields, but these are subjective and rely on patient feedback. The RETeval gives me confidence because it is entirely objective—and it is much easier to perform.
Clinical Benefits
Early detection of retinal abnormalities is a critical step in preventing vision loss. The DR Assessment protocol, in particular, provides a superior risk assessment for progression. While both functional and structural assessments have their benefits, functional changes generally appear well before structural changes. In studies comparing ERG and structural imaging’s abilities to evaluate sight-threatening diabetic retinopathy, RETeval ERG outperformed the traditional imaging techniques in predicting which patients would later need medical intervention.
The way we, as an optometric community, care for patients is advancing. In short, combining structural and functional information provides better results. While advanced structural imaging shows the anatomy of the retinal tissue, electroretinography objectively evaluates the functional abnormalities of the retina. The RETeval gives us information beyond what we can understand using fundus imaging and visual acuity tests. In our practice, it has been a game changer, especially in terms of how we care for patients who have diabetes.
Patient Reaction
The beauty of this test is that it doesn’t cause patient frustration. Patients love the fact that they do not have to respond or provider the “right answer”.
Gone are the days when corneal contact was needed to perform ERG testing. Patients tolerate the test without any complaint. The sensor strips make it a breeze.
Practice Benefits
ERG helps us make referral decisions. Traditionally, we base referral on disease severity and presence or absence of DME as identified using structural tests. But careful consideration of functional abnormalities is important too. Functional tests can offer clear guidance, provided an objective measure like ERG is used. In fact, functional loss alone (provided it’s measured objectively) may be sufficient reason to increase exam frequency or make a referral.
There are more than 560 codes you can select from to bill for ERG. In our practice, we most commonly use CPT code 92273, billing the RETeval as a reimbursable test for DR. Some optometrists use the DR protocol to screen all patients with diabetes, whether or not they’ve been diagnosed with retinopathy, but this application is not reimbursable using this code.
Top Attributes
The DR Assessment protocol is so simple to perform and interpret. It provides a superior risk assessment for progression. A score of 23.5 or higher indicates an 11-fold risk of requiring intervention within 3 years. As diabetic patients worsen into moderate and severe nonproliferative disease, it may become challenging to determine the best time to refer to a retinal specialist. The DR Assessment protocol helps me to clarify the correct time to refer.
In my practice, the greatest value is in assessing diabetic retinopathy progression risk. A simple score that indicates whether my patient is in trouble. This is achieved by measuring both retina cell stress and pupil light response. The results play a significant role in my clinical decision-making, especially with regard to setting follow-up intervals and appropriately timing referrals.
This device is so easy to use. I find it so simple and so convenient, that whenever I think there is a need, I know I can grab my handheld RETeval and perform the test myself. I used to do this all the time because it takes only a few minutes and gives me immediate results. But now I delegate ERG testing to my team, which helps me move through my day without the additional testing affecting patient flow.
The fact that the RETeval device fits in the palm of your hand and is so quick and tech-friendly made adoption seamless and immediate in our practice. A technician can perform the test in a matter of minutes, making it one of the most efficient tools available in our practice. Also, by adding the DR Score to the chart, I have an excellent baseline for future visits, which saves time while providing straightforward documentation that all the pieces of the clinical and coding puzzle fit together appropriately.

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