A comparison of the suitability of cathode ray tube (CRT) and liquid crystal display (LCD) monitors as visual stimulators in mfERG diagnostics

The aim of this study was to determine up to which extent the specific characteristics of cathode ray tube (CRT) and liquid crystal display (LCD) monitors influence the retinal biosignal when used as stimulators in ocular electrophysiology. In a conventional CRT monitor, each pixel lights up only for a duration of a few milliseconds during each frame. In contrast, liquid crystal displays are quasi-static, i.e. each pixel has a constant luminance during the whole length of the frame, but lights up only with a certain delay after the trigger. These different display characteristics may affect the mfERG signal. The temporal and spatial luminance distributions of a CRT and an LCD monitor were measured in white flashes. The total amount of emitted light was calculated by integration of the intensity versus time curves. By means of an mfERG recording system (RETIsystem, Roland Consult, Brandenburg, Germany) first-order kernel (FOK) mfERG signals were computed and then analysed using customized MATLAB (TheMathWorks, Natick, MA, USA) software. With the two stimulator monitors, differences in the mfERG signal were observed. The latencies of mfERG responses recorded with the LCD monitor were significantly increased by 7.1 ms for N1 and 9.5 ms for P1 compared to the CRT. Due to a higher luminance, the N1 amplitude was significantly higher by approx. 2 dB in measurements with the LCD monitor while no significant difference could be detected with regard to the more contrast sensitive P1 amplitude. When using LCD monitors as stimulators the increase in latencies and differences in the luminance versus time profile must be taken into account. Prior to clinical application, the establishment of guidelines for the use of LCD monitors is recommended.