Retinal remodeling triggered by photoreceptor degenerations

Many photoreceptor degenerations initially affect rods, secondarily leading to cone death. It has long been assumed that the surviving neural retina is largely resistant to this sensory deafferentation. New evidence from fast retinal degenerations reveals that subtle plasticities in neuronal form and connectivity emerge early in disease. By screening mature natural, transgenic, and knockout retinal degeneration models with computational molecular phenotyping, we have found an extended late phase of negative remodeling that radically changes retinal structure. Three major transformations emerge: 1) Müller cell hypertrophy and elaboration of a distal glial seal between retina and the choroid/retinal pigmented epithelium; 2) apparent neuronal migration along glial surfaces to ectopic sites; and 3) rewiring through evolution of complex neurite fascicles, new synaptic foci in the remnant inner nuclear layer, and new connections throughout the retina. Although some neurons die, survivors express molecular signatures characteristic of normal bipolar, amacrine, and ganglion cells. Remodeling in human and rodent retinas is independent of the initial molecular targets of retinal degenerations, including defects in the retinal pigmented epithelium, rhodopsin, or downstream phototransduction elements. Although remodeling may constrain therapeutic intervals for molecular, cellular, or bionic rescue, it suggests that the neural retina may be more plastic than previously believed.

Entrainment of circadian rhythm to a photoperiod reversal shows retinal dystrophy in RPE65(-/-) mice

Light entrainment of circadian rhythms is mediated by classical "visual" photoreceptors (rods and cones) as well as "nonvisual" photoreceptive elements (light-detecting cells that do not contribute to classical "vision"). This paper aimed to assess whether light entrainment of locomotor circadian rhythms in mice with impaired rods and cones differs from normal controls and whether this technique, alongside existing techniques, could be used to assess visual function. The study was primarily interested in differences between the entrainment of circadian rhythms of normal-sighted C57Bl/6J mouse and the C57Bl/RPE65 knockout mouse (RPE65(-/-)), although C3H/HeJ (rd/rd) mice were included as a preexisting model of retinal degeneration. Circadian rhythms of motor activity before and after a 12-h light reversal were assessed in custom-built cages that continuously monitored movement. The controls showed a significantly higher mesor and amplitude when compared to the RPE65(-/-) and rd/rd mice. Despite the loss of rods and cones, the RPE65(-/-) and rd/rd maintained a 24-h circadian rhythm entrained to light similar to controls and were capable of circadian reentrainment to a 12-h light reversal. Importantly, this light reentrainment of the circadian phase occurred at a significantly slower rate in the retinal degenerate models than in the controls. The RPE65(-/-) model demonstrates a retinal degenerate reentrainment phenotype when compared to the rd/rd model. It is suggested that these retinal degenerate mice retain the ability to detect light for the purposes of circadian rhythm entrainment. However, alterations of specific parameters of the circadian rhythm with loss of rods and cones may provide measures of loss of visual function (sight).

The retinal anatomy and function of the myelin mutant taiep rat

PURPOSE

To study the histology and the physiological function of the retina in the neurological myelin mutant, taiep rats during the postnatal developmental period (P20-P360).

METHODS

Electroretinography (ERG) was applied to evaluate intensity dependence and spectral sensitivity of the responses to light. Retinal histology, morphometry, and immunocytochemistry were used to characterize the structure of the retina, with particular emphasis on the Müller (glial) cells.

RESULTS

In the taiep rats of all ages studied, the scotopic ERG showed normal a- and b-wave amplitudes and latencies; likewise, the scotopic spectral sensitivity function was the same for control and taiep animals, with a maximal sensitivity (lambda(max)) at 500 nm. However, in adult taiep rats (P90 to P360) a secondary cornea-positive wave ('b(2)') was observed in response to high stimulus intensities, which never occurred in controls. This correlated with the observation that in the photopic ERG responses of the taiep rats, the b-wave was reduced in amplitude, and was followed by a rapid cornea-negative after-potential. After 1 year of life, in taiep rats the outer plexiform layer (OPL) became slightly thinner and the inner plexiform/ganglion cell layers (IPL/GCL) appeared to be swollen, and increased in thickness; in addition, the number of retinal neurons (particularly, of photoreceptor cells) slightly decreased. Increased GFAP immunoreactivity revealed a hypertrophy and reactivity of the Müller cells in 1-year-old taiep rats.

CONCLUSIONS

The present results suggest the occurrence of a relatively mild and slowly progressing neural retinal alteration in taiep rats, which becomes histologically and functionally evident at the end of the first year of life, and mainly affects the circuit(s) of the photopic ON-response. It is speculated that this alteration is due to missing/altered signals from demyelinated optic nerve.

Experimental Retinal Reattachment: A New Perspective

In the feline model, retinal detachment initiates a cascade of changes that include photoreceptor- cell "deconstruction," apoptotic death of some photoreceptors, neurite outgrowth from second- and third-order neurons, remodeling of photoreceptor synaptic terminals, and Müller-cell gliosis. We have previously shown that reattachment within 24 h halts or reverses many of these presumed detrimental changes. However, in patients with retinal detachments, reattachment cannot always be performed within this 24-h window. Moreover, recovery of vision following successful reattachment surgery in the macula is often imperfect. Here, we examine the ability of relatively long-term reattachment (28 d) to stop or reverse several cellular events that occur at 3 d of detachment. In contrast to earlier studies of reattachment, which focused on the regeneration of outer segments, we focus our attention here on other cellular events such as neuronal remodeling and gliosis. Some of these changes are reversed by reattachment, but reattachment itself appears to stimulate other changes that are not associated with detachment. The implications of these events for the return of vision are unknown, but they do indicate that simply reattaching the retina does not return the retina to its pre-detachment state within 28 d.

Morphologic characteristics of retinal degeneration induced by sodium iodate in mice

PURPOSE

Retinal degeneration induced by sodium iodate (NaIO( 3)) in mice was evaluated morphologically.

METHODS

Male and female ICR and C57BL mice were intraperitoneally administered 100 mg/kg NaIO(3) at 7 weeks of age, and were killed 6, 12, 24 hrs, and 3, 7 and 28 days after the treatment. Retinas were examined histologically, ultrastructurally, immunohistochemically, and by the TUNEL method.

RESULTS

Retinal degeneration was evoked in all NaIO(3)-treated mice. The primary site of damage appeared in the retinal pigment epithelial (RPE) cells followed by photoreceptor cell degeneration. Initially, the RPE cells showed necrosis starting 6 hrs post-NaIO(3), followed by photoreceptor outer segment disruption and photoreceptor cell apoptosis at 24 hrs; photoreceptor cell apoptosis peaked at day 3 and was completed by day 7. At day 3, Müller cell proliferation, macrophage migration within the retina, and regeneration of damaged RPE cells occurred. Finally at day 7 and day 28, the retina showed a mosaic pattern of relatively normal retina and areas lacking RPE cells and photoreceptor cells.

CONCLUSIONS

RPE cell necrosis followed by photoreceptor cell apoptosis and the resulting mosaic pattern of the retina phenotypically resembles gyrate atrophy of the choroid and retina.

Preservation of visual responsiveness in the superior colliculus of RCS rats after retinal pigment epithelium cell transplantation

The dystrophic RCS rat undergoes progressive photoreceptor degeneration due to a primary defect in retinal pigment epithelial (RPE) cells. This has a major impact on central visual responsiveness. Here we have examined how functional deterioration is contained by subretinal transplantation of immortalized human RPE cells. Transplantation was done at three to four weeks of age prior to significant photoreceptor loss and recipients were kept on cyclosporin. At six months of age, sensitivity maps and multi-unit response properties were obtained across the visual field by recording at 76 equidistant sites encompassing the whole superior colliculus.A significant degree of functional protection, both in terms of area of responsive retina and response characteristics was observed following RPE transplantation. At best, the sensitivity, latency of onset, and response rise time were all maintained within normal ranges and this was achieved with no more than half of the normal complement of photoreceptors. Although partial, the degree of anatomical preservation (both in terms of outer nuclear layer thickness and area of rescue) correlated well with the level of preserved visual sensitivities. Sham injections also resulted in rescue, though the area of preservation was strictly confined to the needle injury site and the response properties were significantly worse than with RPE injections. This study shows that central physiological responsiveness and correlated retinal morphology can be preserved in an animal model of retinal disease by implantation of an immortalized cell line. The use of retinal sensitivity measurements provides a background for assessing higher visual functions in these animals and a direct comparison for human perimetry measures.

Retinal degeneration and RPE transplantation in Rpe65(-/-) mice

PURPOSE

To determine whether transplanting normal retinal pigment epithelium (RPE) into the subretinal space influences photoreceptor function and degeneration in Rpe65(-/-) mice.

METHODS

RPE cells were isolated from eyes of normal mice and transplanted to the subretinal space of one eye of Rpe65(-/-) mice. The other eye received a subretinal injection of saline or was not touched. Corneal electroretinograms (ERGs) from both eyes were monitored before and after surgery to follow progression of the degeneration. The width of the outer nuclear layer was measured in the area of transplantation and compared with a similar area in control retinas.

RESULTS

Transplantation of RPE increased ERG amplitude maximally at 3.7 weeks after surgery. This rescue effect slowly diminished with time. Sham surgery had little effect on the ERG. The width of the outer nuclear layer in the area receiving RPE transplants was slightly greater than in control subjects. Evidence of the presence of RPE transplants in the subretinal space decreased with time after transplantation without signs of inflammation.

CONCLUSIONS

Retinal degeneration in the Rpe65(-/-) mice is slowly progressive. Photoreceptor function can be transiently increased for several months and anatomic degeneration slightly reduced in Rpe65(-/-) mice by RPE cell transplantation. Loss of the rescue effect may be due to degeneration of the transplanted RPE.

Encapsulated cell-based delivery of CNTF reduces photoreceptor degeneration in animal models of retinitis pigmentosa

PURPOSE

The objective of the present study was to evaluate the therapeutic efficacy of ciliary neurotrophic factor (CNTF) delivered through encapsulated cells directly into the vitreous of the eye in an rcd1 canine model of retinitis pigmentosa. The dose-range effect of the treatment was also investigated.

METHODS

Polymer membrane capsules (1.0 cm in length and 1.0 mm in diameter) were loaded with mammalian cells that were genetically engineered to secrete CNTF. The cell-containing capsules were then surgically implanted into the vitreous of one eye of rcd1 dogs at 7 weeks of age, when retinal degeneration is in progress but not complete. The contralateral eyes were not treated. The capsules remained in the eyes for 7 weeks. At the end of the studies, the capsules were explanted, and CNTF output and cell viability were evaluated. The eyes were processed for histologic evaluation.

RESULTS

In each animal, the number of rows of photoreceptor nuclei in the outer nuclear layer (ONL) was significantly higher in the eye that received a CNTF-secreting implant than in the untreated contralateral eye. No adverse effects were observed on the retina in the treated eyes. The explanted capsules produced a low level of CNTF. The cells in the capsules remained viable and densely distributed throughout.

CONCLUSIONS

CNTF delivered through encapsulated cells directly into the vitreous of the eye protects photoreceptors in the PDE6B-deficient rcd1 canine model. Furthermore, sparing of photoreceptors appeared dose-dependent with minimum protection observed at CNTF doses of 0.2 to 1.0 ng/d. Incrementally greater protection was achieved at higher doses. The surgically implanted, cell-containing capsules were well tolerated, and the cells within the capsule remained viable for the 7-week implantation interval. These results suggest that encapsulated cell therapy may provide a safe and effective strategy for treating retinal disorders in humans.

Developmental expression of nerve growth factor in the eye of rats affected by inherited retinopathy: correlative aspects with retinal structural degeneration

We have previously reported that exogenous administration of nerve growth factor (NGF) in C3H/HeJ mouse strain affected by retinitis pigmentosa (RP) delayed retinal degeneration, suggesting that NGF may be implicated in retinal development. Whether NGF is present in the developing eye was not investigated. To address this question we have used Royal College of Surgeons (RCS) rats, characterised by photoreceptor loss during postnatal life. The results of these studies showed that while the thickness of the outer nuclear layer (ONL) of RCS is comparable to controls, while the amount of NGF expressed in the eye of this mutant rat is significant lower, as compared to control eye. This observation suggests that the lower presence of NGF in the eye of RCS rats during early postnatal life might be one critical key factor implicated in RP. The results of these studies will be presented and discussed.

Critical role of photoreceptor apoptosis in functional damage after retinal detachment

PURPOSE

Although apoptosis is assumed to play a pivotal role in retinal function loss, its mechanism and real influence on retinal function are still unclear. To investigate the relation between retinal function and apoptosis, we studied photoreceptor apoptosis in experimental retinal detachment (RD).

METHODS

We induced RD by subretinal injection of sodium hyaluronate in Brown Norway rats. Apoptotic photoreceptors were detected by TdT-dUTP Terminal Nick-End Labeling (TUNEL). To evaluate the function of the detached retina, electroretinograms (ERGs) were taken on day 1, 3 with corneal electrodes and full-field stimulation.

RESULTS

Apoptotic DNA fragmentation appeared 12 hours after RD, was most prominent on day 3, and decreased thereafter. The ERGs showed that the amplitudes of dark-adapted a-waves and light adapted 2 Hz b-waves decreased immediately after RD and continued to decrease over time. The administration of Fas/Fc chimera recombinant protein or a caspase inhibitor, Z-VAD.fmk, failed to prevent either photoreceptor apoptosis or retinal functional damage. In contrast, brain derived neurotrophic factor (BDNF) and basic fibroblast growth factor (bFGF) significantly impeded both apoptosis and dysfunction. The ERGs recognized the functional changes sensitively, and these ERG changes correlated well to the amount of photoreceptor apoptosis. Immunohistochemical study showed that apoptosis-inducing factor (AIF), a novel caspase-independent apoptotic factor, was relocalized from mitochondria to the nucleus in this process.

CONCLUSIONS

The present results showed that apoptosis was a key phenomenon in the retinal dysfunction in RD and that this process was transmitted mainly by mitochondria-dependent pathways rather than Fas/Fas-L or downstream caspase dependent pathways.

"On" response dysfunction in multifocal posterior pigment epitheliopathy

PURPOSE

To determine the electroretinographic properties of one patient with multifocal posterior pigment epitheliopathy.

METHODS

Rod and cone electroretinograms (ERGs) and photopic ERGs elicited by long-duration stimuli were studied in a patient with multifocal posterior pigment epitheliopathy.

RESULTS

The amplitudes of both the rod and cone ERGs were significantly reduced. Photopic ERGs elicited by long-duration stimuli demonstrated that the b-wave ("on" response) was abolished but the d-wave ("off" response) was reduced by only amplitude.

CONCLUSION

The ERG findings in multifocal posterior pigment epitheliopathy indicate that there is dysfunction not only of the photoreceptors but also in the signal transmission specific for the "on" pathway.

Molecular aspects of retinal degenerative diseases

Retinal degeneration, either acquired or inherited, is a major cause of visual impairment and blindness in humans. Inherited retinal degeneration comprises a large group of diseases that result in the loss of photoreceptor cells. To date, 131 retinal disease loci have been identified, and 76 of the genes at these loci have been isolated (RetNet Web site). Several of these genes were first considered candidates because of their chromosomal localization or homology to genes involved in retinal degeneration in other organisms. In this review, I will discuss recent advances in the identification of genes that cause retinal degeneration, and I will describe the mechanisms of photoreceptor death and potential treatments for retinal degenerative diseases.

[Vitamin A metabolism and retinal degeneration]

Vitamin A plays an important role in the pathogenesis and during the course of retinal degenerations. Following a brief overview of the metabolic pathway of Vitamin A from the entrance into the body to the arrival in retinal target structures, the most important retinal degenerations that are related to the Vitamin A-metabolism are presented. Ways of prevention or therapy of such diseases are discussed in the light of the still incomplete knowledge about basic mechanisms of retinol transport and metabolism.

[Necessary visual information for restoring reading with a retinal implant in a blind patients with massive retinal degeneration of photoreceptors]

DEFINITION OF THE PROBLEM

Our goal is to determine the minimum of information necessary for elementary reading, using a retinal implant. This concerns particularly the fragmentation (pixellisation) of the presented image and its position in the visual field. Fragmentation corresponds to the number of electrodes available, the position of the image in the visual field is equivalent to the site of the implant on the retina.

MATERIAL AND METHODS

10 degrees x 10 degrees windows, containing isolated words or letters, were presented to six healthy subjects on a computer screen. A coupling between the computer and an eye tracker stabilizes these images in an area of the visual field. This coupling constantly corrects the position of the image on the screen according to the direction of gaze.

RESULTS

1) A rapid decrease of the performance is observed at a certain threshold of pixellisation, dependent on the eccentricity of presentation of the images. 2) In central vision, about 400 pixels are sufficient to recognize 80% of the four-letters words. At 10 degrees of eccentricity, about 1225 pixels are needed. 3) An acceptable comprehension of a text (identification of four words out of five), is impossible at eccentricities higher than 10 degrees 4) About 50 pixels are sufficient for a satisfactory recognition of isolated letters, independently of their eccentricity.

CONCLUSION

These data validate the method of investigation and provide valuable indications regarding minimal visual requirements in prosthetic vision.

Quantitative relationship of the scotopic and photopic ERG to photoreceptor cell loss in light damaged rats

In order to use the ERG to track the effects of potential photoreceptor rescue treatments, we have compared retinal histology to the ERG in light damage. Male albino CD rats (40) were purchased at 7 weeks of age and reared in 50 lx cyclic light until 8 week old. They were exposed to a range of light intensities using white fluorescent light (1000, 1500, 2000, 2500 or 3000 lx) for 24 or 48 hr (n = 5 per group). Controls remained in dim cyclic light. Seven days after exposure, dark and light adapted ERGs were recorded from threshold up to 200 cd m-2 using 50 ms Ganzfeld white light stimuli. The STR, and scotopic and photopic b-wave thresholds and amplitudes were measured. After recording the ERG, the eyes were removed from the animals in each of the five 48 hr light exposed groups and control group for histological measurements. These included: (1) outer nuclear layer width in rod photoreceptor cell number (cell count) and micrometers, and (2) outer + inner segment layer width along the vertical meridian in the inferior retina. The product of cell count and outer + inner segment length was calculated. All histological measures showed a statistically significant linear relationship to light exposure intensity (P < 0.0001): r2 = 0.94 (cell count), 0.90 (outer nuclear layer width), 0.77 (outer + inner segment length). The log of the scotopic b-wave threshold and log amplitude showed a significant linear correlation to all histological parameters (P < 0.0001) and there was no significant difference between b-wave threshold and amplitude for any one of the histology measures used. However, overall, log b-wave threshold was significantly better correlated to histology P < 0.02. Only log b-wave amplitude showed a significant increase in variability in light damaged retinas (P < 0.02). The b-wave threshold intensity increased 0.33 log cd m-2 and the maximum amplitude decreased 0.23 log microV with each 10% decrease in cell number in the outer nuclear layer. The sensitivity of the scotopic threshold response, which originates from third order neurons, changed much more slowly with cell loss, than did the b-wave (P < 0.0005) and was well fit by a linear relationship to cell loss. The increase in photopic b-wave threshold was not significant for a cell loss of less than 70-80%. Neither the photopic or scotopic b-wave could be reliably recorded with more than 80% cell loss, but the scotopic threshold response remained. Both the scotopic and photopic ERG showed similar waveform changes near the threshold, including loss of the positive going b-wave and the predominance of a negative going response. Outer nuclear layer cell counts in this study showed the same relationship to log b-wave threshold elevation, as has been previously shown for whole retinal rhodopsin content in light damage, indicating that regional histology measurements can be good indicators of overall cell survival. Both the b-wave threshold and amplitude can be reliably used to track photoreceptor cell loss due to the damaging effects of constant light, but the scotopic threshold response may be more useful in severe damage.

Understanding the origin of visual percepts elicited by electrical stimulation of the human retina

BACKGROUND

The success of a retinal prosthesis for patients with outer retinal degeneration (ORD) depends on the ability to electrically stimulate retinal cells other than photoreceptors. Experiments were undertaken in human volunteers to ascertain whether electrical stimulation of cells other than photoreceptors will result in the perception of light.

METHODS

In two subjects, two areas of laser damage (argon green and krypton red) were created in an eye scheduled for exenteration due to recurrent cancer near the eye. In the operating room prior to exenteration, under local anesthesia, a hand-held stimulating device was inserted via the pars plana and positioned over the damaged areas and normal retina. Subjects' psychophysical responses to electrical stimulation were recorded.

RESULTS

In both subjects, electrical stimulation produced the following perceptions. Normal retina: dark oval (subject 1), dark half-moon (subject 2); krypton red laser-treated retina: small, white light (both subjects); argon green laser treated retina: thin thread (subject 1), thin hook (subject 2). Histologic evaluation of the krypton red-treated retina showed damage confined to the outer retinal layers, while the argon green-treated area evinced damage to both the outer and the inner nuclear layers.

CONCLUSION

The perception produced by electrical stimulation was dependent on the retinal cells present. Electrical stimulation of the krypton red-ablated area best simulated the electrically elicited visual perceptions of our blind, ORD patients, suggesting that the site of stimulation in blind patients is the inner retinal neurons.

Leber congenital amaurosis caused by a homozygous mutation (R90W) in the homeodomain of the retinal transcription factor CRX: direct evidence for the involvement of CRX in the development of photoreceptor function

The CRX (cone-rod homeobox) gene is specifically expressed in developing and mature photoreceptors and encodes an otd/Otx-like paired homeodomain protein. Mutant alleles of the CRX gene have recently been associated with autosomal dominant cone-rod dystrophy (CORD) as well as dominant Leber congenital amaurosis (LCA). Since LCA is more commonly inherited in an autosomal recessive manner, we examined a cohort of recessive LCA patients for CRX mutations. A homozygous substitution of arginine (R) at codon 90 by tryptophan (W) was identified in the CRX homeodomain of one of the probands who was nearly blind from birth. A group of 48 control individuals and 190 previously characterized CORD probands did not reveal this sequence change. The mutant CRXR90W homeodomain demonstrated decreased binding to the previously identified cis sequence elements in the rhodopsin promoter. In transient transfection experiments, the mutant protein showed significantly reduced ability to transactivate the rhodopsin promoter, as well as lower synergistic activation with the bZIP transcription factor NRL. Heterozygosity of the mutant CRX (R90W) allele was detected in both parents and in an older sibling. Ophthalmologic examination and electro-retinography revealed a subtle abnormality of cone function in both the parents. These data suggest that the R90W mutation results in a CRX protein with reduced DNA binding and transcriptional regulatory activity and that the subsequent changes in photoreceptor gene expression lead to the very early onset severe visual impairment in LCA.

Normal retina releases a diffusible factor stimulating cone survival in the retinal degeneration mouse

The role of cellular interactions in the mechanism of secondary cone photoreceptor degeneration in inherited retinal degenerations in which the mutation specifically affects rod photoreceptors was studied. We developed an organ culture model of whole retinas from 5-week-old mice carrying the retinal degeneration mutation, which at this age contain few remaining rods and numerous surviving cones cocultured with primary cultures of mixed cells from postnatal day 8 normal-sighted mice (C57BL/6) retinas or retinal explants from normal (C57BL/6) or dystrophic (C3H/He) 5-week-old mice. After 7 days, the numbers of residual cone photoreceptors were quantified after specific peanut lectin or anti-arrestin antibody labeling by using an unbiased stereological approach. Examination of organ cultured retinas revealed significantly greater numbers of surviving cones (15-20%) if cultured in the presence of retinas containing normal rods as compared with controls or cocultures with rod-deprived retinas. These data indicate the existence of a diffusible trophic factor released from retinas containing rod cells and acting on retinas in which only cones are present. Because cones are responsible for high acuity and color vision, such data could have important implications not only for eventual therapeutic approaches to human retinal degenerations but also to define interactions between retinal photoreceptor types.

Rod and cone function in the Nougaret form of stationary night blindness

BACKGROUND

Recently, a mutation (Gly38Asp) was identified in the alpha subunit of rod transducin in members of the Nougaret pedigree affected with dominantly inherited stationary night blindness.

OBJECTIVE

To evaluate retinal function in patients with the Gly38Asp gene defect.

DESIGN

Ocular examinations, including specialized measures of rod and cone function.

SETTING

A clinical research facility in Boston, Mass.

PATIENTS

A father (aged 48 years) and son (aged 25 years) with the Gly38Asp mutation.

MAIN OUTCOME MEASURES

Psychophysical thresholds to white and narrowband lights and full-field electroretinographic (ERG) responses.

RESULTS

Both patients showed dark-adapted thresholds to white light that were elevated approximately 2 log-units across the retina. Spectral sensitivity testing revealed thresholds that seemed to be governed mostly by rods. Although both patients' dark-adapted ERG responses to a dim blue flash were nondetectable, their dark-adapted ERGs to a white flash showed an a-wave with cone and rod components and a b-wave amplitude larger than what could have been generated by cone function alone. Rod ERGs to bright blue flashes had subnormal, but detectable, amplitudes that seemed to result from a profound reduction in sensitivity. The patients also showed loss of a cone subcomponent in the dark-adapted response to a red flash. The abnormal dark-adapted ERG responses of the patients could be simulated in the ERG responses of normal subjects tested with blue, white, and red flashes presented in the presence of a mesopic background.

CONCLUSIONS

Although the Nougaret form of stationary night blindness has been cited as a prototype of absent rod function with normal cone function, our findings, based on the genealogically and genotypically documented descendants of Jean Nougaret, show that rod function is present, although subnormal, and that there is slight impairment of cone function. The data also suggest that these abnormalities can be simulated by light-adapting the normal retina, compatible with the proposal that the rod transducin encoded by the mutant gene is constitutively active and that the night blindness results from partial desensitization of rods caused by the constitutive activity.

Early onset photoreceptor abnormalities induced by targeted disruption of the interphotoreceptor retinoid-binding protein gene

Vision in all vertebrates is dependent on an exchange of retinoids between the retinal pigment epithelium and the visual photoreceptors. It has been proposed that the interphotoreceptor retinoid-binding protein (IRBP) is essential for this intercellular exchange, and that it serves to prevent the potentially cytotoxic effects of retinoids. Although its precise function in vivo has yet to be defined, the early expression of IRBP suggests that it may also be required for normal photoreceptor development. To further assess the biological role of IRBP, we generated transgenic mice with targeted disruption of the IRBP gene (IRBP-/- mice). Specifically, homologous recombination was used to replace the first exon and promoter region of the IRBP gene with a phosphoglycerate kinase-promoted neomycin-resistant gene. Immunocytochemical and Western blot analyses demonstrated the absence of IRBP expression in the IRBP-/- mice. As early as postnatal day 11, histological examination of the retinas of IRBP-/- mice revealed a loss of photoreceptor nuclei and changes in the structural integrity of the receptor outer segments. At 30 d of age, the photoreceptor abnormalities in IRBP-/- mice were more severe, and electroretinographic recordings revealed a marked loss in photic sensitivity. In contrast, no morphological or electrophysiological changes were detected in age-matched heterozygotes. These observations indicate that normal photoreceptor development and function are highly dependent on the early expression of IRBP, and that in the absence of IRBP there is a slowly progressive degeneration of retinal photoreceptors.

A case of localized retinal damage in thallium poisoning

PURPOSE

To determine the cause of visual impairment and to document the late eye disturbances in a case of thallium poisoning.

PATIENT

A 44-year-old woman presented with a history of repeated attacks of complete alopecia over a period of several months, diffuse pain in both legs, transient gastrointestinal disturbances, abasia with a progressive paraparesis, paresthesia in the fingertips, and polyneuropathy. She complained of slowly progressive visual deterioration in both eyes which began about six months after the first attack of alopecia. The optic discs showed distinct signs of temporal atrophy together with a deep temporal excavation. The Goldmann perimetry revealed an absolute central scotoma. Traces of thallium were found in the urine and in the serum. The district attorney later discovered that her husband had been trying to poison her with thallium.

METHODS

The clinical and electrophysiological examinations included visual evoked potentials (VEP) and electroretinography (flash ERG, multifocal ERG and pattern ERG).

RESULTS

The VEP showed a reduction in amplitude and a prolonged latency indicating a conduction block. The pattern ERG was initially normal. At a follow-up examination 6 years later, a slight amplitude reduction in the pattern ERG was found. The multifocal ERG showed a diminished amplitude in the center of the retina (up to +/- 10 degrees visual angle).

CONCLUSIONS

The electrophysiological investigations in our patient--who had an optic atrophy--indicated a conduction block of the retinal nerve fibers (VEP) and an additional lesion at or before the retinal bipolar cells (multifocal ERG), localized in the central +/- 10 degrees. These findings suggest that thallium poisoning can lead to a combined lesion of the retinal nerve fibers and the neural retina.

Light-induced cell death of retinal photoreceptors in the absence of p53

PURPOSE

Cell death by apoptosis is essential for normal development and tissue homeostasis, and it is involved also in a variety of pathologic processes. Apoptosis is the final common pathway of photoreceptor cell death in retinal dystrophies and degeneration. So far, little is known about genes regulating apoptosis in the retina. The tumor-suppressor gene product p53 is a potent regulator of apoptosis in numerous systems. However, p53-independent apoptotic pathways also have been described. In this study the authors investigated the role of p53 in the light-induced apoptosis of retinal photoreceptors using mice lacking p53.

METHODS

Free-moving p53-/- and p53+/+ mice were dark adapted and were exposed to 8,500 or 15,000 lux of diffuse, cool, white fluorescent light for 2 hours. Animals were killed before and immediately after light exposure or at 12 hours in darkness after light exposure. Eyes were enucleated and processed for light and electron microscopy and histochemistry (TdT-dUTP terminal nick-end labeling method). Isolated retinas were subjected to the extraction of total retinal DNA. Electroretinogram (ERG) recordings were performed at all time points.

RESULTS

Morphologic, biochemical, histochemical, and ERG analysis showed that the retinas of untreated p53-/- mice and wild-type control mice were structurally and functionally indistinguishable. After exposure to diffuse white fluorescent light, light-induced photoreceptor cell death was analyzed and was found to be the same in both groups of mice.

CONCLUSIONS

These data suggest that light-induced apoptosis of photoreceptors is independent of functional p53.