Blue-light background impairs visual exogenous attention shift

Previous research into the effects of blue light on visual-spatial attention has yielded mixed results due to a lack of properly controlling critical factors like S-cone stimulation, ipRGCs stimulation, and color. We adopted the clock paradigm and systematically manipulated these factors to see how blue light impacts the speed of exogenous and endogenous attention shifts. Experiments 1 and 2 revealed that, relative to the control light, exposure to the blue-light background decreased the speed of exogenous (but not endogenous) attention shift to external stimuli. To further clarify the contribution(s) of blue-light sensitive photoreceptors (i.e., S-cone and ipRGCs), we used a multi-primary system that could manipulate the stimulation of a single type of photoreceptor without changing the stimulation of other photoreceptors (i.e., the silent substitution method). Experiments 3 and 4 revealed that stimulation of S-cones and ipRGCs did not contribute to the impairment of exogenous attention shift. Our findings suggest that associations with blue colors, such as the concept of blue light hazard, cause exogenous attention shift impairment. Some of the previously documented blue-light effects on cognitive performances need to be reevaluated and reconsidered in light of our findings.

The Verriest Lecture: Pathways to color in the eye and brain

In common with the majority of New World monkeys, marmosets show polymorphic color vision by allelic variation of X-chromosome genes encoding opsin pigments in the medium/long wavelength range. Male marmosets are thus obligate dichromats ("red-green color blind"), whereas females carrying distinct alleles on X chromosomes show one of three trichromatic phenotypes. Marmosets thus represent a "natural knock-out" system enabling comparison of red-green color vision in dichromatic and trichromatic visual systems. Further, study of short-wave (blue) cone pathways in marmosets has provided insights into primitive visual pathways for depth perception and attention. These investigations represent a parallel line to clinical research on color vision defects that was pioneered in studies by Guy Verreist, whom we honor in this eponymous lecture.

Melanopsin-driven surround induction on the red/green balance of yellow

To test the potential role of melanopsin-dependent ipRGCs in surround induction effects, we used a four-channel projector apparatus to hold the cone activity in a surround constant while varying the amount of melanopsin activity between two levels: low (baseline) and high (136% of the baseline). Rods were partially controlled by having the subjects complete conditions after either adapting to a bright field or darkness. The subjects adjusted the red/green balance of a 2.5° central target that varied in its ratio of L and M cones, but was equiluminant with the surround, to a perceptual null point (neither reddish nor greenish). When the surround melanopsin activity was higher, the subjects set their yellow balances at significantly higher L/(L+M) ratios, suggesting the high melanopsin surround was inducing greenishness into the central yellow stimulus. This is consistent with surround brightness effects that show the induction of greenishness into a central yellow test by high luminance surrounds. This potentially provides further evidence for a general role of melanopsin activity in brightness perception.

Using equiluminance settings to estimate the cardinal chromatic directions for individuals

Color information is processed by the retina and lateral geniculate along principal dimensions known as the cardinal directions of color space. Normal differences in spectral sensitivity can impact the stimulus directions that isolate these axes for individual observers and can arise from variation in lens and macular pigment density, photopigment opsins, photoreceptor optical density, and relative cone numbers. Some of these factors that influence the chromatic cardinal axes also impact luminance sensitivity. We modeled and empirically tested how well tilts on the individual's equiluminant plane are correlated with rotations in the directions of their cardinal chromatic axes. Our results show that, especially for the SvsLM axis, the chromatic axes can be partially predicted by luminance settings, providing a potential procedure for efficiently characterizing the cardinal chromatic axes for observers.

Size variations in synaptic terminals among different types of photoreceptors and across the zebrafish retina

Photoreceptor synaptic terminals are responsible for transmitting visual information to downstream neurons. In vertebrate retinas, photoreceptor synaptic terminals are of different sizes and structures. The molecular mechanisms that underlie photoreceptor synaptic development are not clearly understood. Here, we have systematically examined the size variations in the synaptic terminals of cone and rod photoreceptors in the adult zebrafish retina. We reveal that the average cone pedicle sizes expand in the order of UV, blue, green, and red cones, echoing the increasing maximally sensitive wavelengths of the opsins expressed in the corresponding cone types. In addition, rod spherules are smaller than all cone pedicles. The terminals of each photoreceptor type also display distinct regional variations across the retina and between males and females. These findings establish the basis for using the zebrafish retina to study the molecular mechanisms that regulate the sizes and structures of photoreceptor terminals for proper visual functions.

Nonlinear cortical encoding of color predicts enhanced McCollough effects in anomalous trichromats

Nonlinear encoding of chromatic contrast by the early visual cortex predicts that anomalous trichromats will show a larger McCollough effect than normal trichromats. In Experiment 1 we employed the McCollough effect to probe the cortical representation of saturation in normal trichromats, and used the results to predict enhanced McCollough effects for anomalous trichromats, which we measured in Experiment 2. In Experiment 1 three participants adapted to red and green orthogonal gratings of four different saturations. Using nulling to measure aftereffect strength, we found that halving the saturation of the inducing gratings decreased aftereffect strength only slightly, consistent with a compressive coding of saturation in early visual cortex. In anomalous trichromats, cone contrasts between red and green are greatly decreased from those of normal trichromats, but induced aftereffects are only slightly decreased, because of the non-linearity in the cortical encoding of saturation. To null the aftereffect, however, the retinal color deficiency must be overcome by adding more color to the null than required by normal trichromats. We confirmed this prediction in Experiment 2 where four anomalous trichromats required nulling stimuli approximately four times more saturated than did normal trichromats. We consider two competing models to explain our results: in a 'pigment swap' model anomalous trichromats have an altered photopigment but process color postreceptorally in the same way as normal trichromats; in a 'postreceptoral compensation' model the cortical representation of red-green contrasts is amplified to compensate for reduced cone contrasts. The latter provided a better fit to our data.

Stargardt-like Clinical Characteristics and Disease Course Associated with Variants in the WDR19 Gene

Variants in WDR19 (IFT144) have been implicated as another possible cause of Stargardt disease. The purpose of this study was to compare longitudinal multimodal imaging of a WDR19-Stargardt patient, harboring p.(Ser485Ile) and a novel c.(3183+1_3184-1)_(3261+1_3262-1)del variant, with 43 ABCA4-Stargardt patients. Age at onset, visual acuity, Ishihara color vision, color fundus, fundus autofluorescence (FAF), spectral-domain optical coherence tomography (OCT) images, microperimetry and electroretinography (ERG) were evaluated. First symptom of WDR19 patient was nyctalopia at the age of 5 years. After the age of 18 years, OCT showed hyper-reflectivity at the level of the external limiting membrane/outer nuclear layer. There was abnormal cone and rod photoreceptor function on ERG. Widespread fundus flecks appeared, followed by perifoveal photoreceptor atrophy. Fovea and peripapillary retina remained preserved until the latest exam at 25 years of age. ABCA4 patients had median age of onset at 16 (range 5-60) years and mostly displayed typical Stargardt triad. A total of 19% had foveal sparing. In comparison to ABCA4 patients, the WDR19 patient had a relatively large foveal preservation and severe rod photoreceptor impairment; however, it was still within the ABCA4 disease spectrum. Addition of WDR19 in the group of genes producing phenocopies of Stargardt disease underlines the importance of genetic testing and may help to understand its pathogenesis.

Adeno-associated virus (AAV)-mediated Cre recombinase expression in melanopsin ganglion cells without leaky expression in rod/cone photoreceptors

BACKGROUND

Constituting about 5 % of mouse retinal ganglion cells (RGCs), intrinsically photosensitive retinal ganglion cells (ipRGCs) express the photopigment melanopsin (gene symbol Opn4) and drive such photoresponses as pupil constriction, melatonin suppression, and circadian photoentrainment. Opn4Cre mice with Cre recombinase-expressing ipRGCs have enabled genetic manipulation of ipRGCs; unfortunately, while Cre expression within the inner retina is ipRGC-specific, leaky expression also occurs in some outer retinal photoreceptors, so Cre-induced alterations in the latter cells may confound certain studies of ipRGC function. Methods that express Cre in ipRGCs but not rods or cones are needed.

NEW METHOD

We have constructed a recombinant serotype-2 adeno-associated virus, rAAV2-Opn4-Cre, with the improved Cre recombinase (iCre) gene under the control of a ∼3kbp Opn4 promoter sequence, and injected it intravitreally into mice to transduce inner retinal neurons while sparing the outer retina.

RESULTS

We introduced rAAV2-Opn4-Cre into Cre reporter mice in which enhanced green fluorescent protein (EGFP) expression indicates Cre expression. Single-cell electrophysiological recordings and intracellular dye fills showed that 84 % of the EGFP+ cells were ipRGCs including M1-M6 types, while 16 % were conventional RGCs.

COMPARISON WITH EXISTING METHODS

Whereas Opn4Cre mice express Cre in some rod/cone photoreceptors, intravitreally applied rAAV2-Opn4-Cre induces Cre only in the inner retina, albeit with leaky expression in some conventional RGCs.

CONCLUSIONS

rAAV2-Opn4-Cre has overcome a significant limitation of Opn4Cre mice. We recommend usage scenarios where the Cre-expressing conventional RGCs should not pose a problem.

Micro-cone arrays enhance outcoupling efficiency in horticulture luminescent solar concentrators

Luminescent solar concentrators (LSCs) have shown the ability to realize spectral conversion, which could tailor the solar spectrum to better match photosynthesis requirements. However, conventional LSCs are designed to trap, rather than extract, spectrally converted light. Here, we propose an effective method for improving outcoupling efficiency based on protruded and extruded micro-cone arrays patterned on the bottom surface of LSCs. Using Monte Carlo ray tracing, we estimate a maximum external quantum efficiency (EQE) of 37.73% for our horticulture LSC (HLSC), corresponding to 53.78% improvement relative to conventional, planar LSCs. Additionally, structured HLSCs provide diffuse light, which is beneficial for plant growth. Our micro-patterned surfaces provide a solution to light trapping in LSCs and a foundation for the practical application of HLSCs.

Transcriptional control of cone photoreceptor diversity by a thyroid hormone receptor

Cone photoreceptor diversity allows detection of wavelength information in light, the first step in color (chromatic) vision. In most mammals, cones express opsin photopigments for sensitivity to medium/long (M, "green") or short (S, "blue") wavelengths and are differentially arrayed over the retina. Cones appear early in retinal neurogenesis but little is understood of the subsequent control of diversity of these postmitotic neurons, because cone populations are sparse and, apart from opsins, poorly defined. It is also a challenge to distinguish potentially subtle differences between cell subtypes within a lineage. Therefore, we derived a Cre driver to isolate individual M and S opsin-enriched cones, which are distributed in counter-gradients over the mouse retina. Fine resolution transcriptome analyses identified expression gradients for groups of genes. The postnatal emergence of gradients indicated divergent differentiation of cone precursors during maturation. Using genetic tagging, we demonstrated a role for thyroid hormone receptor β2 (TRβ2) in control of gradient genes, many of which are enriched for TRβ2 binding sites and TRβ2-regulated open chromatin. Deletion of TRβ2 resulted in poorly distinguished cones regardless of retinal location. We suggest that TRβ2 controls a bipotential transcriptional state to promote cone diversity and the chromatic potential of the species.

A demonstration of cone function plasticity after gene therapy in achromatopsia

Recent advances in regenerative therapy have placed the treatment of previously incurable eye diseases within arms' reach. Achromatopsia is a severe monogenic heritable retinal disease that disrupts cone function from birth, leaving patients with complete colour blindness, low acuity, photosensitivity and nystagmus. While successful gene-replacement therapy in non-primate models of achromatopsia has raised widespread hopes for clinical treatment, it was yet to be determined if and how these therapies can induce new cone function in the human brain. Using a novel multimodal approach, we demonstrate for the first time that gene therapy can successfully activate dormant cone-mediated pathways in children with achromatopsia (CNGA3- and CNGB3-associated, 10-15 years). To test this, we combined functional MRI population receptive field mapping and psychophysics with stimuli that selectively measure cone photoreceptor signalling. We measured cortical and visual cone function before and after gene therapy in four paediatric patients, evaluating treatment-related change against benchmark data from untreated patients (n = 9) and normal-sighted participants (n = 28). After treatment, two of the four children displayed strong evidence for novel cone-mediated signals in visual cortex, with a retinotopic pattern that was not present in untreated achromatopsia and which is highly unlikely to emerge by chance. Importantly, this change was paired with a significant improvement in psychophysical measures of cone-mediated visual function. These improvements were specific to the treated eye, and provide strong evidence for successful read-out and use of new cone-mediated information. These data show for the first time that gene replacement therapy in achromatopsia within the plastic period of development can awaken dormant cone-signalling pathways after years of deprivation. This reveals unprecedented neural plasticity in the developing human nervous system and offers great promise for emerging regenerative therapies.

Characterization of Retinal Development in 13-Lined Ground Squirrels

Purpose

The cone-dominant, 13-lined ground squirrel (13-LGS) retina mimics the human central retina, but a thorough examination of retinal development in this species has not been reported. Here, the embryonic and postnatal development of the 13-LGS retina was studied to further characterize 13-LGS as a practical alternative animal model for investigating cone-based vision in health and disease.

Methods

The spatiotemporal expression of key progenitor and cell type markers was examined in retinas from defined embryonic and postnatal stages using immunohistochemistry. Postnatal gene expression changes were validated by quantitative PCR.

Results

The 13-LGS neuroblastic layer expressed key progenitor markers (Sox2, Vsx2, Pax6, and Lhx2) at E18. Sequential cell fate determination evidenced by the first appearance of cell-type-specific marker labeling was at embryonic stage 18 (E18) with ganglion cells (Brn-3A, HuC/D) and microglia (Iba1); at E22.5 with photoreceptor progenitors (Otx2, recoverin) followed shortly by horizontal and amacrine cells (Lhx1, Oc1) at E24 to E25.5; and at postnatal stage 15 (P15) with bipolar cells (Vsx1, CaBP5) and Müller glia cells (GS, Rlbp1). Photoreceptor maturation indicated by opsin-positive outer segments and peanut agglutinin (PNA) labeling of cone sheaths was completed at the time of eye opening (P21-P24).

Conclusions

The timeline and order of retinal cell development in the 13-LGS generally matches that recorded from other mammalian models but with a stark variation in the proportion of various cell types due to cone-dense photoreceptors.

Translational Relevance

This thorough examination of an emerging translationally relevant cone-dominant specie provides a baseline for future disease modeling and stem cell approach studies of human vision.

Visual Axis and Stiles-Crawford Effect Peak Show a Positional Correlation in Normal Eyes: A Cohort Study

Purpose

The purpose of this study was to locate the visual axis and evaluate its correlation with the Stiles-Crawford effect (SCE) peak.

Methods

Ten young, healthy individuals (20 eyes) were enrolled. An optical system was developed to locate the visual axis and measure SCE. To locate the visual axis, 2 small laser spots at 450 nm and 680 nm were co-aligned and delivered to the retina. The participants were asked to move a translatable pinhole until these spots were perceived to overlap each other. The same system assessed SCE at 680 nm using a bipartite, 2-channel (reference and test) Maxwellian-view optical system. The peak positions were estimated using a two-dimensional Gaussian fitting function and correlated with the visual axis positions.

Results

Both the visual axis (x = 0.24 ± 0.35 mm, y = -0.16 ± 0.34 mm) and the SCE peak (x = 0.27 ± 0.35 mm, y = -0.15 ± 0.31 mm) showed intersubject variability among the cohort. The SCE peak positions were highly correlated in both the horizontal and vertical meridians to the visual axes (R2 = 0.98 and 0.96 for the x and y coordinates, respectively). Nine of the 10 participants demonstrated mirror symmetry for the coordinates of the visual axis and the SCE peak between the eyes (R2 = 0.71 for the visual axis and 0.76 for the SCE peak).

Conclusions

The visual axis and SCE peak locations varied among the participants; however, they were highly correlated with each other for each individual. These findings suggest a potential mechanism underlying the foveal cone photoreceptor alignment.

Near infrared autofluorescence imaging of retinal pigmented epithelial cells using 663 nm excitation

PURPOSE

Fundus autofluorescence (AF) using adaptive optics scanning laser ophthalmoscopy (AOSLO) enables morphometric analysis of individual retinal pigmented epithelial (RPE) cells. However, only a few excitation wavelengths in the visible and near-infrared have been evaluated. Visible light excitation (<600 nm) presents additional safety hazards and is uncomfortable for patients. Near-infrared excitation (>700 nm) overcomes those problems but introduces others, including decreased AF signal and cone signatures that obscure RPE structure. Here we investigated the use of an intermediate wavelength, 663 nm, for excitation and compared it to 795 nm.

METHODS

Subjects were imaged using AOSLO equipped with a detection channel to collect AF emission between 814 and 850 nm. Two light sources (663 and 795 nm) were used to excite the retinal fluorophores. We recorded 90 s videos and registered them with custom software to integrate AF images for analysis.

RESULTS

We imaged healthy eyes and an eye with pattern dystrophy. Similar AF microstructures were detected with each excitation source, despite ~4 times lower excitation power with 663 nm. The signal-to-noise values showed no meaningful difference between 663 nm and 795 nm excitation and a similar trend was observed for image contrast between the two excitation wavelengths.

CONCLUSIONS

Lower light levels can be used with shorter wavelength excitation to achieve comparable images of the microstructure of the RPE as have been obtained using higher light levels at longer wavelengths. Further experiments are needed to fully characterize AF across spectrum and determine the optimal excitation and emission bandwidths that balance efficiency, patient comfort, and efficacy.

The circadian clock mediates the response to oxidative stress in a cone photoreceptor‒like (661W) cell line via regulation of glutathione peroxidase activity

Background: The mammalian retina contains an autonomous circadian clock that controls many physiological functions within this tissue. Our previous studies have indicated that disruption of this circadian clock by removing Bmal1 from the retina affects the visual function, retinal circuitry, and cone photoreceptor viability during aging. In the present study, we employed a mouse-derived cone photoreceptor‒like cell, 661W, to investigate which molecular mechanisms of the circadian clock may modulate cone photoreceptor viability during aging. Methods: Bmal1 knockout (BKO) cells were generated from 661W cells using the CRISPR/Cas9 gene editing tool. Deletion of Bmal1 from 661W was verified by western blot and monitoring Per2-luc bioluminescence circadian rhythms. To investigate the effect of Bmal1 removal on an oxidative stress challenge, cells were treated with hydrogen peroxide (H 2O 2,1 mM) for two hours and then cell viability was assessed. Cells were also cultured and harvested for gene expression analysis and antioxidant assay. Results: Our data indicated that 661W cells contain a functional circadian clock that mediates the response to an oxidative stress challenge in vitro and that such a response is no longer present in the BKO cell. We also hypothesized that the effect was due to the circadian regulation of the intracellular antioxidant defense mechanism. Our results revealed that in 661W cells, the antioxidant defense mechanism showed time dependent variation , whereas in BKO cells, there was an overall reduction in this antioxidant defense mechanism, and it no longer showed time dependent variation. Conclusions: Our work supported the notion that the presence of a functional circadian clock and its ability to modulate the response to an oxidative stress is the underlying mechanism that may protect cones during aging.

Deletion of CEP164 in mouse photoreceptors post-ciliogenesis interrupts ciliary intraflagellar transport (IFT)

Centrosomal protein of 164 kDa (CEP164) is located at distal appendages of primary cilia and is necessary for basal body (BB) docking to the apical membrane. To investigate the function of photoreceptor CEP164 before and after BB docking, we deleted CEP164 during retina embryonic development (Six3Cre), in postnatal rod photoreceptors (iCre75) and in mature retina using tamoxifen induction (Prom1-ETCre). BBs dock to the cell cortex during postnatal day 6 (P6) to extend a connecting cilium (CC) and an axoneme. P6 retina-specific knockouts (retCep164-/-) are unable to dock BBs, thereby preventing formation of CC or outer segments (OSs). In rod-specific knockouts (rodCep164-/-), Cre expression starts after P7 and CC/OS form. P16 rodCep164-/- rods have nearly normal OS lengths, and maintain OS attachment through P21 despite loss of CEP164. Intraflagellar transport components (IFT88, IFT57 and IFT140) were reduced at P16 rodCep164-/- BBs and CC tips and nearly absent at P21, indicating impaired intraflagellar transport. Nascent OS discs, labeled with a fluorescent dye on P14 and P18 and harvested on P19, showed continued rodCep164-/- disc morphogenesis but absence of P14 discs mid-distally, indicating OS instability. Tamoxifen induction with PROM1ETCre;Cep164F/F (tamCep164-/-) adult mice affected maintenance of both rod and cone OSs. The results suggest that CEP164 is key towards recruitment and stabilization of IFT-B particles at the BB/CC. IFT impairment may be the main driver of ciliary malfunction observed with hypomorphic CEP164 mutations.

Development of dim-light vision in the nocturnal reef fish family Holocentridae. II: Retinal morphology

Ontogenetic changes in the habitats and lifestyles of animals are often reflected in their visual systems. Coral reef fishes start life in the shallow open ocean but inhabit the reef as juveniles and adults. Alongside this change in habitat, some species also change lifestyles and become nocturnal. However, it is not fully understood how the visual systems of nocturnal reef fishes develop and adapt to these significant ecological shifts over their lives. Therefore, we used a histological approach to examine visual development in the nocturnal coral reef fish family, Holocentridae. We examined 7 representative species spanning both subfamilies, Holocentrinae (squirrelfishes) and Myripristinae (soldierfishes). Pre-settlement larvae showed strong adaptation for photopic vision with high cone densities and had also started to develop a multibank retina (i.e. multiple rod layers), with up to two rod banks present. At reef settlement, holocentrids showed greater adaptation for scotopic vision, with higher rod densities and higher summation of rods onto the ganglion cell layer. By adulthood, they had well-developed scotopic vision with a highly rod-dominated multibank retina comprising 5-17 rod banks and enhanced summation of rods onto the ganglion cell layer. Although the ecological demands of the two subfamilies were similar throughout their lives, their visual systems differed after settlement, with Myripristinae showing more pronounced adaptation for scotopic vision than Holocentrinae. Thus, it is likely that both ecology and phylogeny contribute to the development of the holocentrid visual system.

Photoreceptors, visual pigments and intraretinal variability in spectral sensitivity in two species of smelts (Pisces, Osmeridae)

The main goal of this study was to clarify whether the spectral properties of retinal photoreceptors reflect the features of behaviour of closely related fish species cohabiting shallow marine and fresh waters. The spectral sensitivity of photoreceptors was compared between two smelt species, Hypomesus japonicus and Japanese smelt Hypomesus nipponensis. The spectral absorption of the visual pigments was measured using microspectrophotometry. In H. japonicus, a mostly marine species, all photoreceptors contained visual pigments based on retinal and were distributed differently in specific retinal areas. The absorbance maxima (λ_max ) of rods and long-wave-sensitive members of double cones throughout the retina amounted to 507 and 573 nm, respectively, but the λ_max value of the short-wave-sensitive members of double cones and single cones in the temporal hemiretina showed a significant blue shift compared to the nasal hemiretina: 485 vs. 516 nm and 375 vs. 412 nm, respectively, thus enhancing the short-wave sensitivity of the temporal hemiretina. In H. nipponensis, an euryhaline species, the estimated λ_max value of both rods and cones significantly varied between the groups caught in different localities (sea, river or estuary) because of the presence of rhodopsin/porphyropsin mixtures. The long-wavelength shift in rod and cone photoreceptors was observed because of changes in the chromophore complement in closely related but ecologically different species dwelling in freshened bodies of water. Considering the data available in the literature, several putative common opsin genes have been suggested for species under study.

Comprehensive variant spectrum of the CNGA3 gene in patients affected by achromatopsia

Achromatopsia (ACHM) is a congenital cone photoreceptor disorder characterized by impaired color discrimination, low visual acuity, photosensitivity, and nystagmus. To date, six genes have been associated with ACHM (CNGA3, CNGB3, GNAT2, PDE6C, PDE6H, and ATF6), the majority of these being implicated in the cone phototransduction cascade. CNGA3 encodes the CNGA3 subunit of the cyclic nucleotide-gated ion channel in cone photoreceptors and is one of the major disease-associated genes for ACHM. Herein, we provide a comprehensive overview of the CNGA3 variant spectrum in a cohort of 1060 genetically confirmed ACHM patients, 385 (36.3%) of these carrying "likely disease-causing" variants in CNGA3. Compiling our own genetic data with those reported in the literature and in public databases, we further extend the CNGA3 variant spectrum to a total of 316 variants, 244 of which we interpreted as "likely disease-causing" according to ACMG/AMP criteria. We report 48 novel "likely disease-causing" variants, 24 of which are missense substitutions underlining the predominant role of this mutation class in the CNGA3 variant spectrum. In addition, we provide extensive in silico analyses and summarize reported functional data of previously analyzed missense, nonsense and splicing variants to further advance the pathogenicity assessment of the identified variants.

Mobility test to assess functional vision in dark-adapted patients with Leber congenital amaurosis

BACKGROUND

Inherited retinal degenerations (IRDs) affect daylight and night vision to different degrees. In the current work, we devise a method to quantify mobility under dark-adapted conditions in patients with severe childhood blindness due to Leber congenital amaurosis (LCA). Mobility thresholds from two different LCA genotypes are compared to dark-adapted vision measurements using the full-field stimulus test (FST), a conventional desktop outcome measure of rod vision.

METHODS

A device consisting of vertical LED strips on a plane resembling a beaded curtain was programmed to produce a rectangular pattern target defining a 'door' of varying luminance that could appear at one of three positions. Mobility performance was evaluated by letting the subject walk from a fixed starting position ~ 4 m away from the device with instructions to touch the door. Success was defined as the subject touching within the 'door' area. Ten runs were performed and the process was repeated for different levels of luminance. Tests were performed monocularly in dark-adapted and dilated eyes. Results from LCA patients with the GUCY2D and CEP290 genotypes and normal subjects were analyzed using logistic regression to estimate the mobility threshold for successful navigation. The relation of thresholds for mobility, FST and visual acuity were quantified using linear regression.

RESULTS

Normal subjects had mobility thresholds near limits of dark-adapted rod vision. GUCY2D-LCA patients had a wide range of mobility thresholds from within 1 log of normal to greater than 8 log abnormal. CEP290-LCA patients had abnormal mobility thresholds that were between 5 and 6 log from normal. Sensitivity loss estimates using FST related linearly to the mobility thresholds which were not correlated with visual acuity.

CONCLUSIONS

The mobility task we developed can quantify functional vision in severely disabled patients with LCA. Taken together with other outcome measures of rod and cone photoreceptor-mediated vision, dark-adapted functional vision should provide a more complete understanding of the natural history and effects of treatment in patients with LCA.

Insight from OPN1LW Gene Haplotypes into the Cause and Prevention of Myopia

Nearsightedness (myopia) is a global health problem of staggering proportions that has driven the hunt for environmental and genetic risk factors in hopes of gaining insight into the underlying mechanism and providing new avenues of intervention. Myopia is the dominant risk factor for leading causes of blindness, including myopic maculopathy and retinal detachment. The fundamental defect in myopia-an excessively elongated eyeball-causes blurry distance vision that is correctable with lenses or surgery, but the risk of blindness remains. Haplotypes of the long-wavelength and middle-wavelength cone opsin genes (OPN1LW and OPN1MW, respectively) that exhibit profound exon-3 skipping during pre-messenger RNA splicing are associated with high myopia. Cone photoreceptors expressing these haplotypes are nearly devoid of photopigment. Conversely, cones in the same retina that express non-skipping haplotypes are relatively full of photopigment. We hypothesized that abnormal contrast signals arising from adjacent cones differing in photopigment content stimulate axial elongation, and spectacles that reduce contrast may significantly slow myopia progression. We tested for an association between spherical equivalent refraction and OPN1LW haplotype in males of European ancestry as determined by long-distance PCR and Sanger sequencing and identified OPN1LW exon 3 haplotypes that increase the risk of common myopia. We also evaluated the effects of contrast-reducing spectacles lenses on myopia progression in children. The work presented here provides new insight into the cause and prevention of myopia progression.

Robust categorical color constancy along daylight locus in red-green color deficiency

Categorical color constancy in normal trichromats has been found to be very robust in real scenes. In this study, we investigated categorical color constancy in red-green dichromats and anomalous trichromats. Eight dichromats (two protanopes and six deuteranopes), eight anomalous trichromats (four protanomalous and four deuteranomalous trichromats), and eight normal trichromats sorted 208 Munsell matte surfaces into Berlin and Kay's basic color categories under D65 illuminant, F illuminant with correlated color temperature 4200 K, and TL84 illuminant with correlated color temperature 2700 K. Color constancy was quantified by a color constancy index. The results showed that the constancy index of dichromats (0.79) was considerable and significantly lower than that of normal trichromats (0.87) while that of anomalous trichromats (0.84) was not. The impairment of color constancy performance in dichromats was expected to be caused by their large intra-subject variabilities in color naming. The results indicate robust categorical color constancy along daylight locus in red-green dichromats and anomalous trichromats, which might be contributed by cone adaptation mechanism and be independent of color discrimination mechanism. It suggests that the color categorization by color vision deficient subjects can be reasonable without any assistants of artificial equipment in daily life under sunlight and common illuminations.

Effect of observer age and stimulus size on the performance of CIE color matching functions

Both observer age and size of stimulus as characterized using the field of view (FOV) are two important parameters to affect the color matching functions (CMFs) of human observers. They are also included in the cone fundamental and CMFs models that were recently proposed by the International Commission on Illumination (CIE) in 2006. In contrast to the great number of studies investigating the performance of CMFs in characterizing color matches and mismatches using different primary sets, few study investigated the effect of CMFs in characterizing these two factors. In this study, we carefully designed a series of test stimuli in five colors, which had different magnitudes of calculated color difference to the corresponding reference stimulus using the CIE 2006 CMFs model. The stimuli were presented in two FOVs (i.e., 8.6° and 2.9°). A group of young and senior observers were asked to judge which of the two test stimuli appeared to be similar to the reference stimulus, which was a forced choice. The color differences calculated using the CIE 1931 2° and 1964 10° CMFs were found to have higher correlations to the visual color differences judged by the senior and young observers respectively, regardless of the actual FOVs used in the experiment. In addition, though the CIE 2006 CMFs with the different parameter settings always had better performance in predicting the perceived color differences, they failed to characterize the effect of observer age and stimulus size. Also, the experiment results did not support the CIE's recommendation of using the 10° CMFs for stimuli with an FOV greater than 4° and the 2° CMFs for those smaller than 4°.

Comparison of Cone Mosaic Metrics From Images Acquired With the SPECTRALIS High Magnification Module and Adaptive Optics Scanning Light Ophthalmoscopy

Purpose

To compare cone mosaic metrics derived from adaptive optics scanning light ophthalmoscopy (AOSLO) images with those derived from Heidelberg Engineering SPECTRALIS High Magnification Module (HMM) images.

Methods

Participants with contiguous cone mosaics had HMM imaging performed at locations superior and temporal to the fovea. These images were registered and averaged offline and then aligned to split-detection AOSLO images; 200 × 200-µm regions of interest were extracted from both modalities. Cones were semi-automatically identified by two graders to provide estimates of cone density and spacing.

Results

Thirty participants with contiguous cone mosaics were imaged (10 males, 20 females; age range, 11-67 years). Image quality varied, and 80% of our participants had analyzable HMM images. The intergrader intraclass correlation coefficients for cone metrics were good for both modalities (0.688-0.757 for HMM; 0.805-0.836 for AOSLO). Cone density estimates from HMM images were lower by 2661 cones/mm2 (24.1%) on average compared to AOSLO-derived estimates. Accordingly, HMM estimates of cone spacing were increased on average compared to AOSLO.

Conclusions

The cone mosaic can be visualized in vivo using the SPECTRALIS HMM, although image quality is variable and imaging is not successful in every individual. Metrics extracted from HMM images can differ from those from AOSLO, although excellent agreement is possible in individuals with excellent optical quality and precise co-registration between modalities.

Translational Relevance

Emerging non-adaptive optics-based photoreceptor imaging is more clinically accessible than adaptive optics techniques and has potential to expand high-resolution imaging in a clinical environment.

Short-term Assessment of Subfoveal Injection of Adeno-Associated Virus-Mediated hCHM Gene Augmentation in Choroideremia Using Adaptive Optics Ophthalmoscopy

Importance

Subretinal injection for gene augmentation in retinal degenerations forcefully detaches the neural retina from the retinal pigment epithelium, potentially damaging photoreceptors and/or retinal pigment epithelium cells.

Objective

To use adaptive optics scanning light ophthalmoscopy (AOSLO) to assess the short-term integrity of the cone mosaic following subretinal injections of adeno-associated virus vector designed to deliver a functional version of the CHM gene (AAV2-hCHM) in patients with choroideremia.

Design, Setting, and Participants

This longitudinal case series study enrolled adult patients with choroideremia from February 2015 to January 2016 in the US. To be included in the study, study participants must have received uniocular subfoveal injections of low-dose (5 × 1010 vector genome per eye) or high-dose (1 × 1011 vector genome per eye) AAV2-hCHM. Analysis began February 2015.

Main Outcomes and Measures

The macular regions of both eyes were imaged before and 1 month after injection using a custom-built multimodal AOSLO. Postinjection cone inner segment mosaics were compared with preinjection mosaics at multiple regions of interest. Colocalized spectral-domain optical coherence tomography and dark-adapted cone sensitivity was also acquired at each time point.

Results

Nine study participants ranged in age from 26 to 50 years at the time of enrollment, and all were White men. Postinjection AOSLO images showed preservation of the cone mosaic in all 9 AAV2-hCHM-injected eyes. Mosaics appeared intact and contiguous 1 month postinjection, with the exception of foveal disruption in 1 patient. Optical coherence tomography showed foveal cone outer segment shortening postinjection. Cone-mediated sensitivities were unchanged in 8 of 9 injected and 9 of 9 uninjected eyes. One participant showed acute loss of foveal optical coherence tomography cone outer segment-related signals along with cone sensitivity loss that colocalized with disruption of the mosaic on AOSLO.

Conclusions and Relevance

Integrity of the cone mosaic is maintained following subretinal delivery of AAV2-hCHM, providing strong evidence in support of the safety of the injections. Minor foveal thinning observed following surgery corresponds with short-term cone outer segment shortening rather than cone cell loss. Foveal cone loss in 1 participant raises the possibility of individual vulnerability to the subretinal injection.