101
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Münch M, Ladaique M, Roemer S, Hashemi K, Kawasaki A. Melanopsin-Mediated Acute Light Responses Measured in Winter and in Summer: Seasonal Variations in Adults with and without Cataracts. Front Neurol 2017; 8:464. [PMID: 28955293 PMCID: PMC5601987 DOI: 10.3389/fneur.2017.00464] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 08/21/2017] [Indexed: 11/19/2022] Open
Abstract
Seasonal adaptation is a ubiquitous behavior seen in many species on both global hemispheres and is conveyed by changing photoperiods. In humans this seasonal adaptation is less apparent, in part because changes in daylength are masked by the use of electrical lighting at night. On the other hand, cataracts which reduce light transmission, may compound seasonal changes related to the reduced daylength of winter. To better understand the effects of different photoperiod lengths in healthy adults without and with cataracts, we tested their melanopsin-mediated light responses in summer vs. winter. Fifty-two participants (mean age 67.4 years; 30 with bilateral cataracts and 22 age-matched controls with clear lenses; pseudophakes) were tested twice, once in summer and once in winter. At each test session we assessed the electroretinogram and pupil responses during daytime and we determined melatonin suppression, subjective sleepiness and mood in response to light exposure in the evening. Circadian rest-activity cycles and sleep from activity recordings were also analyzed for both seasons. Both groups had similar visual function. There were no seasonal differences in the electroretinogram. For the pupil responses to bright blue light, the post-illumination pupil response (PIPR) was greater in winter than summer in pseudophakes, but not in cataract participants, whereas melatonin suppression to acute light exposure showed no differences between both groups and seasons. Overall, intra-daily variability of rest-activity was worse in winter but participants felt sleepier and reported worse mood at the laboratory in evening time in the summer. Those with cataracts had poorer sleep quality with lower sleep efficiency, and higher activity during sleep in winter than summer. In this study, the PIPR showed a seasonal variation in which a larger response was found during winter. This variation was only detected in participants with a clear intraocular lens. In the cataract group, visual function was not impaired yet these participants showed a lack of seasonal changes in the pupil response to blue light and poorer sleep in winter. These findings raise the question for tailored lighting conditions for cataract patients in order to counter potentially deleterious effects of living with chronically lower light exposure.
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Affiliation(s)
- Mirjam Münch
- Group Sleep Research & Clinical Chronobiology, Institute of Physiology, Charité University Médicine Berlin, Berlin, Germany
| | - Myriam Ladaique
- Hôpital Ophtalmique Jules Gonin, University of Lausanne, Lausanne, Switzerland
| | - Ségolène Roemer
- Hôpital Ophtalmique Jules Gonin, University of Lausanne, Lausanne, Switzerland
| | - Kattayoon Hashemi
- Hôpital Ophtalmique Jules Gonin, University of Lausanne, Lausanne, Switzerland
| | - Aki Kawasaki
- Hôpital Ophtalmique Jules Gonin, University of Lausanne, Lausanne, Switzerland
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102
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Rukmini AV, Najjar RP, Atalay E, Sharma S, Lock JZ, Baskaran M, Nongpiur M, Gooley JJ, Aung T, Milea D. Pupillary responses to light are not affected by narrow irido-corneal angles. Sci Rep 2017; 7:10190. [PMID: 28860528 PMCID: PMC5579237 DOI: 10.1038/s41598-017-10303-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 08/07/2017] [Indexed: 11/09/2022] Open
Abstract
Chromatic pupillometry is an emerging method for evaluating ocular health that relies upon the differential stimulation of rods, cones, and intrinsically photosensitive retinal ganglion cells (ipRGCs). Although it has been investigated in conditions affecting the outer or inner retina, there is a paucity of studies in conditions where the anterior chamber of the eye is affected. Primary angle closure suspects (PACS) are defined as eyes with narrow anterior chamber angles and intact retina. PACS patients are at risk of developing primary angle closure glaucoma and are prophylactically treated by performing laser peripheral iridotomy (LPI). Here we evaluated pupillary responses to monchromatic lights in 18 PACS before and after LPI, and compared the results with those of 36 age-matched controls who had gonioscopically open angles. Dose response curves for pupillary constriction were similar between PACS patients and controls (p = 0.98 for blue and 0.90 for red light) and within subjects pre- and post-LPI (p = 0.58 for blue and 0.20 for red light). Baseline-adjusted pupillary constriction responses to blue and red lights were similar in controls and PACS, and not altered after LPI. Our findings suggest that narrow irido-corneal angles and LPI do not influence pupillary responses in PACS.
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Affiliation(s)
- A V Rukmini
- Singapore Eye Research Institute, Singapore, 169856, Singapore
| | - Raymond P Najjar
- Singapore Eye Research Institute, Singapore, 169856, Singapore.,The Ophthalmology & Visual Sciences ACP (EYE-ACP), SingHealth and Duke-NUS, Singapore, 169857, Singapore
| | - Eray Atalay
- Singapore Eye Research Institute, Singapore, 169856, Singapore
| | - Sourabh Sharma
- Singapore Eye Research Institute, Singapore, 169856, Singapore.,Singapore National Eye Centre, Singapore, 168751, Singapore
| | - Jing Zhan Lock
- Singapore Eye Research Institute, Singapore, 169856, Singapore
| | - Mani Baskaran
- Singapore Eye Research Institute, Singapore, 169856, Singapore.,The Ophthalmology & Visual Sciences ACP (EYE-ACP), SingHealth and Duke-NUS, Singapore, 169857, Singapore.,Singapore National Eye Centre, Singapore, 168751, Singapore
| | - Monisha Nongpiur
- Singapore Eye Research Institute, Singapore, 169856, Singapore.,The Ophthalmology & Visual Sciences ACP (EYE-ACP), SingHealth and Duke-NUS, Singapore, 169857, Singapore.,Singapore National Eye Centre, Singapore, 168751, Singapore
| | - Joshua J Gooley
- Program in Neuroscience and Behavioural Disorders, Duke-NUS Medical School, Singapore, 169857, Singapore.,Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore
| | - Tin Aung
- Singapore Eye Research Institute, Singapore, 169856, Singapore.,Singapore National Eye Centre, Singapore, 168751, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
| | - Dan Milea
- Singapore Eye Research Institute, Singapore, 169856, Singapore. .,The Ophthalmology & Visual Sciences ACP (EYE-ACP), SingHealth and Duke-NUS, Singapore, 169857, Singapore. .,Singapore National Eye Centre, Singapore, 168751, Singapore.
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103
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Charng J, Jacobson SG, Heon E, Roman AJ, McGuigan DB, Sheplock R, Kosyk MS, Swider M, Cideciyan AV. Pupillary Light Reflexes in Severe Photoreceptor Blindness Isolate the Melanopic Component of Intrinsically Photosensitive Retinal Ganglion Cells. Invest Ophthalmol Vis Sci 2017; 58:3215-3224. [PMID: 28660274 PMCID: PMC5490362 DOI: 10.1167/iovs.17-21909] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Purpose Pupillary light reflex (PLR) is driven by outer retinal photoreceptors and by melanopsin-expressing intrinsically photosensitive retinal ganglion cells of the inner retina. To isolate the melanopic component, we studied patients with severe vision loss due to Leber congenital amaurosis (LCA) caused by gene mutations acting on the outer retina. Methods Direct PLR was recorded in LCA patients (n = 21) with known molecular causation and severe vision loss. Standard stimuli (2.5 log scot-cd.m−2; ∼13 log quanta.cm−2.s−1; achromatic full-field) with 0.1- or 5-second duration were used in all patients. Additional recordings were performed with higher luminance (3.9 log scot-cd.m−2) in a subset of patients. Results The LCA patients showed no detectable PLR to the standard stimulus with short duration. With longer-duration stimuli, a PLR was detectable in the majority (18/21) of patients. The latency of the PLR was 2.8 ± 1.3 seconds, whereas normal latency was 0.19 ± 0.02 seconds. Peak contraction amplitude in patients was 1.1 ± 0.9 mm at 6.2 ± 2.3 seconds, considerably different from normal amplitude of 4.2 ± 0.4 mm at 3.0 ± 0.4 seconds. Recordings with higher luminance demonstrated that PLRs in severe LCA could also be evoked with short-duration stimuli. Conclusions The PLR in severe LCA patients likely represents the activation of the melanopic circuit in isolation from rod and cone input. Knowledge of the properties of the human melanopic PLR allows not only comparison to those in animal models but also serves to define the fidelity of postretinal transmission in clinical trials targeting patients with no outer retinal function.
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Affiliation(s)
- Jason Charng
- Scheie Eye Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Samuel G Jacobson
- Scheie Eye Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Elise Heon
- Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Alejandro J Roman
- Scheie Eye Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - David B McGuigan
- Scheie Eye Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Rebecca Sheplock
- Scheie Eye Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Mychajlo S Kosyk
- Scheie Eye Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Malgorzata Swider
- Scheie Eye Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Artur V Cideciyan
- Scheie Eye Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
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104
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Yeh CY, Koehl KL, Harman CD, Iwabe S, Guzman JM, Petersen-Jones SM, Kardon RH, Komáromy AM. Assessment of Rod, Cone, and Intrinsically Photosensitive Retinal Ganglion Cell Contributions to the Canine Chromatic Pupillary Response. Invest Ophthalmol Vis Sci 2017; 58:65-78. [PMID: 28061512 PMCID: PMC5231906 DOI: 10.1167/iovs.16-19865] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Purpose The purpose of this study was to evaluate a chromatic pupillometry protocol for specific functional assessment of rods, cones, and intrinsically photosensitive retinal ganglion cells (ipRGCs) in dogs. Methods Chromatic pupillometry was tested and compared in 37 dogs in different stages of primary loss of rod, cone, and combined rod/cone and optic nerve function, and in 5 wild-type (WT) dogs. Eyes were stimulated with 1-s flashes of dim (1 cd/m2) and bright (400 cd/m2) blue light (for scotopic conditions) or bright red (400 cd/m2) light with 25-cd/m2 blue background (for photopic conditions). Canine retinal melanopsin/Opn4 was cloned, and its expression was evaluated using real-time quantitative reverse transcription-PCR and immunohistochemistry. Results Mean ± SD percentage of pupil constriction amplitudes induced by scotopic dim blue (scDB), scotopic bright blue (scBB), and photopic bright red (phBR) lights in WT dogs were 21.3% ± 10.6%, 50.0% ± 17.5%, and 19.4% ± 7.4%, respectively. Melanopsin-mediated responses to scBB persisted for several minutes (7.7 ± 4.6 min) after stimulus offset. In dogs with inherited retinal degeneration, loss of rod function resulted in absent scDB responses, followed by decreased phBR responses with disease progression and loss of cone function. Primary loss of cone function abolished phBR responses but preserved those responses to blue light (scDB and scBB). Although melanopsin/Opn4 expression was diminished with retinal degeneration, melanopsin-expressing ipRGCs were identified for the first time in both WT and degenerated canine retinas. Conclusions Pupil responses elicited by light stimuli of different colors and intensities allowed differential functional assessment of canine rods, cones, and ipRGCs. Chromatic pupillometry offers an effective tool for diagnosing retinal and optic nerve diseases.
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Affiliation(s)
- Connie Y Yeh
- College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, United States 2School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Kristin L Koehl
- College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, United States
| | - Christine D Harman
- College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, United States
| | - Simone Iwabe
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - José M Guzman
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Simon M Petersen-Jones
- College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, United States
| | - Randy H Kardon
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa, United States 4Veterans Affairs Health Care System, Iowa City, Iowa, United States
| | - András M Komáromy
- College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, United States 2School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
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105
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Kostic C, Crippa SV, Martin C, Kardon RH, Biel M, Arsenijevic Y, Kawasaki A. Determination of Rod and Cone Influence to the Early and Late Dynamic of the Pupillary Light Response. Invest Ophthalmol Vis Sci 2017; 57:2501-8. [PMID: 27152964 PMCID: PMC4868103 DOI: 10.1167/iovs.16-19150] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE This study aims to identify which aspects of the pupil light reflex are most influenced by rods and cones independently by analyzing pupil recordings from different mouse models of photoreceptor deficiency. METHODS One-month-old wild type (WT), rodless (Rho-/-), coneless (Cnga3-/-), or photoreceptor less (Cnga3-/-; Rho-/- or Gnat1-/-) mice were subjected to brief red and blue light stimuli of increasing intensity. To describe the initial dynamic response to light, the maximal pupillary constriction amplitudes and the derivative curve of the first 3 seconds were determined. To estimate the postillumination phase, the constriction amplitude at 9.5 seconds after light termination was related to the maximal constriction amplitude. RESULTS Rho-/- mice showed decreased constriction amplitude but more prolonged pupilloconstriction to all blue and red light stimuli compared to wild type mice. Cnga3-/- mice had constriction amplitudes similar to WT however following maximal constriction, the early and rapid dilation to low intensity blue light was decreased. To high intensity blue light, the Cnga3-/- mice demonstrated marked prolongation of the pupillary constriction. Cnga3-/-; Rho-/- mice had no pupil response to red light of low and medium intensity. CONCLUSIONS From specific gene defective mouse models which selectively voided the rod or cone function, we determined that mouse rod photoreceptors are highly contributing to the pupil response to blue light stimuli but also to low and medium red stimuli. We also observed that cone cells mainly drive the partial rapid dilation of the initial response to low blue light stimuli. Thus photoreceptor dysfunction can be derived from chromatic pupillometry in mouse models.
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Affiliation(s)
- Corinne Kostic
- Department of Ophthalmology University Lausanne, Hôpital Ophtalmique Jules Gonin, Lausanne, Switzerland
| | - Sylvain V Crippa
- Department of Ophthalmology University Lausanne, Hôpital Ophtalmique Jules Gonin, Lausanne, Switzerland
| | - Catherine Martin
- Department of Ophthalmology University Lausanne, Hôpital Ophtalmique Jules Gonin, Lausanne, Switzerland
| | - Randy H Kardon
- Department of Ophthalmology, University of Iowa School of Medicine and Iowa City VA Center for Prevention and Treatment of Visual Loss, Iowa City, Iowa, United States
| | - Martin Biel
- Center for Integrated Protein Science Munich CiPS at the Department of Pharmacy - Center for Drug Research, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Yvan Arsenijevic
- Department of Ophthalmology University Lausanne, Hôpital Ophtalmique Jules Gonin, Lausanne, Switzerland
| | - Aki Kawasaki
- Department of Ophthalmology University Lausanne, Hôpital Ophtalmique Jules Gonin, Lausanne, Switzerland
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106
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Kelbsch C, Maeda F, Lisowska J, Lisowski L, Strasser T, Stingl K, Wilhelm B, Wilhelm H, Peters T. Analysis of retinal function using chromatic pupillography in retinitis pigmentosa and the relationship to electrically evoked phosphene thresholds. Acta Ophthalmol 2017; 95:e261-e269. [PMID: 27683070 DOI: 10.1111/aos.13259] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 07/31/2016] [Indexed: 12/01/2022]
Abstract
PURPOSE To analyse pupil responses to specific chromatic stimuli in patients with advanced retinitis pigmentosa (RP) to ascertain whether chromatic pupillography can be used as an objective marker for residual retinal function. To examine correlations between parameters of the pupil response and the perception threshold of electrically evoked phosphenes. METHODS Chromatic pupillography was performed in 40 patients with advanced RP (visual acuity < 0.02 or visual field ≤5°, non-recordable ERGs) and 40 age-matched healthy subjects. Pupil responses to full-field red (605 nm) and blue (420 nm) stimuli of 28 lx corneal illumination were recorded and analysed for two stimulus durations (1 and 4 seconds). The perception threshold of phosphenes to transcorneal electrostimulation was ascertained and correlated to the pupil responses and visual acuity. RESULTS Patients with RP showed significantly reduced pupil responses to red and blue stimuli compared with the controls. With red stimuli, pupillary escape could be observed; blue stimuli resulted in a well-preserved postillumination pupil response. Phosphene thresholds were significantly increased in patients with RP and correlated with the parameters of the pupil response if all subjects were considered. Within the RP group alone, this relationship was less pronounced and statistically not significant. CONCLUSIONS Chromatic pupillography demonstrated a significant decrease in outer retinal photoreceptor responses but a persisting and disinhibited intrinsic photosensitive retinal ganglion cell function in advanced RP. These phenomena may be useful as an objective marker for the efficacy of any interventional treatment for hereditary retinal diseases as well as for the selection of suitable patients for an electronic retinal implant.
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Affiliation(s)
- Carina Kelbsch
- Pupil Research Group at the Centre for Ophthalmology; University of Tübingen; Tübingen Germany
| | - Fumiatsu Maeda
- Pupil Research Group at the Centre for Ophthalmology; University of Tübingen; Tübingen Germany
- Department of Orthoptics and Visual Sciences; Faculty of Medical Technology; Niigata University of Health and Welfare; Niigata Japan
| | - Jolanta Lisowska
- Pupil Research Group at the Centre for Ophthalmology; University of Tübingen; Tübingen Germany
- Medical University of Bialystok; Bialystok Poland
| | - Lukasz Lisowski
- Pupil Research Group at the Centre for Ophthalmology; University of Tübingen; Tübingen Germany
- Medical University of Bialystok; Bialystok Poland
| | - Torsten Strasser
- Pupil Research Group at the Centre for Ophthalmology; University of Tübingen; Tübingen Germany
- Institute for Ophthalmic Research; University of Tübingen; Tübingen Germany
| | - Krunoslav Stingl
- Pupil Research Group at the Centre for Ophthalmology; University of Tübingen; Tübingen Germany
- Institute for Ophthalmic Research; University of Tübingen; Tübingen Germany
| | - Barbara Wilhelm
- Pupil Research Group at the Centre for Ophthalmology; University of Tübingen; Tübingen Germany
| | - Helmut Wilhelm
- Pupil Research Group at the Centre for Ophthalmology; University of Tübingen; Tübingen Germany
| | - Tobias Peters
- Pupil Research Group at the Centre for Ophthalmology; University of Tübingen; Tübingen Germany
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107
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Jacobson SG, Cideciyan AV, Sumaroka A, Roman AJ, Charng J, Lu M, Choudhury S, Schwartz SB, Heon E, Fishman GA, Boye SE. Defining Outcomes for Clinical Trials of Leber Congenital Amaurosis Caused by GUCY2D Mutations. Am J Ophthalmol 2017; 177:44-57. [PMID: 28212877 DOI: 10.1016/j.ajo.2017.02.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Revised: 02/01/2017] [Accepted: 02/03/2017] [Indexed: 11/19/2022]
Abstract
PURPOSE To determine outcome measures for a clinical trial of Leber congenital amaurosis (LCA) associated with mutations in the GUCY2D gene. DESIGN Retrospective observational case series. METHODS Twenty-eight patients with GUCY2D-LCA (aged 2-59 years) were studied clinically and with chromatic full-field sensitivity testing (FST), optical coherence tomography (OCT), pupillometry, and the NEI Visual Function Questionnaire (VFQ). RESULTS FST permitted quantitation of cone and rod sensitivity in these patients with severe visual impairment. For most patients, the degree of rod and cone sensitivity losses showed a relationship, thereby providing an opportunity to divide patients into cohorts by severity of rod and cone dysfunction. OCT analyses indicated that retinal structure could be used not only as an objective safety measure but also as an exploratory efficacy outcome. A foveal bulge was not present in 67% of patients. The intensity of inner segment/outer segment (ellipsoid zone line) reflectivity was reduced significantly at the fovea and in the rod-dense superior retina. Based on OCT and FST parameters, most patients had dissociation of structure and function. Abnormal pupillometry sensitivity in the majority of GUCY2D-LCA patients provided another objective efficacy outcome. NEI VFQ scores showed a similar range of findings to those of other severe retinal diseases. CONCLUSION Conventional outcome measures, such as visual acuity and the NEI VFQ, will need to be complemented by methods more specific to this GUCY2D-LCA population. Any therapeutic strategy should determine if there is an effect on rod as well as cone function and structure. FST provides a photoreceptor-based subjective outcome; and OCT in 2 retinal regions, fovea and superior retina, can assess photoreceptor structure. A change in the relationship of structure and function away from baseline becomes evidence of efficacy.
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Affiliation(s)
- Samuel G Jacobson
- Scheie Eye Institute, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Artur V Cideciyan
- Scheie Eye Institute, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Alexander Sumaroka
- Scheie Eye Institute, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Alejandro J Roman
- Scheie Eye Institute, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jason Charng
- Scheie Eye Institute, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Monica Lu
- Scheie Eye Institute, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Shreyasi Choudhury
- Department of Ophthalmology, College of Medicine, University of Florida, Gainesville, Florida
| | - Sharon B Schwartz
- Scheie Eye Institute, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Elise Heon
- Department of Ophthalmology and Vision Sciences, Program of Genetics and Genomic Biology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Gerald A Fishman
- Pangere Center for Hereditary Retinal Diseases, The Chicago Lighthouse, Chicago, Illinois
| | - Shannon E Boye
- Department of Ophthalmology, College of Medicine, University of Florida, Gainesville, Florida
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108
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Meltzer E, Sguigna PV, Subei A, Beh S, Kildebeck E, Conger D, Conger A, Lucero M, Frohman BS, Frohman AN, Saidha S, Galetta S, Calabresi PA, Rennaker R, Frohman TC, Kardon RH, Balcer LJ, Frohman EM. Retinal Architecture and Melanopsin-Mediated Pupillary Response Characteristics: A Putative Pathophysiologic Signature for the Retino-Hypothalamic Tract in Multiple Sclerosis. JAMA Neurol 2017; 74:574-582. [PMID: 28135360 PMCID: PMC5822208 DOI: 10.1001/jamaneurol.2016.5131] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 10/21/2016] [Indexed: 12/19/2022]
Abstract
Importance A neurophysiologic signature of the melanopsin-mediated persistent constriction phase of the pupillary light reflex may represent a surrogate biomarker for the integrity of the retinohypothalamic tract, with potential utility for investigating alterations in homeostatic mechanisms associated with brain disorders and implications for identifying new treatments. Objective To characterize abnormalities of retinal architecture in patients with multiple sclerosis (MS) and corresponding alterations in the melanopsin-mediated sustained pupillary constriction response. Design, Setting, and Participants The case-control study was an experimental assessment of various stimulus-induced pupillary response characteristics and was conducted at a university clinical center for MS from September 6, 2012, to February 2015. Twenty-four patients with MS (48 eyes) and 15 individuals serving as controls (30 eyes) participated. The melanopsin-mediated, sustained pupillary constriction phase response following cessation of a blue light stimulus was compared with the photoreceptor-mediated pupillary constriction phase response following cessation of a red light stimulus. Optical coherence tomography was used to characterize the association between pupillary response characteristics and alterations in retinal architecture, specifically, the thickness of the retinal ganglion cell layer and inner plexiform layer (GCL + IPL). Main Outcomes and Measures Association of pupillary response characteristics with alterations in retinal architecture. Results Of 24 patients with MS included in the analysis, 17 were women (71%); mean (SD) age was 47 (11) years. Compared with eyes from individuals with MS who had normal optical coherence tomography-derived measures of retinal GCL + IPL thickness, eyes of patients who had GCL + IPL thickness reductions to less than the first percentile exhibited a correspondingly significant attenuation of the melanopsin-mediated sustained pupillary response (mean [SD] pupillary diameter ratios at a point in time, 0.18 [0.1] vs 0.33 [0.09]; P < .001, generalized estimating equation models accounting for age and within-patient intereye correlations). Conclusions and Relevance In this case-control study, attenuation of the melanopsin-mediated sustained pupillary constriction response was significantly associated with thinning of the GCL + IPL sector of the retina in the eyes of patients with MS, particularly those with a history of acute optic neuritis. Melanopsin-containing ganglion cells in the retina represent, at least in part, the composition of the retinohypothalamic tract. As such, our findings may signify the ability to elucidate a putative surrogate neurophysiologic signature that correlates with a constellation of homeostatic mechanisms in both health and illness.
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Affiliation(s)
- Ethan Meltzer
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center at Dallas
| | - Peter V. Sguigna
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center at Dallas
| | - Adnan Subei
- Department of Neurology, Michigan State University, East Lansing
| | - Shin Beh
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center at Dallas
| | - Eric Kildebeck
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center at Dallas
- Center for Engineering Innovation, University of Texas at Dallas
| | - Darrel Conger
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center at Dallas
| | - Amy Conger
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center at Dallas
| | - Marlen Lucero
- Student, Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center at Dallas
| | - Benjamin S. Frohman
- Student, Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center at Dallas
| | - Ashley N. Frohman
- Student, Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center at Dallas
| | - Shiv Saidha
- Department of Neurology, Johns Hopkins Hospital, Baltimore, Maryland
| | - Steven Galetta
- Department of Neurology, Population Health, New York University School of Medicine, New York
| | | | | | - Teresa C. Frohman
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center at Dallas
| | - Randy H. Kardon
- Department of Ophthalmology, University of Iowa, Iowa City
- Iowa City Veterans Affairs Center for Prevention and Treatment of Visual Loss, Iowa City
| | - Laura J. Balcer
- Department of Neurology, Population Health, New York University School of Medicine, New York
- Department of Ophthalmology, New York University School of Medicine, New York
| | - Elliot M. Frohman
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center at Dallas
- Department of Bioengineering, University of Texas at Dallas
- Department of Ophthalmology, University of Texas Southwestern Medical Center at Dallas
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109
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Park JC, Chen YF, Blair NP, Chau FY, Lim JI, Leiderman YI, Shahidi M, McAnany JJ. Pupillary responses in non-proliferative diabetic retinopathy. Sci Rep 2017; 7:44987. [PMID: 28332564 PMCID: PMC5362954 DOI: 10.1038/srep44987] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 02/17/2017] [Indexed: 01/24/2023] Open
Abstract
The goal of this study was to determine the extent of rod-, cone-, and melanopsin-mediated pupillary light reflex (PLR) abnormalities in diabetic patients who have non-proliferative diabetic retinopathy (NPDR). Fifty diabetic subjects who have different stages of NPDR and 25 age-equivalent, non-diabetic controls participated. PLRs were measured in response to full-field, brief-flash stimuli under conditions that target the rod, cone, and intrinsically-photosensitive (melanopsin) retinal ganglion cell pathways. Pupil responses were compared among the subjects groups using age-corrected linear mixed models. Compared to control, the mean baseline pupil diameters were significantly smaller for all patient groups in the dark (all p < 0.001) and for the moderate-severe NPDR group in the light (p = 0.003). Pairwise comparisons indicated: (1) the mean melanopsin-mediated PLR was significantly reduced in the mild and moderate-severe groups (both p < 0.001); (2) the mean cone-mediated PLR was reduced significantly in the moderate-severe group (p = 0.008); (3) no significant differences in the mean rod-mediated responses. The data indicate abnormalities in NPDR patients under conditions that separately assess pupil function driven by different photoreceptor classes. The results provide evidence for compromised neural function in these patients and provide a promising approach for quantifying their neural abnormalities.
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Affiliation(s)
- Jason C Park
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, 1855 W. Taylor St., Chicago, IL 60612, USA
| | - Yi-Fan Chen
- Center for Clinical and Translational Sciences, University of Illinois at Chicago, 914 S Wood Street, Chicago, IL 60612, USA
| | - Norman P Blair
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, 1855 W. Taylor St., Chicago, IL 60612, USA
| | - Felix Y Chau
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, 1855 W. Taylor St., Chicago, IL 60612, USA
| | - Jennifer I Lim
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, 1855 W. Taylor St., Chicago, IL 60612, USA
| | - Yannek I Leiderman
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, 1855 W. Taylor St., Chicago, IL 60612, USA
| | - Mahnaz Shahidi
- Department of Ophthalmology, University of Southern California, 1450 San Pablo St, Los Angeles, CA 90033, USA
| | - J Jason McAnany
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, 1855 W. Taylor St., Chicago, IL 60612, USA
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110
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Milioni ALV, Nagy BV, Moura ALA, Zachi EC, Barboni MT, Ventura DF. Neurotoxic impact of mercury on the central nervous system evaluated by neuropsychological tests and on the autonomic nervous system evaluated by dynamic pupillometry. Neurotoxicology 2017; 59:263-269. [DOI: 10.1016/j.neuro.2016.04.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 04/09/2016] [Accepted: 04/11/2016] [Indexed: 11/25/2022]
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111
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Ishibashi F, Kojima R, Taniguchi M, Kosaka A, Uetake H, Tavakoli M. The Preferential Impairment of Pupil Constriction Stimulated by Blue Light in Patients with Type 2 Diabetes without Autonomic Neuropathy. J Diabetes Res 2017; 2017:6069730. [PMID: 28421205 PMCID: PMC5380853 DOI: 10.1155/2017/6069730] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 12/12/2016] [Accepted: 02/23/2017] [Indexed: 12/14/2022] Open
Abstract
The main aim of the present paper is to examine whether the pupillary light reflex (PLR) mediated by intrinsically photosensitive retinal ganglion cells (ipRGCs) is impaired in type 2 diabetic patients. One hundred and three diabetic patients without diabetic autonomic neuropathy (DAN) and 42 age-matched controls underwent a series of detailed neurological examinations. The patients were stratified into three groups: stage I, no neuropathy; stage II, asymptomatic neuropathy; stage III, symptomatic but without DAN. The PLR to 470 and 635 nm light at 20 cd/m2 was recorded. Small fiber neuropathy was assessed by corneal confocal microscopy and quantifying corneal nerve fiber (CNF) morphology. The 470 nm light induced a stronger and faster PLR than did 635 nm light in all subjects. The PLR to both lights was impaired equally across all of the diabetic subgroups. The postillumination pupil response (PIPR) after 470 nm light offset at ≥1.7 sec was attenuated in diabetic patients without differences between subgroups. Receiver operating characteristic analysis revealed that the PIPR mediated by ipRGCs in patients with stage II and stage III neuropathy was different from that of the control subjects. Clinical factors, nerve conduction velocity, and CNF measures were significantly correlated with PLR parameters with 470 nm light. PLR kinetics were more impaired by stimulation with blue light than with red light in diabetic patients without DAN.
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Affiliation(s)
| | | | | | | | | | - Mitra Tavakoli
- University of Exeter Medical School, Exeter, UK
- *Mitra Tavakoli:
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112
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113
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Laurenzo SA, Kardon R, Ledolter J, Poolman P, Schumacher AM, Potash JB, Full JM, Rice O, Ketcham A, Starkey C, Fiedorowicz JG. Pupillary response abnormalities in depressive disorders. Psychiatry Res 2016; 246:492-499. [PMID: 27821359 PMCID: PMC5161673 DOI: 10.1016/j.psychres.2016.10.039] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 10/19/2016] [Indexed: 10/20/2022]
Abstract
Depressive disorders lack objective physiological measurements to characterize the affected population and facilitate study of relevant mechanisms. The melanopsin-mediated light signaling pathway may contribute to seasonal variation and can be measured non-invasively by pupillometry. We prospectively studied changes in melanopsin-mediated pupillary constriction in 19 participants with major depressive disorder (MDD) and 10 control across the summer and winter solstices. The melanopsin-mediated response, as measured by the pupil's sustained constriction six s after a high intensity blue light stimulus, was marginally attenuated in those with MDD relative to controls (p=0.071). The participants with MDD unexpectedly showed a significantly reduced transient pupillary response to low intensity red (p=0.011) and blue light (p=0.013), but not high intensity red and blue light. Sustained pupillary constriction in response to high intensity blue light was more pronounced with increasing daylight hours (p=0.037) and was more strongly related to objectively measured versus estimated light exposure. Melanopsin-mediated impairments in pupil response may serve as a biological marker for vulnerability to depression in low light conditions. Assessment of these and other responses to light stimuli, such as response to low intensity light, may be useful for the study of the neurobiology of MDD and related mood disorders.
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Affiliation(s)
- Scott A. Laurenzo
- Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, United States
| | - Randy Kardon
- Department of Ophthalmology, Roy J. and Lucille A. Carver College of Medicine, United States,Iowa City Veterans Affairs center for Prevention of Visual Loss, Department of Veterans Affairs Hospital, United States
| | - Johannes Ledolter
- Iowa City Veterans Affairs center for Prevention of Visual Loss, Department of Veterans Affairs Hospital, United States,Tippie College of Business, The University of Iowa, Iowa City, IA 52242, USA
| | - Pieter Poolman
- Department of Ophthalmology, Roy J. and Lucille A. Carver College of Medicine, United States,Iowa City Veterans Affairs center for Prevention of Visual Loss, Department of Veterans Affairs Hospital, United States
| | - Ashley M. Schumacher
- Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, United States
| | - James B. Potash
- Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, United States
| | - Jan M. Full
- Department of Ophthalmology, Roy J. and Lucille A. Carver College of Medicine, United States,Iowa City Veterans Affairs center for Prevention of Visual Loss, Department of Veterans Affairs Hospital, United States
| | - Olivia Rice
- Department of Ophthalmology, Roy J. and Lucille A. Carver College of Medicine, United States,Iowa City Veterans Affairs center for Prevention of Visual Loss, Department of Veterans Affairs Hospital, United States
| | - Anna Ketcham
- Department of Ophthalmology, Roy J. and Lucille A. Carver College of Medicine, United States,Iowa City Veterans Affairs center for Prevention of Visual Loss, Department of Veterans Affairs Hospital, United States
| | - Cole Starkey
- Department of Ophthalmology, Roy J. and Lucille A. Carver College of Medicine, United States,Iowa City Veterans Affairs center for Prevention of Visual Loss, Department of Veterans Affairs Hospital, United States
| | - Jess G. Fiedorowicz
- Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, United States,Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, United States,Department of Epidemiology, College of Public Health, United States,Corresponding author at: Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, United States
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114
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The diagnostic accuracy of chromatic pupillary light responses in diseases of the outer and inner retina. Graefes Arch Clin Exp Ophthalmol 2016; 255:519-527. [DOI: 10.1007/s00417-016-3496-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 08/04/2016] [Accepted: 09/13/2016] [Indexed: 11/26/2022] Open
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Adhikari P, Zele AJ, Thomas R, Feigl B. Quadrant Field Pupillometry Detects Melanopsin Dysfunction in Glaucoma Suspects and Early Glaucoma. Sci Rep 2016; 6:33373. [PMID: 27622679 PMCID: PMC5020729 DOI: 10.1038/srep33373] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 08/23/2016] [Indexed: 12/20/2022] Open
Abstract
It is difficult to detect visual function deficits in patients at risk for glaucoma (glaucoma suspects) and at early disease stages with conventional ophthalmic tests such as perimetry. To this end, we introduce a novel quadrant field measure of the melanopsin retinal ganglion cell mediated pupil light response corresponding with typical glaucomatous arcuate visual field defects. The melanopsin-mediated post-illumination pupil response (PIPR) was measured in 46 patients with different stages of glaucoma including glaucoma suspects and compared to a healthy group of 21 participants with no disease. We demonstrate that the superonasal quadrant PIPR differentiated glaucoma suspects and early glaucoma patients from controls with fair (AUC = 0.74) and excellent (AUC = 0.94) diagnostic accuracy, respectively. The superonasal PIPR provides a linear functional correlate of structural retinal nerve fibre thinning in glaucoma suspects and early glaucoma patients. This first report that quadrant PIPR stimulation detects melanopsin dysfunction in patients with early glaucoma and at pre-perimetric stages may have future implications in treatment decisions of glaucoma suspects.
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Affiliation(s)
- Prakash Adhikari
- Medical Retina and Visual Science Laboratories, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Brisbane, QLD, 4059, Australia
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, QLD, Australia
| | - Andrew J. Zele
- Medical Retina and Visual Science Laboratories, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Brisbane, QLD, 4059, Australia
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, QLD, Australia
| | - Ravi Thomas
- Queensland Eye Institute, South Brisbane, QLD, Australia
- University of Queensland, Brisbane, QLD, Australia
| | - Beatrix Feigl
- Medical Retina and Visual Science Laboratories, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Brisbane, QLD, 4059, Australia
- Queensland Eye Institute, South Brisbane, QLD, Australia
- School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
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116
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Individual Differences in the Post-Illumination Pupil Response to Blue Light: Assessment without Mydriatics. BIOLOGY 2016; 5:biology5030034. [PMID: 27618116 PMCID: PMC5037353 DOI: 10.3390/biology5030034] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 08/25/2016] [Accepted: 08/30/2016] [Indexed: 11/17/2022]
Abstract
Melanopsin-containing retinal ganglion cells play an important role in the non-image forming effects of light, through their direct projections on brain circuits involved in circadian rhythms, mood and alertness. Individual differences in the functionality of the melanopsin-signaling circuitry can be reliably quantified using the maximum post-illumination pupil response (PIPR) after blue light. Previous protocols for acquiring PIPR relied on the use of mydriatics to dilate the light-exposed eye. However, pharmacological pupil dilation is uncomfortable for the participants and requires ophthalmological expertise. Hence, we here investigated whether an individual's maximum PIPR can be validly obtained in a protocol that does not use mydriatics but rather increases the intensity of the light stimulus. In 18 participants (5 males, mean age ± SD: 34.6 ± 13.6 years) we evaluated the PIPR after exposure to intensified blue light (550 µW/cm²) provided to an undilated dynamic pupil. The test-retest reliability of the primary PIPR outcome parameter was very high, both between day-to-day assessments (Intraclass Correlation Coefficient (ICC) = 0.85), as well as between winter and summer assessments (ICC = 0.83). Compared to the PIPR obtained with the use of mydriatics and 160 µW/cm² blue light exposure, the method with intensified light without mydriatics showed almost zero bias according to Bland-Altman plots and had moderate to strong reliability (ICC = 0.67). In conclusion, for PIPR assessments, increasing the light intensity is a feasible and reliable alternative to pupil dilation to relieve the participant's burden and to allow for performance outside the ophthalmological clinic.
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117
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Gracitelli CPB, Tatham AJ, Zangwill LM, Weinreb RN, Abe RY, Diniz-Filho A, Paranhos A, Baig S, Medeiros FA. Asymmetric Macular Structural Damage Is Associated With Relative Afferent Pupillary Defects in Patients With Glaucoma. Invest Ophthalmol Vis Sci 2016; 57:1738-46. [PMID: 27064394 PMCID: PMC4829086 DOI: 10.1167/iovs.15-18079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE We examined the relationship between relative afferent pupillary defects (RAPDs) and macular structural damage measured by macular thickness and macular ganglion cell-inner plexiform layer (mGCIPL) thickness in patients with glaucoma. METHODS A cross-sectional study was done of 106 glaucoma patients and 85 healthy individuals from the Diagnostic Innovations in Glaucoma Study. All subjects underwent standard automated perimetry (SAP) and optic nerve and macular imaging using Cirrus Spectral Domain Optical Coherence Tomography (SDOCT). Glaucoma was defined as repeatable abnormal SAP or progressive glaucomatous changes on stereo photographs. Pupil responses were assessed using an automated pupillometer, which records the magnitude of RAPD (RAPD score), with additional RAPD scores recorded for each of a series of colored stimuli (blue, red, green, and yellow). The relationship between RAPD score and intereye differences (right minus left eye) in circumpapillary retinal nerve fiber layer (cpRNFL) thickness, mGCIPL, macular thickness, and SAP mean deviation (MD), was examined using linear regression. RESULTS There was fair correlation between RAPD score and asymmetric macular structural damage measured by intereye difference in mGCIPL thickness (R(2) = 0.285, P < 0.001). The relationship between RAPD score and intereye difference in macular thickness was weaker (R(2) = 0.167, P < 0.001). Intereye difference in cpRNFL thickness (R(2) = 0.350, P < 0.001) and SAP MD (R(2) = 0.594, P < 0.001) had stronger association with RAPD scores compared to intereye difference in mGCIPL and macular thickness. CONCLUSIONS Objective assessment of pupillary responses using a pupillometer was associated with asymmetric macular structural damage in patients with glaucoma.
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Affiliation(s)
- Carolina P B Gracitelli
- Hamilton Glaucoma Center and Department of Ophthalmology University of California San Diego, La Jolla, California, United States 2Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil
| | - Andrew J Tatham
- Hamilton Glaucoma Center and Department of Ophthalmology University of California San Diego, La Jolla, California, United States 3Princess Alexandra Eye Pavilion and Department of Ophthalmology, University of Edinburgh, United Kingdom
| | - Linda M Zangwill
- Hamilton Glaucoma Center and Department of Ophthalmology University of California San Diego, La Jolla, California, United States
| | - Robert N Weinreb
- Hamilton Glaucoma Center and Department of Ophthalmology University of California San Diego, La Jolla, California, United States
| | - Ricardo Y Abe
- Hamilton Glaucoma Center and Department of Ophthalmology University of California San Diego, La Jolla, California, United States
| | - Alberto Diniz-Filho
- Hamilton Glaucoma Center and Department of Ophthalmology University of California San Diego, La Jolla, California, United States
| | - Augusto Paranhos
- Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil
| | - Saif Baig
- Hamilton Glaucoma Center and Department of Ophthalmology University of California San Diego, La Jolla, California, United States
| | - Felipe A Medeiros
- Hamilton Glaucoma Center and Department of Ophthalmology University of California San Diego, La Jolla, California, United States
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118
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Adhikari P, Feigl B, Zele AJ. Rhodopsin and Melanopsin Contributions to the Early Redilation Phase of the Post-Illumination Pupil Response (PIPR). PLoS One 2016; 11:e0161175. [PMID: 27548480 PMCID: PMC4993463 DOI: 10.1371/journal.pone.0161175] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 08/01/2016] [Indexed: 12/03/2022] Open
Abstract
Melanopsin expressing intrinsically photosensitive Retinal Ganglion Cells (ipRGCs) entirely control the post-illumination pupil response (PIPR) from 6 s post-stimulus to the plateau during redilation after light offset. However, the photoreceptor contributions to the early redilation phase of the PIPR (< 6 s post-stimulus) have not been reported. Here, we evaluated the photoreceptor contributions to the early phase PIPR (0.6 s to 5.0 s) by measuring the spectral sensitivity of the criterion PIPR amplitude in response to 1 s light pulses at five narrowband stimulus wavelengths (409, 464, 508, 531 and 592 nm). The retinal irradiance producing a criterion PIPR was normalised to the peak and fitted by either a single photopigment nomogram or the combined melanopsin and rhodopsin spectral nomograms with the +L+M cone photopic luminous efficiency (Vλ) function. We show that the PIPR spectral sensitivity at times ≥ 1.7 s after light offset is best described by the melanopsin nomogram. At times < 1.7 s, the peak PIPR sensitivity shifts to longer wavelengths (range: 482 to 498 nm) and is best described by the combined photoreceptor nomogram, with major contributions from melanopsin and rhodopsin. This first report of melanopsin and rhodopsin contributions to the early phase PIPR is in line with the electrophysiological findings of ipRGC and rod signalling after the cessation of light stimuli and provides a cut-off time for isolating photoreceptor specific function in healthy and diseased eyes.
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Affiliation(s)
- Prakash Adhikari
- Visual Science and Medical Retina Laboratories, Institute of Health and Biomedical Innovation, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- School of Optometry and Vision Science, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Beatrix Feigl
- Visual Science and Medical Retina Laboratories, Institute of Health and Biomedical Innovation, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- School of Biomedical Sciences, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- Queensland Eye Institute, Brisbane, Queensland, Australia
| | - Andrew J. Zele
- Visual Science and Medical Retina Laboratories, Institute of Health and Biomedical Innovation, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- School of Optometry and Vision Science, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- * E-mail:
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119
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Truong JQ, Ciuffreda KJ. Comparison of pupillary dynamics to light in the mild traumatic brain injury (mTBI) and normal populations. Brain Inj 2016; 30:1378-1389. [DOI: 10.1080/02699052.2016.1195922] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- James Q. Truong
- Department of Biological and Vision Sciences, SUNY College of Optometry, New York, NY, USA
| | - Kenneth J. Ciuffreda
- Department of Biological and Vision Sciences, SUNY College of Optometry, New York, NY, USA
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120
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Truong JQ, Ciuffreda KJ. Quantifying pupillary asymmetry through objective binocular pupillometry in the normal and mild traumatic brain injury (mTBI) populations. Brain Inj 2016; 30:1372-1377. [DOI: 10.1080/02699052.2016.1192220] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- James Q. Truong
- Department of Biological and Vision Sciences, SUNY College of Optometry, New York, NY, USA
| | - Kenneth J. Ciuffreda
- Department of Biological and Vision Sciences, SUNY College of Optometry, New York, NY, USA
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121
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Abstract
Visual function is an important parameter to consider when managing patients with papilledema. Though the current standard of care uses standard automated perimetry (SAP) to obtain this information, this test is inherently subjective and prone to patient errors. Objective visual function tests including the visual evoked potential, pattern electroretinogram, photopic negative response of the full field electroretinogram, and pupillary light response have the potential to replace or supplement subjective visual function tests in papilledema management. This article reviews the evidence for use of objective visual function tests to assess visual function in papilledema and discusses future investigations needed to develop them as clinically practical and useful measures for this purpose.
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Affiliation(s)
- Heather E Moss
- Department of Ophthalmology & Visual Sciences, Department of Neurology & Rehabilitation, University of Illinois at Chicago, Chicago, IL
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122
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Lei S, Goltz HC, Sklar JC, Wong AMF. The absence of attenuating effect of red light exposure on pre-existing melanopsin-driven post-illumination pupil response. Vision Res 2016; 124:59-65. [PMID: 27371765 DOI: 10.1016/j.visres.2016.06.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 06/01/2016] [Accepted: 06/02/2016] [Indexed: 11/18/2022]
Abstract
It has been proposed that after activation by blue light, activated melanopsin is converted back to its resting state by long wavelength red light exposure, a putative mechanism of melanopsin chromophore recovery in vivo. We tested this hypothesis by investigating whether red light attenuates the ongoing post-illumination pupil response (PIPR) induced by melanopsin-activating blue light. Pupillary light responses were tested using "Blue+Red" double flashes and "Blue Only" single flash stimuli in 10 visually normal subjects. For "Blue+Red" conditions, PIPR was induced with an intense blue flash, followed by experimental red light exposure of variable intensity and duration (Experiment 1) immediately or 9s after the offset of the blue flash (Experiment 2). For "Blue Only" conditions, only the PIPR-inducing blue stimuli were presented (reference condition). PIPR was defined as the mean pupil size from 10 to 30s (Experiment 1) and from 25 to 60s (Experiment 2) after the offset of blue light stimuli. The results showed that PIPR from "Blue+Red" conditions did not differ significantly from those of "Blue Only" conditions (p=0.55) in Experiment 1. The two stimulation conditions also did not differ in Experiment 2 (p=0.38). We therefore conclude that red light exposure does not alter the time course of PIPR induced by blue light. This finding does not support the hypothesis that long wavelength red light reverses activated melanopsin; rather it lends support to the hypothesis that the wavelengths of stimuli driving both the forward and backward reactions of melanopsin may be similar.
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Affiliation(s)
- Shaobo Lei
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Canada
| | - Herbert C Goltz
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Canada; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada
| | - Jaime C Sklar
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Canada
| | - Agnes M F Wong
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Canada; Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Canada; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada.
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123
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Jain V, Srivastava I, Palchaudhuri S, Goel M, Sinha-Mahapatra SK, Dhingra NK. Classical Photoreceptors Are Primarily Responsible for the Pupillary Light Reflex in Mouse. PLoS One 2016; 11:e0157226. [PMID: 27295136 PMCID: PMC4905644 DOI: 10.1371/journal.pone.0157226] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 05/26/2016] [Indexed: 11/23/2022] Open
Abstract
Pupillary light reflex (PLR) is an important clinical tool to assess the integrity of visual pathways. The available evidence suggests that melanopsin-expressing retinal ganglion cells (mRGCs) mediate PLR—driven by the classical photoreceptors (rods and cones) at low irradiances and by melanopsin activation at high irradiances. However, genetic or pharmacological elimination of melanopsin does not completely abolish PLR at high irradiances, raising the possibility that classical photoreceptors may have a role even at high irradiances. Using an inducible mouse model of photoreceptor degeneration, we asked whether classical photoreceptors are responsible for PLR at all irradiances, and found that the PLR was severely attenuated at all irradiances. Using multiple approaches, we show that the residual PLR at high irradiances in this mouse was primarily from the remnant rods and cones, with a minor contribution from melanopsin activation. In contrast, in rd1 mouse where classical photoreceptor degeneration occurs during development, the PLR was absent at low irradiances but intact at high irradiances, as reported previously. Since mRGCs receive inputs from classical photoreceptors, we also asked whether developmental loss of classical photoreceptors as in rd1 mouse leads to compensatory takeover of the high-irradiance PLR by mRGCs. Specifically, we looked at a distinct subpopulation of mRGCs that express Brn3b transcription factor, which has been shown to mediate PLR. We found that rd1 mouse had a significantly higher proportion of Brn3b-expressing M1 type of mRGCs than in the inducible model. Interestingly, inducing classical photoreceptor degeneration during development also resulted in a higher proportion of Brn3b-expressing M1 cells and partially rescued PLR at high irradiances. These results suggest that classical photoreceptors are primarily responsible for PLR at all irradiances, while melanopsin activation makes a minor contribution at very high irradiances.
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Affiliation(s)
- Varsha Jain
- National Brain Research Centre, Manesar (Gurgaon), Haryana, India 122051
| | - Ipsit Srivastava
- National Brain Research Centre, Manesar (Gurgaon), Haryana, India 122051
| | | | - Manvi Goel
- National Brain Research Centre, Manesar (Gurgaon), Haryana, India 122051
| | | | - Narender K. Dhingra
- National Brain Research Centre, Manesar (Gurgaon), Haryana, India 122051
- * E-mail:
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Greenwald SH, Charette JR, Staniszewska M, Shi LY, Brown SDM, Stone L, Liu Q, Hicks WL, Collin GB, Bowl MR, Krebs MP, Nishina PM, Pierce EA. Mouse Models of NMNAT1-Leber Congenital Amaurosis (LCA9) Recapitulate Key Features of the Human Disease. THE AMERICAN JOURNAL OF PATHOLOGY 2016; 186:1925-1938. [PMID: 27207593 DOI: 10.1016/j.ajpath.2016.03.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 03/08/2016] [Accepted: 03/16/2016] [Indexed: 12/20/2022]
Abstract
The nicotinamide nucleotide adenylyltransferase 1 (NMNAT1) enzyme is essential for regenerating the nuclear pool of NAD(+) in all nucleated cells in the body, and mounting evidence also suggests that it has a separate role in neuroprotection. Recently, mutations in the NMNAT1 gene were associated with Leber congenital amaurosis, a severe retinal degenerative disease that causes blindness during infancy. Availability of a reliable mammalian model of NMNAT1-Leber congenital amaurosis would assist in determining the mechanisms through which disruptions in NMNAT1 lead to retinal cell degeneration and would provide a resource for testing treatment options. To this end, we identified two separate N-ethyl-N-nitrosourea-generated mouse lines that harbor either a p.V9M or a p.D243G mutation. Both mouse models recapitulate key aspects of the human disease and confirm the pathogenicity of mutant NMNAT1. Homozygous Nmnat1 mutant mice develop a rapidly progressing chorioretinal disease that begins with photoreceptor degeneration and includes attenuation of the retinal vasculature, optic atrophy, and retinal pigment epithelium loss. Retinal function deteriorates in both mouse lines, and, in the more rapidly progressing homozygous Nmnat1(V9M) mutant mice, the electroretinogram becomes undetectable and the pupillary light response weakens. These mouse models offer an opportunity for investigating the cellular mechanisms underlying disease pathogenesis, evaluating potential therapies for NMNAT1-Leber congenital amaurosis, and conducting in situ studies on NMNAT1 function and NAD(+) metabolism.
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Affiliation(s)
- Scott H Greenwald
- Ocular Genomics Institute, Department of Ophthalmology, Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, Massachusetts
| | | | - Magdalena Staniszewska
- Ocular Genomics Institute, Department of Ophthalmology, Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, Massachusetts
| | | | - Steve D M Brown
- Mammalian Genetics Unit, Medical Research Council (MRC), Harwell Campus, Oxfordshire, United Kingdom
| | - Lisa Stone
- The Jackson Laboratory, Bar Harbor, Maine
| | - Qin Liu
- Ocular Genomics Institute, Department of Ophthalmology, Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, Massachusetts
| | | | | | - Michael R Bowl
- Mammalian Genetics Unit, Medical Research Council (MRC), Harwell Campus, Oxfordshire, United Kingdom
| | | | | | - Eric A Pierce
- Ocular Genomics Institute, Department of Ophthalmology, Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, Massachusetts.
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125
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Park JC, Moss HE, McAnany JJ. The Pupillary Light Reflex in Idiopathic Intracranial Hypertension. Invest Ophthalmol Vis Sci 2016; 57:23-9. [PMID: 26746015 PMCID: PMC4713014 DOI: 10.1167/iovs.15-18181] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Purpose To evaluate the effects of idiopathic intracranial hypertension (IIH) on rod-, cone-, and melanopsin-mediated pupillary light reflexes (PLRs). Methods Pupillary light reflexes elicited by full-field, brief-flash stimuli were recorded in 13 IIH patients and 13 normal controls. Subjects were dark-adapted for 10 minutes and the PLR was recorded in response to short-wavelength flashes (0.001 cd/m2: rod condition; 450 cd/m2: melanopsin condition). Subjects were then exposed to a rod-suppressing field and 10 cd/m2 long-wavelength flashes were presented (cone condition). Pupillary light reflexes were quantified as the maximum transient constriction (rod and cone conditions) and the post-illumination pupil constriction (melanopsin condition), relative to the baseline pupil size. Diagnostic power was evaluated using receiver operating characteristic (ROC) analysis. Results The IIH patients had significantly smaller PLRs under the melanopsin (P < 0.001) and rod (P = 0.04) paradigms; a trend for reduced cone-mediated PLRs was also found (P = 0.08). Receiver operating characteristic analysis indicated areas under the curves (AUC) of 0.83 (melanopsin-meditated; P = 0.001), 0.71 (rod-mediated; P = 0.07), and 0.77 (cone-mediated; P = 0.02). The AUC (0.90, P < 0.001), sensitivity (85%), and specificity (85%) were high for ROC analysis performed on the mean of the rod, cone, and melanopsin PLRs. Conclusions Pupillary light reflex reductions in IIH patients indicate compromised RGC function. PLR measurement, particularly under rod- and melanopsin-mediated conditions, may be a useful adjunct to standard clinical measures of visual function in IIH.
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Affiliation(s)
- Jason C Park
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Heather E Moss
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, United States 2Department of Neurology & Rehabilitation, University of Illinois at Chicago, Chicago, Illinois, United States
| | - J Jason McAnany
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, United States 3Department of Psychology, University of Illinois at Chicago, Chicago, Illinois, United States 4Department of Bioengineering, University o
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Collison FT, Park JC, Fishman GA, Stone EM, McAnany JJ. Two-color pupillometry in enhanced S-cone syndrome caused by NR2E3 mutations. Doc Ophthalmol 2016; 132:157-66. [PMID: 27033713 DOI: 10.1007/s10633-016-9535-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 03/22/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE The purpose of this study was to evaluate pupillary light reflexes (PLRs) mediated by rod, cone, and intrinsically photosensitive retinal ganglion cell pathways as indices of outer- and inner-retinal function in patients who have enhanced S-cone syndrome (ESCS) due to NR2E3 mutations. METHODS Four patients with ESCS (ages 16-23 years) participated in the study. Subjects were tested with long- and short-wavelength single-flash full-field ERG stimuli under light-adapted conditions. They were also tested with an established pupillometry protocol involving 1-s duration, long- and short-wavelength stimuli under dark- and light-adapted conditions. The PLR was measured as a function of stimulus luminance. Transient PLRs were measured under all conditions, and sustained PLRs were measured under the highest luminance dark-adapted condition. RESULTS Two-color light-adapted full-field ERGs demonstrated larger amplitude responses for short-wavelength stimuli relative to long-wavelength stimuli of the same photopic luminance, with three of four ESCS patients having super-normal a-wave amplitudes to the short-wavelength stimulus. b/a wave ratios were reduced in all four cases. Transient PLRs elicited by low-luminance stimuli under dark-adapted conditions (rod-mediated) were unrecordable, whereas the sustained PLRs elicited by high-luminance stimuli (melanopsin-mediated) were normal. Cone-mediated PLRs were recordable for all four patients, but generally lower than normal in amplitude. However, the cone-mediated PLR was larger for the short-wavelength stimulus compared to the photopically matched long-wavelength stimulus at high luminances, a pattern that was not observed for control subjects. None of the PLR conditions demonstrated "super-normal" responses. CONCLUSION ESCS patients appear to have generally well-preserved cone- and melanopsin-mediated PLRs, indicating intact inner-retinal function. Two-color pupillometry demonstrates greater sensitivity to short-wavelength light under higher-luminance conditions and could complement the ERG as a tool for evaluating retinal function in ESCS.
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Affiliation(s)
- Frederick T Collison
- The Pangere Center for Hereditary Retinal Diseases, The Chicago Lighthouse, 1850 West Roosevelt Rd., Chicago, IL, 60608, USA
| | - Jason C Park
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago College of Medicine, 1905 West Taylor St., Chicago, IL, 60612, USA
| | - Gerald A Fishman
- The Pangere Center for Hereditary Retinal Diseases, The Chicago Lighthouse, 1850 West Roosevelt Rd., Chicago, IL, 60608, USA. .,Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago College of Medicine, 1905 West Taylor St., Chicago, IL, 60612, USA.
| | - Edwin M Stone
- Stephen A. Wynn Institute for Vision Research, Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, 375 Newton Rd. 4111 MERF, Iowa City, IA, 52242, USA
| | - J Jason McAnany
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago College of Medicine, 1905 West Taylor St., Chicago, IL, 60612, USA
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Collison FT, Park JC, Fishman GA, McAnany JJ, Stone EM. Full-Field Pupillary Light Responses, Luminance Thresholds, and Light Discomfort Thresholds in CEP290 Leber Congenital Amaurosis Patients. Invest Ophthalmol Vis Sci 2016; 56:7130-6. [PMID: 26529047 DOI: 10.1167/iovs.15-17467] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
PURPOSE To investigate visual function in patients with CEP290 Leber congenital amaurosis (LCA-CEP290), using three full-field tests that can be performed by patients with poor fixation. METHODS Six patients (age range, 9-39 years) with LCA-CEP290 participated in the study. Stimuli for all three tests (full-field stimulus test [FST], pupillometry, and light discomfort threshold [LDT] testing) were generated by the Diagnosys ColorDome ganzfeld, by using achromatic stimuli as well as long- and short-wavelength stimuli to target rod and cone photoreceptors with all three tests and, in the latter two tests, melanopsin photoreceptors. RESULTS Dark-adapted FST thresholds in LCA-CEP290 patients were cone mediated and elevated between 4.8 and 6.2 log units above the normal achromatic threshold. The FST threshold was not measurable in one patient. The rod-mediated transient pupillary light reflex (PLR) was absent in all but the youngest patient, where unreliable responses precluded PLR quantification. Cone-mediated transient PLRs were subnormal in five patients, and absent in another. Sustained melanopsin-mediated PLRs were measurable in all patients. Full-field LDT thresholds were elevated compared to normal controls, and were lower for short-wavelengh than for long-wavelength stimuli. CONCLUSIONS The FST thresholds and transient PLRs were cone mediated in our cohort LCA-CEP290 patients. Rod-mediated PLRs were undetectable, whereas melanopsin-mediated sustained responses were detected in all patients, suggesting a relative preservation of inner-retina function. The LDT elevations for the patients are somewhat paradoxical, given their subjective perception of photoaversion. Relative aversion to short-wavelength light suggests influence from melanopsin on LDTs in these patients.
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Affiliation(s)
- Frederick T Collison
- The Pangere Center for Inherited Retinal Diseases The Chicago Lighthouse for People Who Are Blind or Visually Impaired, Chicago, Illinois, United States
| | - Jason C Park
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago College of Medicine, Chicago, Illinois, United States
| | - Gerald A Fishman
- The Pangere Center for Inherited Retinal Diseases The Chicago Lighthouse for People Who Are Blind or Visually Impaired, Chicago, Illinois, United States 2Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago College of Medicin
| | - J Jason McAnany
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago College of Medicine, Chicago, Illinois, United States
| | - Edwin M Stone
- The University of Iowa Carver College of Medicine, Department of Ophthalmology and Visual Sciences, Stephen A. Wynn Institute for Vision Research, Howard Hughes Medical Institute, Iowa City, Iowa, United States
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Gracitelli CPB, Duque-Chica GL, Moura ALDA, Roizenblatt M, Nagy BV, de Melo GR, Borba PD, Teixeira SH, Tufik S, Ventura DF, Paranhos A. Relationship between Daytime Sleepiness and Intrinsically Photosensitive Retinal Ganglion Cells in Glaucomatous Disease. J Ophthalmol 2016; 2016:5317371. [PMID: 26955483 PMCID: PMC4756205 DOI: 10.1155/2016/5317371] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 01/02/2016] [Accepted: 01/12/2016] [Indexed: 11/29/2022] Open
Abstract
Patients with glaucoma showed to have higher daytime sleepiness measured by Epworth sleepiness scale. In addition, this symptom was associated with pupillary reflex and polysomnography parameters. These ipRGC functions might be impaired in patients with glaucoma, leading to worse quality of life.
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Affiliation(s)
- Carolina P. B. Gracitelli
- Department of Ophthalmology, Federal University of São Paulo, Rua Botucatu, 821 Vila Clementino, 04023-062 São Paulo, SP, Brazil
| | - Gloria Liliana Duque-Chica
- Experimental Psychology Department, Institute of Psychology, University of São Paulo, São Paulo, SP, Brazil
| | - Ana Laura de Araújo Moura
- Department of Ophthalmology, Federal University of São Paulo, Rua Botucatu, 821 Vila Clementino, 04023-062 São Paulo, SP, Brazil
- Experimental Psychology Department, Institute of Psychology, University of São Paulo, São Paulo, SP, Brazil
| | - Marina Roizenblatt
- Department of Ophthalmology, Federal University of São Paulo, Rua Botucatu, 821 Vila Clementino, 04023-062 São Paulo, SP, Brazil
| | - Balazs V. Nagy
- Experimental Psychology Department, Institute of Psychology, University of São Paulo, São Paulo, SP, Brazil
| | - Geraldine Ragot de Melo
- Department of Ophthalmology, Federal University of São Paulo, Rua Botucatu, 821 Vila Clementino, 04023-062 São Paulo, SP, Brazil
| | - Paula Delegrego Borba
- Department of Ophthalmology, Federal University of São Paulo, Rua Botucatu, 821 Vila Clementino, 04023-062 São Paulo, SP, Brazil
| | - Sérgio H. Teixeira
- Department of Ophthalmology, Federal University of São Paulo, Rua Botucatu, 821 Vila Clementino, 04023-062 São Paulo, SP, Brazil
| | - Sergio Tufik
- Sleep Medicine Division, Psychobiology Department, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Dora Fix Ventura
- Experimental Psychology Department, Institute of Psychology, University of São Paulo, São Paulo, SP, Brazil
| | - Augusto Paranhos
- Department of Ophthalmology, Federal University of São Paulo, Rua Botucatu, 821 Vila Clementino, 04023-062 São Paulo, SP, Brazil
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Adhikari P, Pearson CA, Anderson AM, Zele AJ, Feigl B. Effect of Age and Refractive Error on the Melanopsin Mediated Post-Illumination Pupil Response (PIPR). Sci Rep 2015; 5:17610. [PMID: 26620343 PMCID: PMC4664956 DOI: 10.1038/srep17610] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 11/03/2015] [Indexed: 12/19/2022] Open
Abstract
Melanopsin containing intrinsically photosensitive Retinal Ganglion cells (ipRGCs) mediate the pupil light reflex (PLR) during light onset and at light offset (the post-illumination pupil response, PIPR). Recent evidence shows that the PLR and PIPR can provide non-invasive, objective markers of age-related retinal and optic nerve disease; however there is no consensus on the effects of healthy ageing or refractive error on the ipRGC mediated pupil function. Here we isolated melanopsin contributions to the pupil control pathway in 59 human participants with no ocular pathology across a range of ages and refractive errors. We show that there is no effect of age or refractive error on ipRGC inputs to the human pupil control pathway. The stability of the ipRGC mediated pupil response across the human lifespan provides a functional correlate of their robustness observed during ageing in rodent models.
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Affiliation(s)
- Prakash Adhikari
- Medical Retina and Visual Science Laboratories, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Brisbane QLD 4059, Australia
| | - Candice A Pearson
- Medical Retina and Visual Science Laboratories, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Brisbane QLD 4059, Australia
| | - Alexandra M Anderson
- Medical Retina and Visual Science Laboratories, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Brisbane QLD 4059, Australia
| | - Andrew J Zele
- Medical Retina and Visual Science Laboratories, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Brisbane QLD 4059, Australia
| | - Beatrix Feigl
- Medical Retina and Visual Science Laboratories, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Brisbane QLD 4059, Australia.,Queensland Eye Institute, South Brisbane QLD, Australia
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Rukmini AV, Milea D, Baskaran M, How AC, Perera SA, Aung T, Gooley JJ. Pupillary Responses to High-Irradiance Blue Light Correlate with Glaucoma Severity. Ophthalmology 2015; 122:1777-85. [PMID: 26299721 DOI: 10.1016/j.ophtha.2015.06.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 04/27/2015] [Accepted: 06/02/2015] [Indexed: 10/23/2022] Open
Abstract
PURPOSE To evaluate whether a chromatic pupillometry test can be used to detect impaired function of intrinsically photosensitive retinal ganglion cells (ipRGCs) in patients with primary open-angle glaucoma (POAG) and to determine if pupillary responses correlate with optic nerve damage and visual loss. DESIGN Cross-sectional study. PARTICIPANTS One hundred sixty-one healthy controls recruited from a community polyclinic (55 men; 151 ethnic Chinese) and 40 POAG patients recruited from a glaucoma clinic (22 men; 35 ethnic Chinese) 50 years of age or older. METHODS Subjects underwent monocular exposure to narrowband blue light (469 nm) or red light (631 nm) using a modified Ganzfeld dome. Each light stimulus was increased gradually over 2 minutes to activate sequentially the rods, cones, and ipRGCs that mediate the pupillary light reflex. Pupil diameter was recorded using an infrared pupillography system. MAIN OUTCOME MEASURES Pupillary responses to blue light and red light were compared between control subjects and those with POAG by constructing dose-response curves across a wide range of corneal irradiances (7-14 log photons/cm(2) per second). In patients with POAG, pupillary responses were evaluated relative to standard automated perimetry testing (Humphrey Visual Field [HVF]; Carl Zeiss Meditec, Dublin, CA) and scanning laser ophthalmoscopy parameters (Heidelberg Retinal Tomography [HRT]; Heidelberg Engineering, Heidelberg, Germany). RESULTS The pupillary light reflex was reduced in patients with POAG only at higher irradiance levels, corresponding to the range of activation of ipRGCs. Pupillary responses to high-irradiance blue light associated more strongly with disease severity compared with responses to red light, with a significant linear correlation observed between pupil diameter and HVF mean deviation (r = -0.44; P = 0.005) as well as HRT linear cup-to-disc ratio (r = 0.61; P < 0.001) and several other optic nerve head parameters. CONCLUSIONS In glaucomatous eyes, reduced pupillary responses to high-irradiance blue light were associated with greater visual field loss and optic disc cupping. In POAG, a short chromatic pupillometry test that evaluates the function of ipRGCs can be used to estimate the degree of damage to retinal ganglion cells that mediate image-forming vision. This approach could prove useful in detecting glaucoma.
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Affiliation(s)
- Annadata V Rukmini
- Program in Neuroscience and Behavioral Disorders, Duke-National University of Singapore Graduate Medical School, Singapore, Republic of Singapore
| | - Dan Milea
- Program in Neuroscience and Behavioral Disorders, Duke-National University of Singapore Graduate Medical School, Singapore, Republic of Singapore; Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Republic of Singapore
| | - Mani Baskaran
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Republic of Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Alicia C How
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Republic of Singapore
| | - Shamira A Perera
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Republic of Singapore
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Republic of Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Joshua J Gooley
- Program in Neuroscience and Behavioral Disorders, Duke-National University of Singapore Graduate Medical School, Singapore, Republic of Singapore; Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore.
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Münch M, Léon L, Collomb S, Kawasaki A. Comparison of acute non-visual bright light responses in patients with optic nerve disease, glaucoma and healthy controls. Sci Rep 2015; 5:15185. [PMID: 26478261 PMCID: PMC4609937 DOI: 10.1038/srep15185] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 09/22/2015] [Indexed: 11/30/2022] Open
Abstract
This study examined the effect of optic nerve disease, hence retinal ganglion cell loss, on non-visual functions related to melanopsin signalling. Test subjects were patients with bilateral visual loss and optic atrophy from either hereditary optic neuropathy (n = 11) or glaucoma (n = 11). We measured melatonin suppression, subjective sleepiness and cognitive functions in response to bright light exposure in the evening. We also quantified the post-illumination pupil response to a blue light stimulus. All results were compared to age-matched controls (n = 22). Both groups of patients showed similar melatonin suppression when compared to their controls. Greater melatonin suppression was intra-individually correlated to larger post-illumination pupil response in patients and controls. Only the glaucoma patients demonstrated a relative attenuation of their pupil response. In addition, they were sleepier with slower reaction times during nocturnal light exposure. In conclusion, glaucomatous, but not hereditary, optic neuropathy is associated with reduced acute light effects. At mild to moderate stages of disease, this is detected only in the pupil function and not in responses conveyed via the retinohypothalamic tract such as melatonin suppression.
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Affiliation(s)
- M Münch
- Solar Energy and Building Physics Laboratory, Environmental and Civil Engineering Institute, Swiss Federal Institute of Technology, Lausanne, Switzerland
| | - L Léon
- University of Lausanne, Hôpital Ophtalmique Jules-Gonin, Lausanne, Switzerland
| | - S Collomb
- University of Lausanne, Hôpital Ophtalmique Jules-Gonin, Lausanne, Switzerland
| | - A Kawasaki
- University of Lausanne, Hôpital Ophtalmique Jules-Gonin, Lausanne, Switzerland
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Vartanian GV, Zhao X, Wong KY. Using Flickering Light to Enhance Nonimage-Forming Visual Stimulation in Humans. Invest Ophthalmol Vis Sci 2015. [PMID: 26207303 DOI: 10.1167/iovs.15-16468] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Intrinsically photosensitive retinal ganglion cells (ipRGCs) mediate nonimage-forming visual functions such as pupillary constriction and circadian photoentrainment. Optimizing daytime nonimage-forming photostimulation has health benefits. We aimed to enhance ipRGC excitation using flickering instead of steady light. METHODS Human subjects were tested with a three-dimensional matrix of flickering 463-nm stimuli: three photon counts (13.7, 14.7 and 15.7 log photons cm(-2)), three duty cycles (12%, 47%, and 93%) and seven flicker frequencies (0.1, 0.25, 0.5, 1, 2, 4, and 7 Hz). Steady-state pupil constrictions were measured. RESULTS Among stimuli containing 13.7 log photons cm-2, the one flickering at 2 Hz with a 12% duty cycle evoked the greatest pupil constriction of 48% ± 4%, 71% greater than that evoked by an equal-intensity (12.3 log photons cm(-2) s(-1)) continuous light. This frequency and duty cycle were also best for 14.7 log photons cm-2 stimuli, inducing a 58% ± 4% constriction which was 38% more than that caused by an equal-intensity (13.3 log photons cm(-2) s(-1)) constant light. For 15.7 log photons cm-2 stimuli, the 1-Hz, 47% duty cycle flicker was optimal although it evoked the same constriction as the best 14.7 log photons cm(-2) flicker. CONCLUSIONS Pupillary constriction depends on flicker frequency and duty cycle besides intensity. Among the stimuli tested, the one with the lowest photon count inducing a maximal response is 13.3 log photons cm(-2) s(-1) flickering at 2 Hz with 12% duty cycle. Our data could guide the design of healthier architectural lighting and better phototherapy devices for treating seasonal affective disorder and jet lag.
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Affiliation(s)
- Garen V Vartanian
- Department of Ophthalmology & Visual Sciences, University of Michigan, Ann Arbor, Michigan, United States 2Graduate Program in Macromolecular Science & Engineering, University of Michigan, Ann Arbor, Michigan, United States
| | - Xiwu Zhao
- Department of Ophthalmology & Visual Sciences, University of Michigan, Ann Arbor, Michigan, United States
| | - Kwoon Y Wong
- Department of Ophthalmology & Visual Sciences, University of Michigan, Ann Arbor, Michigan, United States 3Department of Molecular, Cellular & Developmental Biology, University of Michigan, Ann Arbor, Michigan, United States
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Dark adaptation-induced changes in rod, cone and intrinsically photosensitive retinal ganglion cell (ipRGC) sensitivity differentially affect the pupil light response (PLR). Graefes Arch Clin Exp Ophthalmol 2015; 253:1997-2005. [DOI: 10.1007/s00417-015-3137-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 07/30/2015] [Accepted: 08/11/2015] [Indexed: 10/23/2022] Open
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van der Meijden WP, te Lindert BHW, Bijlenga D, Coppens JE, Gómez-Herrero G, Bruijel J, Kooij JJS, Cajochen C, Bourgin P, Van Someren EJW. Post-illumination pupil response after blue light: Reliability of optimized melanopsin-based phototransduction assessment. Exp Eye Res 2015. [PMID: 26209783 DOI: 10.1016/j.exer.2015.07.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Melanopsin-containing retinal ganglion cells have recently been shown highly relevant to the non-image forming effects of light, through their direct projections on brain circuits that regulate alertness, mood and circadian rhythms. A quantitative assessment of functionality of the melanopsin-signaling pathway could be highly relevant in order to mechanistically understand individual differences in the effects of light on these regulatory systems. We here propose and validate a reliable quantification of the melanopsin-dependent Post-Illumination Pupil Response (PIPR) after blue light, and evaluated its sensitivity to dark adaptation, time of day, body posture, and light exposure history. Pupil diameter of the left eye was continuously measured during a series of light exposures to the right eye, of which the pupil was dilated using tropicamide 0.5%. The light exposure paradigm consisted of the following five consecutive blocks of five minutes: baseline dark; monochromatic red light (peak wavelength: 630 nm, luminance: 375 cd/m(2)) to maximize the effect of subsequent blue light; dark; monochromatic blue light (peak wavelength: 470 nm, luminance: 375 cd/m(2)); and post-blue dark. PIPR was quantified as the difference between baseline dark pupil diameter and post-blue dark pupil diameter (PIPR-mm). In addition, a relative PIPR was calculated by dividing PIPR by baseline pupil diameter (PIPR-%). In total 54 PIPR assessments were obtained in 25 healthy young adults (10 males, mean age ± SD: 26.9 ± 4.0 yr). From repeated measurements on two consecutive days in 15 of the 25 participants (6 males, mean age ± SD: 27.8 ± 4.3 yrs) test-retest reliability of both PIPR outcome parameters was calculated. In the presence of considerable between-subject differences, both outcome parameters had very high test-retest reliability: Cronbach's α > 0.90 and Intraclass Correlation Coefficient > 0.85. In 12 of the 25 participants (6 males, mean age ± SD: 26.5 ± 3.6 yr) we examined the potential confounding effects of dark adaptation, time of the day (morning vs. afternoon), body posture (upright vs. supine position), and 24-h environmental light history on the PIPR assessment. Mixed effect regression models were used to analyze these possible confounders. A supine position caused larger PIPR-mm (β = 0.29 mm, SE = 0.10, p = 0.01) and PIPR-% (β = 4.34%, SE = 1.69, p = 0.02), which was due to an increase in baseline dark pupil diameter; this finding is of relevance for studies requiring a supine posture, as in functional Magnetic Resonance Imaging, constant routine protocols, and bed-ridden patients. There were no effects of dark adaptation, time of day, and light history. In conclusion, the presented method provides a reliable and robust assessment of the PIPR to allow for studies on individual differences in melanopsin-based phototransduction and effects of interventions.
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Affiliation(s)
- Wisse P van der Meijden
- Netherlands Institute for Neuroscience, Dept. Sleep and Cognition, Amsterdam, The Netherlands.
| | - Bart H W te Lindert
- Netherlands Institute for Neuroscience, Dept. Sleep and Cognition, Amsterdam, The Netherlands
| | - Denise Bijlenga
- PsyQ Psycho-Medical Programs, Program Adult ADHD, The Hague, The Netherlands
| | - Joris E Coppens
- Netherlands Institute for Neuroscience, Dept. Sleep and Cognition, Amsterdam, The Netherlands
| | - Germán Gómez-Herrero
- Netherlands Institute for Neuroscience, Dept. Sleep and Cognition, Amsterdam, The Netherlands
| | - Jessica Bruijel
- Netherlands Institute for Neuroscience, Dept. Sleep and Cognition, Amsterdam, The Netherlands
| | - J J Sandra Kooij
- PsyQ Psycho-Medical Programs, Program Adult ADHD, The Hague, The Netherlands
| | - Christian Cajochen
- Center for Chronobiology, Psychiatric Hospital of the University of Basel, Basel, Switzerland
| | - Patrice Bourgin
- Sleep Disorders Center, CHU and FMTS, CNRS-UPR 3212, Institute of Cellular and Integrative Neurosciences, University of Strasbourg, Strasbourg, France
| | - Eus J W Van Someren
- Netherlands Institute for Neuroscience, Dept. Sleep and Cognition, Amsterdam, The Netherlands; Depts. of Integrative Neurophysiology and Medical Psychology, Center for Neurogenomics and Cognitive Research (CNCR), Neuroscience Campus Amsterdam, VU University and Medical Center, Amsterdam, The Netherlands
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Komáromy AM, Abrams KL, Heckenlively JR, Lundy SK, Maggs DJ, Leeth CM, MohanKumar PS, Petersen‐Jones SM, Serreze DV, Woerdt A. Sudden acquired retinal degeneration syndrome (SARDS) – a review and proposed strategies toward a better understanding of pathogenesis, early diagnosis, and therapy. Vet Ophthalmol 2015; 19:319-31. [DOI: 10.1111/vop.12291] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- András M. Komáromy
- College of Veterinary Medicine Michigan State University 736 Wilson Road East Lansing MI 48824 USA
- School of Veterinary Medicine University of Pennsylvania 3900 Delancey Street Philadelphia PA 19104 USA
| | | | - John R. Heckenlively
- Kellogg Eye Center University of Michigan 1000 Wall Street Ann Arbor MI 48105 USA
| | - Steven K. Lundy
- Division of Rheumatology Department of Internal Medicine University of Michigan 300 North Ingalls Building Ann Arbor MI 48109 USA
| | - David J. Maggs
- Department of Surgical and Radiological Sciences School of Veterinary Medicine University of California‐Davis 1 Shields Avenue Davis CA 95616 USA
| | - Caroline M. Leeth
- Department of Animal and Poultry Sciences College of Agriculture and Life Sciences 175 West Campus Drive, MC 0306, 3280 Litton Reaves Hall Virginia Tech Blacksburg VA 24061 USA
| | - Puliyur S. MohanKumar
- Department of Pathobiology and Diagnostic Investigation College of Veterinary Medicine Michigan State University East Lansing MI 48824 USA
| | - Simon M. Petersen‐Jones
- College of Veterinary Medicine Michigan State University 736 Wilson Road East Lansing MI 48824 USA
| | | | - Alexandra Woerdt
- The Animal Medical Center 510 East 62nd Street New York NY 10065 USA
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136
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Differential monocular vs. binocular pupil responses from melanopsin-based photoreception in patients with anterior ischemic optic neuropathy. Sci Rep 2015; 5:10780. [PMID: 26074032 PMCID: PMC4466591 DOI: 10.1038/srep10780] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 05/05/2015] [Indexed: 01/05/2023] Open
Abstract
We examined the effect of anterior ischemic optic neuropathy (AION) on the activity of intrinsically photosensitive retinal ganglion cells (ipRGCs) using the pupil as proxy. Eighteen patients with AION (10 unilateral, 8 bilateral) and 29 age-matched control subjects underwent chromatic pupillometry. Red and blue light stimuli increasing in 0.5 log steps were presented to each eye independently under conditions of dark and light adaptation. The recorded pupil contraction was plotted against stimulus intensity to generate scotopic and photopic response curves for assessment of synaptically-mediated ipRGC activity. Bright blue light stimuli presented monocularly and binocularly were used for melanopsin activation. The post-stimulus pupil size (PSPS) at the 6th second following stimulus offset was the marker of intrinsic ipRGC activity. Finally, questionnaires were administered to assess the influence of ipRGCs on sleep. The pupil response and PSPS to all monocularly-presented light stimuli were impaired in AION eyes, indicating ipRGC dysfunction. To binocular light stimulation, the PSPS of AION patients was similar to that of controls. There was no difference in the sleep habits of the two groups. Thus after ischemic injury to one or both optic nerves, the summated intrinsic ipRGC activity is preserved when both eyes receive adequate light exposure.
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137
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Gracitelli CP, Duque-Chica GL, Roizenblatt M, Moura ALDA, Nagy BV, Ragot de Melo G, Borba PD, Teixeira SH, Tufik S, Ventura DF, Paranhos A. Intrinsically Photosensitive Retinal Ganglion Cell Activity Is Associated with Decreased Sleep Quality in Patients with Glaucoma. Ophthalmology 2015; 122:1139-48. [DOI: 10.1016/j.ophtha.2015.02.030] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 02/19/2015] [Accepted: 02/20/2015] [Indexed: 11/17/2022] Open
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138
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Svensson M, Olsén L, Winkler PA, Petersen-Jones SM, Bergström T, Garncarz Y, Narfström K. Progressive retinal atrophy in the Polski Owczarek Nizinny dog: a clinical and genetic study. Vet Ophthalmol 2015; 19:195-205. [PMID: 26009980 DOI: 10.1111/vop.12284] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe ophthalmic, functional, structural, and genetical characteristics of progressive retinal atrophy (PRA) in the polski owczarek nizinny (PON) breed of dog. ANIMALS STUDIED CLINICALLY Client-owned PON dogs (n = 82) from Sweden. PROCEDURES Routine examination for presumed inherited eye disease was performed in all dogs. Bilateral full-field electroretinography (ERG) was performed in 11 affected and 4 control dogs. Eyes from one affected dog were studied with light microscopy. DNA samples from 34 Swedish and 30 PON dogs collected by Michigan State University (MSU) were tested for the mutations causing the rcd4 and prcd forms of PRA. RESULTS Sixteen of the eighty-two Swedish dogs were diagnosed with PRA. Slight vascular attenuation, first seen at 4.5 years of age, preceded changes in tapetal reflectivity. The initial ERG changes in affected dogs showed markedly diminished rod responses, while cone responses were barely affected. Eventually, cone responses were also reduced. Retinal morphology showed approximately a 50% reduction of photoreceptor nuclei in the outer nuclear layer. Fourteen of fifteen PRA-affected Swedish dogs and eighteen of twenty of the MSU PRA-affected dogs tested genetically were positive for the rcd4 mutation. All tested dogs were negative for the mutation causing prcd-PRA. CONCLUSIONS PRA of PON dogs is a late-onset degenerative disease with slow progression. There is early loss of rod function, while the cone system deteriorates later. The rcd4 mutation in the C2ORF71 gene was associated with the majority of the PRA cases tested. The possibility of additional forms of PRA in the breed cannot be excluded.
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Affiliation(s)
- Marika Svensson
- Blue Star Animal Hospital, Gjutjärnsgatan 4, Gothenburg, 417 07, Sweden
| | - Lena Olsén
- Division of Pharmacology and Toxicology, Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, Uppsala, SE-750 07, Sweden
| | - Paige A Winkler
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, 736 Wilson Road D, 208, East Lansing, MI, USA.,Genetics Program, Michigan State University, East Lansing, MI, 48824, USA
| | - Simon M Petersen-Jones
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, 736 Wilson Road D, 208, East Lansing, MI, USA.,Genetics Program, Michigan State University, East Lansing, MI, 48824, USA
| | - Tomas Bergström
- Department of Animal Breeding and Genetics, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Yacek Garncarz
- Veterinary Eye Clinic, Grupy AK Polnoc 2/u10, Warsaw, 00-713, Poland
| | - Kristina Narfström
- College of Veterinary Medicine, 900 East Campus Drive, Columbia, MO, 65211, USA.,Retvet KB, Karlsuddsvägen 14b, Vaxholm, 185 93, Sweden
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139
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Park JC, McAnany JJ. Effect of stimulus size and luminance on the rod-, cone-, and melanopsin-mediated pupillary light reflex. J Vis 2015; 15:15.3.13. [PMID: 25788707 DOI: 10.1167/15.3.13] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
This study determined if the pupillary light reflex (PLR) driven by brief stimulus presentations can be accounted for by the product of stimulus luminance and area (i.e., corneal flux density, CFD) under conditions biased toward the rod, cone, and melanopsin pathways. Five visually normal subjects participated in the study. Stimuli consisted of 1-s short- and long-wavelength flashes that spanned a large range of luminance and angular subtense. The stimuli were presented in the central visual field in the dark (rod and melanopsin conditions) and against a rod-suppressing short-wavelength background (cone condition). Rod- and cone-mediated PLRs were measured at the maximum constriction after stimulus onset whereas the melanopsin-mediated PLR was measured 5-7 s after stimulus offset. The rod- and melanopsin-mediated PLRs were well accounted for by CFD, such that doubling the stimulus luminance had the same effect on the PLR as doubling the stimulus area. Melanopsin-mediated PLRs were elicited only by short-wavelength, large (>16°) stimuli with luminance greater than 10 cd/m(2), but when present, the melanopsin-mediated PLR was well accounted for by CFD. In contrast, CFD could not account for the cone-mediated PLR because the PLR was approximately independent of stimulus size but strongly dependent on stimulus luminance. These findings highlight important differences in how stimulus luminance and size combine to govern the PLR elicited by brief flashes under rod-, cone-, and melanopsin-mediated conditions.
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Affiliation(s)
- Jason C Park
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - J Jason McAnany
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA Department of Bioengineering, University of Illinois at Chicago, Chicago, IL, USA
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140
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Psychophysical measurement of rod and cone thresholds in stargardt disease with full-field stimuli. Retina 2015; 34:1888-95. [PMID: 24695063 DOI: 10.1097/iae.0000000000000144] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate psychophysical thresholds in Stargardt disease with the full-field stimulus test (FST). METHODS Visual acuity, spectral domain optical coherence tomography, full-field electroretinogram, and FST measurements were made in 1 eye of 24 patients with Stargardt disease. Dark-adapted rod FST thresholds were measured with short-wavelength stimuli, and cone FST thresholds were obtained from the cone plateau phase of dark adaptation using long-wavelength stimuli. Correlation coefficients were calculated for FST thresholds versus macular thickness, visual acuity, and electroretinogram amplitudes. RESULTS The Stargardt disease patients' FST cone thresholds correlated significantly with visual acuity, macular thickness, and electroretinogram cone response amplitudes (all P < 0.01). The patients' FST rod thresholds correlated with electroretinogram rod response amplitudes (P < 0.01) but not macular thickness (P = 0.05). All patients with Stargardt disease with flecks confined to the macula, and most of the patients with flecks extending outside of the macula had normal FST thresholds. All patients with extramacular atrophic changes had elevated FST cone thresholds and most had elevated FST rod thresholds. CONCLUSION Full-field stimulus test rod and cone threshold elevation in patients with Stargardt disease correlated well with measures of structure and function, as well as ophthalmoscopic retinal appearance. The Full-field stimulus test appears to be a useful tool for assessing rod and cone function in Stargardt disease.
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141
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Multifocal retinopathy in Dachshunds with CLN2 neuronal ceroid lipofuscinosis. Exp Eye Res 2015; 134:123-32. [PMID: 25697710 DOI: 10.1016/j.exer.2015.02.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 02/10/2015] [Accepted: 02/12/2015] [Indexed: 11/24/2022]
Abstract
The CLN2 form of neuronal ceroid lipofuscinosis is an autosomal recessively inherited lysosomal storage disease that is characterized by progressive vision loss culminating in blindness, cognitive and motor decline, neurodegeneration, and premature death. CLN2 disease results from mutations in the gene that encodes the soluble lysosomal enzyme tripeptidyl peptidase-1. A null mutation in the TPP1 gene encoding this enzyme causes a CLN2-like disease in Dachshunds. Dachshunds that are homozygous for this mutation serve as a model for human CLN2 disease, exhibiting clinical signs and neuropathology similar to those of children with this disorder. Affected dogs reach end-stage terminal disease status at 10-11 months of age. In addition to retinal changes typical of CLN2 disease, a retinopathy consisting of multifocal, bullous retinal detachment lesions was identified in 65% of (TPP1-/-) dogs in an established research colony. These lesions did not occur in littermates that were heterozygous or homozygous for the normal TPP1 allele. Retinal changes and the functional effects of this multifocal retinopathy were examined objectively over time using ophthalmic examinations, fundus photography, electroretinography (ERG), quantitative pupillary light response (PLR) recording, fluorescein angiography, optical coherence tomography (OCT) and histopathology. The retinopathy consisted of progressive multifocal serous retinal detachments. The severity of the disease-related retinal thinning was no more serious in most detached areas than in adjacent areas of the retina that remained in close apposition to the retinal pigment epithelium. The retinopathy observed in these dogs was somewhat similar to canine multifocal retinopathy (CMR), a disease caused by a mutation of the bestrophin gene BEST1. ERG a-wave amplitudes were relatively preserved in the Dachshunds with CLN2 disease, whether or not they developed the multifocal retinopathy. The retinopathy also had minimal effects on the PLR. Histological evaluation indicated that the CLN2 disease-related retinal degeneration was not exacerbated in areas where the retina was detached except where the detached areas were very large. DNA sequence analysis ruled out a mutation in the BEST1 exons or splice junctions as a cause for the retinopathy. Perfect concordance between the TPP1 mutation and the retinopathy in the large number of dogs examined indicates that the retinopathy most likely occurs as a direct result of the TPP1 mutation. Therefore, inhibition of the development and progression of these lesions can be used as an indicator of the efficacy of therapeutic interventions currently under investigation for the treatment of CLN2 disease in the Dachshund model. In addition, these findings suggest that TPP1 mutations may underlie multifocal retinopathies of unknown cause in animals and humans.
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Joyce DS, Feigl B, Cao D, Zele AJ. Temporal characteristics of melanopsin inputs to the human pupil light reflex. Vision Res 2014; 107:58-66. [PMID: 25497360 DOI: 10.1016/j.visres.2014.12.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 11/21/2014] [Accepted: 12/01/2014] [Indexed: 11/30/2022]
Abstract
Rods, cones and melanopsin containing intrinsically photosensitive retinal ganglion cells (ipRGCs) operate in concert to regulate pupil diameter. The temporal properties of intrinsic ipRGC signalling are distinct to those of rods and cones, including longer latencies and sustained signalling after light offset. We examined whether the melanopsin mediated post-illumination pupil response (PIPR) and pupil constriction were dependent upon the inter-stimulus interval (ISI) between successive light pulses and the temporal frequency of sinusoidal light stimuli. Melanopsin excitation was altered by variation of stimulus wavelength (464 nm and 638 nm lights) and irradiance (11.4 and 15.2 log photons cm(-2) s(-1)). We found that 6s PIPR amplitude was independent of ISI and temporal frequency for all melanopsin excitation levels, indicating complete summation. In contrast to the PIPR, the maximum pupil constriction increased with increasing ISI with high and low melanopsin excitation, but time to minimum diameter was slower with high melanopsin excitation only. This melanopsin response to briefly presented pulses (16 and 100 ms) slows the temporal response of the maximum pupil constriction. We also demonstrate that high melanopsin excitation attenuates the phasic peak-trough pupil amplitude compared to conditions with low melanopsin excitation, indicating an interaction between inner and outer retinal inputs to the pupil light reflex. We infer that outer retina summation is important for rapidly controlling pupil diameter in response to short timescale fluctuations in illumination and may occur at two potential sites, one that is presynaptic to extrinsic photoreceptor input to ipRGCs, or another within the pupil control pathway if ipRGCs have differential temporal tuning to extrinsic and intrinsic signalling.
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Affiliation(s)
- Daniel S Joyce
- Visual Science and Medical Retina Laboratories, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Beatrix Feigl
- Visual Science and Medical Retina Laboratories, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; Queensland Eye Institute, Brisbane, Australia
| | - Dingcai Cao
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, USA
| | - Andrew J Zele
- Visual Science and Medical Retina Laboratories, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
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Nakayama M, Nowak W, Ishikawa H, Asakawa K, Ichibe Y. Discovering irregular pupil light responses to chromatic stimuli using waveform shapes of pupillograms. EURASIP JOURNAL ON BIOINFORMATICS & SYSTEMS BIOLOGY 2014; 2014:18. [PMID: 28194168 PMCID: PMC5270378 DOI: 10.1186/s13637-014-0018-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Accepted: 07/02/2014] [Indexed: 11/10/2022]
Abstract
Background The waveforms of the pupillary light reflex (PLR) can be analyzed in a diagnostic test that allows for differentiation between disorders affecting photoreceptors and disorders affecting retinal ganglion cells, using various signal processing techniques. This procedure has been used on both healthy subjects and patients with age-related macular degeneration (AMD), as a simple diagnostic procedure is required for diagnosis. Results The Fourier descriptor technique is used to extract the features of PLR waveform shapes of pupillograms and their amplitudes. To detect those patients affected by AMD using the extracted features, multidimensional scaling (MDS) and clustering techniques were used to emphasize stimuli and subject differences. The detection performance of AMD using the features and the MDS technique shows only a qualitative tendency, however. To evaluate the detection performance quantitatively, a set of combined features was created to evaluate characteristics of the PLR waveform shapes in detail. Classification performance was compared across three categories (AMD patients, aged, and healthy subjects) using the Random Forest method, and weighted values were optimized using variations of the classification error rates. The results show that the error rates for healthy pupils and AMD-affected pupils were low when the value of the coefficient for a combination of PLR amplitudes and features of waveforms was optimized as 1.5. However, the error rates for patients with age-affected eyes was not low. Conclusions A classification procedure for AMD patients has been developed using the features of PLR waveform shapes and their amplitudes. The results show that the error rates for healthy PLRs and AMD PLRs were low when the Random Forest method was used to produce the classification. The classification of pupils of patients with age-affected eyes should be carefully considered in order to produce optimum results. Electronic supplementary material The online version of this article (doi:10.1186/s13637-014-0018-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Minoru Nakayama
- Department of Human System Science, Tokyo Institute of Technology, Ookayama, Meguro, Tokyo, 152-8552 Japan
| | - Wioletta Nowak
- Institute of Biomedical Engineering and Instrumentation, Wroclaw University of Technology, Wroclaw, 50-370 Poland
| | - Hitoshi Ishikawa
- School of Allied Health Sciences, Kitasato University, Kitasato, Minami, Sagamihara, 252-0373 Japan
| | - Ken Asakawa
- School of Allied Health Sciences, Kitasato University, Kitasato, Minami, Sagamihara, 252-0373 Japan
| | - Yoshiaki Ichibe
- School of Medicine, Kitasato University, Kitasato, Minami, Sagamihara, 252-0373 Japan
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144
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Sabeti F, Maddess T, Essex RW, Saikal A, James AC, Carle CF. Multifocal pupillography in early age-related macular degeneration. Optom Vis Sci 2014; 91:904-15. [PMID: 24987814 DOI: 10.1097/opx.0000000000000319] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To investigate the potential of multifocal pupillographic objective perimetry to assess changes in retinal function with clinical severity of age-related macular degeneration (AMD). METHODS Pupil responses were recorded from 40 subjects with AMD and 23 normal control subjects (mean ± SD age, 71.3 ± 5.1 years). Age-related macular degeneration subjects were classified according to the Age-Related Eye Disease Study (AREDS) classification system and allocated into one of four AMD severity groups. Three multifocal pupillographic objective perimetry stimulus variants that were identical in luminance but varied in spatiotemporal sequence were used. In one of the three protocols, stimuli were presented with a pedestal flicker for 266 milliseconds at 15 Hz. RESULTS On average, response amplitudes demonstrated a significant change in sensitivity with progression from early-stage (0.32 ± 0.08 dB, t = 3.88) to late-stage (-1.60 ± 0.12 dB, t = -12.7) age-related macular degeneration. Response delays followed a similar trend with the longest delays in AREDS4 (57.2 ± 1.9 milliseconds, t = 29.5). Ring analysis identified the largest mean effect on responses within the central 6 degrees of fixation. The NewStimuli protocol achieved the best diagnostic accuracy across all severity groups with area under the curve values of 0.85 ± 0.066 (AREDS1), 0.908 ± 0.085 (AREDS2), 0.929 ± 0.040 (AREDS3), and 1.0 ± 0.0 (AREDS4). CONCLUSIONS The mean effect of AMD on contraction amplitudes and response delays reflected the severity of disease, and the NewStimuli protocol achieved good diagnostic accuracy across all AMD severity groups. Multifocal pupillographic objective perimetry may potentially be a useful method in monitoring progression of AMD and assessing change in retinal function with novel interventions in early AMD. Longitudinal studies are required to identify biomarkers that predict eyes at risk of progression.
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Affiliation(s)
- Faran Sabeti
- *PhD †MBBS ‡BSc ARC Centre of Excellence in Vision Science and Centre for Visual Sciences, The John Curtin School of Medical Research, The Australian National University, Canberra, Australian Capital Territory, Australia (all authors); and Ophthalmology Department, The Australian National University, Canberra Hospital, Australian Capital Territory, Australia (RWE)
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145
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Melanopsin-expressing intrinsically photosensitive retinal ganglion cells in retinal disease. Optom Vis Sci 2014; 91:894-903. [PMID: 24879087 DOI: 10.1097/opx.0000000000000284] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Melanopsin-containing intrinsically photosensitive retinal ganglion cells (ipRGCs) are a class of photoreceptors with established roles in non-image-forming processes. Their contributions to image-forming vision may include the estimation of brightness. Animal models have been central for understanding the physiological mechanisms of ipRGC function and there is evidence of conservation of function across species. Intrinsically photosensitive retinal ganglion cells can be divided into five ganglion cell subtypes that show morphological and functional diversity. Research in humans has established that ipRGCs signal environmental irradiance to entrain the central body clock to the solar day for regulating circadian processes and sleep. In addition, ipRGCs mediate the pupil light reflex (PLR), making the PLR a readily accessible behavioral marker of ipRGC activity. Less is known about ipRGC function in retinal and optic nerve disease, with emerging research providing insight into their function in diabetes, retinitis pigmentosa, glaucoma, and hereditary optic neuropathy. We briefly review the anatomical distributions, projections, and basic physiological mechanisms of ipRGCs and their proposed and known functions in animals and humans with and without eye disease. We introduce a paradigm for differentiating inner and outer retinal inputs to the pupillary control pathway in retinal disease and apply this paradigm to patients with age-related macular degeneration (AMD). In these cases of patients with AMD, we provide the initial evidence that ipRGC function is altered and that the dysfunction is more pronounced in advanced disease. Our perspective is that with refined pupillometry paradigms, the PLR can be extended to AMD assessment as a tool for the measurement of inner and outer retinal dysfunction.
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146
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Whiting RE, Narfström K, Yao G, Pearce JW, Coates JR, Castaner LJ, Jensen CA, Dougherty BN, Vuillemenot BR, Kennedy D, O'Neill CA, Katz ML. Enzyme replacement therapy delays pupillary light reflex deficits in a canine model of late infantile neuronal ceroid lipofuscinosis. Exp Eye Res 2014; 125:164-72. [DOI: 10.1016/j.exer.2014.06.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 06/05/2014] [Accepted: 06/09/2014] [Indexed: 12/12/2022]
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147
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Narita A, Shirai K, Kubota N, Takayama R, Takahashi Y, Onuki T, Numakura C, Kato M, Hamada Y, Sakai N, Ohno A, Asami M, Matsushita S, Hayashi A, Kumada T, Fujii T, Horino A, Inoue T, Kuki I, Asakawa K, Ishikawa H, Ohno K, Nishimura Y, Tamasaki A, Maegaki Y, Ohno K. Abnormal pupillary light reflex with chromatic pupillometry in Gaucher disease. Ann Clin Transl Neurol 2014; 1:135-40. [PMID: 25356393 PMCID: PMC4212477 DOI: 10.1002/acn3.33] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 12/20/2013] [Accepted: 12/20/2013] [Indexed: 11/13/2022] Open
Abstract
The hallmark of neuronopathic Gaucher disease (GD) is oculomotor abnormalities, but ophthalmological assessment is difficult in uncooperative patients. Chromatic pupillometry is a quantitative method to assess the pupillary light reflex (PLR) with minimal patient cooperation. Thus, we investigated whether chromatic pupillometry could be useful for neurological evaluations in GD. In our neuronopathic GD patients, red light-induced PLR was markedly impaired, whereas blue light-induced PLR was relatively spared. In addition, patients with non-neuronopathic GD showed no abnormalities. These novel findings show that chromatic pupillometry is a convenient method to detect neurological signs and monitor the course of disease in neuronopathic GD.
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Affiliation(s)
- Aya Narita
- Division of Child Neurology, Institute of Neurological Science, Tottori University Faculty of Medicine Yonago, Japan
| | - Kentarou Shirai
- Division of Child Neurology, Institute of Neurological Science, Tottori University Faculty of Medicine Yonago, Japan
| | - Norika Kubota
- Department of Pediatrics, National Hospital Organization Matsue Medical Center Shimane, Japan
| | - Rumiko Takayama
- Department of Clinical Research, National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders Shizuoka, Japan
| | - Yukitoshi Takahashi
- Department of Clinical Research, National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders Shizuoka, Japan
| | - Takanori Onuki
- Department of Pediatrics, Yamagata University School of Medicine Yamagata, Japan
| | - Chikahiko Numakura
- Department of Pediatrics, Yamagata University School of Medicine Yamagata, Japan
| | - Mitsuhiro Kato
- Department of Pediatrics, Yamagata University School of Medicine Yamagata, Japan
| | - Yusuke Hamada
- Department of Pediatrics, Osaka University Graduate School of Medicine Osaka, Japan
| | - Norio Sakai
- Department of Pediatrics, Osaka University Graduate School of Medicine Osaka, Japan
| | - Atsuko Ohno
- Department of Pediatric Neurology, Aichi Children's Health and Medical Center Aichi, Japan
| | - Maya Asami
- Department of Pediatrics, School of Medicine, Iwate Medical University Morioka, Japan
| | - Shoko Matsushita
- Department of Pediatrics, School of Medicine, Iwate Medical University Morioka, Japan
| | - Anri Hayashi
- Department of Pediatrics, Shiga Medical Center for Children Shiga, Japan
| | - Tomohiro Kumada
- Department of Pediatrics, Shiga Medical Center for Children Shiga, Japan
| | - Tatsuya Fujii
- Department of Pediatrics, Shiga Medical Center for Children Shiga, Japan
| | - Asako Horino
- Department of Pediatric Neurology, Children's Medical Center, Osaka City General Hospital Osaka, Japan
| | - Takeshi Inoue
- Department of Pediatric Neurology, Children's Medical Center, Osaka City General Hospital Osaka, Japan
| | - Ichiro Kuki
- Department of Pediatric Neurology, Children's Medical Center, Osaka City General Hospital Osaka, Japan
| | - Ken Asakawa
- Department of Orthoptics and Visual Sciences, Kitasato University School of Allied Health Sciences Kanagawa, Japan
| | - Hitoshi Ishikawa
- Department of Orthoptics and Visual Sciences, Kitasato University School of Allied Health Sciences Kanagawa, Japan
| | - Koyo Ohno
- Division of Child Neurology, Institute of Neurological Science, Tottori University Faculty of Medicine Yonago, Japan
| | - Yoko Nishimura
- Division of Child Neurology, Institute of Neurological Science, Tottori University Faculty of Medicine Yonago, Japan
| | - Akiko Tamasaki
- Division of Child Neurology, Institute of Neurological Science, Tottori University Faculty of Medicine Yonago, Japan
| | - Yoshihiro Maegaki
- Division of Child Neurology, Institute of Neurological Science, Tottori University Faculty of Medicine Yonago, Japan
| | - Kousaku Ohno
- Division of Child Neurology, Institute of Neurological Science, Tottori University Faculty of Medicine Yonago, Japan
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148
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Barrionuevo PA, Nicandro N, McAnany JJ, Zele AJ, Gamlin P, Cao D. Assessing rod, cone, and melanopsin contributions to human pupil flicker responses. Invest Ophthalmol Vis Sci 2014; 55:719-27. [PMID: 24408974 DOI: 10.1167/iovs.13-13252] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE We determined the relative contributions of rods, cones, and melanopsin to pupil responses in humans using temporal sinusoidal stimulation for light levels spanning the low mesopic to photopic range. METHODS A four-primary Ganzfeld photostimulator controlled flicker stimulations at seven light levels (-2.7 to 2 log cd/m(2)) and five frequencies (0.5-8 Hz). Pupil diameter was measured using a high-resolution eye tracker. Three kinds of sinusoidal photoreceptor modulations were generated using silent substitution: rod modulation, cone modulation, and combined rod and cone modulation in phase (experiment 1) or cone phase shifted (experiment 2) from a fixed rod phase. The melanopsin excitation was computed for each condition. A vector sum model was used to estimate the relative contribution of rods, cones, and melanopsin to the pupil response. RESULTS From experiment 1, the pupil frequency response peaked at 1 Hz at two mesopic light levels for the three modulation conditions. Analyzing the rod-cone phase difference for the combined modulations (experiment 2) identified a V-shaped response amplitude with a minimum between 135° and 180°. The pupil response phases increased as cone modulation phase increased. The pupil amplitude increased with increasing light level for cone, and combined (in-phase rod and cone) modulation, but not for the rod modulation. CONCLUSIONS These results demonstrate that cone- and rod-pathway contributions are more predominant than melanopsin contribution to the phasic pupil response. The combined rod, cone, and melanopsin inputs to the phasic state of the pupil light reflex follow linear summation.
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Affiliation(s)
- Pablo A Barrionuevo
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois
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149
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Roecklein K, Wong P, Ernecoff N, Miller M, Donofry S, Kamarck M, Wood-Vasey WM, Franzen P. The post illumination pupil response is reduced in seasonal affective disorder. Psychiatry Res 2013; 210:150-8. [PMID: 23809464 PMCID: PMC3795919 DOI: 10.1016/j.psychres.2013.05.023] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Revised: 05/15/2013] [Accepted: 05/19/2013] [Indexed: 10/26/2022]
Abstract
Individuals with seasonal affective disorder (SAD) may have a decreased retinal sensitivity in the non-image forming light-input pathway. We examined the post illumination pupil response (PIPR) among individuals with SAD and healthy controls to identify possible differences in the melanopsin signaling pathway. We also investigated whether melanopsin gene (OPN4) variations would predict variability in the PIPR. Fifteen SAD and 15 control participants (80% women, mean age 36.7 years, S.D.=14.5) were assessed in the fall/winter. Participants were diagnosed based on DSM-IV-TR criteria. Infrared pupillometry was used to measure pupil diameter prior to, during, and after red and blue stimuli. In response to blue light, the SAD group had a reduced PIPR and a lower PIPR percent change relative to controls. The PIPR after the blue stimulus also varied on the basis of OPN4 I394T genotype, but not OPN4 P10L genotype. These findings may indicate that individuals with SAD have a less sensitive light input pathway as measured by the PIPR, leading to differences in neurobiological and behavioral responses such as alertness, circadian photoentrainment, and melatonin release. In addition, this sensitivity may vary based on sequence variations in OPN4, although a larger sample and replication is needed.
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Affiliation(s)
- Kathryn Roecklein
- Department of Psychology, University of Pittsburgh, 201S Bouquet St, Pittsburgh, PA 15260, USA.
| | - Patricia Wong
- Department of Psychology, University of Pittsburgh, 201 S Bouquet St, Pittsburgh, PA 15260, USA
| | - Natalie Ernecoff
- Department of Psychology, University of Pittsburgh, 201 S Bouquet St, Pittsburgh, PA 15260, USA
| | - Megan Miller
- Department of Psychology, University of Pittsburgh, 201 S Bouquet St, Pittsburgh, PA 15260, USA
| | - Shannon Donofry
- Department of Psychology, University of Pittsburgh, 201 S Bouquet St, Pittsburgh, PA 15260, USA
| | - Marissa Kamarck
- Department of Psychology, University of Pittsburgh, 201 S Bouquet St, Pittsburgh, PA 15260, USA
| | | | - Peter Franzen
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh PA, USA
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150
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Kawasaki A, Collomb S, Léon L, Münch M. Pupil responses derived from outer and inner retinal photoreception are normal in patients with hereditary optic neuropathy. Exp Eye Res 2013; 120:161-6. [PMID: 24275502 DOI: 10.1016/j.exer.2013.11.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 11/03/2013] [Accepted: 11/13/2013] [Indexed: 10/26/2022]
Abstract
We compared the pupil responses originating from outer versus inner retinal photoreception between patients with isolated hereditary optic neuropathy (HON, n = 8) and healthy controls (n = 8). Three different testing protocols were used. For the first two protocols, a response function of the maximal pupil contraction versus stimulus light intensity was generated and the intensity at which half of the maximal pupil contraction, the half-max intensity, was determined. For the third protocol, the pupil size after light offset, the re-dilation rate and re-dilation amplitude were calculated to assess the post-light stimulus response. Patients with HON had bilateral, symmetric optic atrophy and significant reduction of visual acuity and visual field compared to controls. There were no significant mean differences in the response curve and pupil response parameters that reflect mainly rod, cone or melanopsin activity between patients and controls. In patients, there was a significant correlation between the half-max intensity of the red light sequence and visual field loss. In conclusion, pupil responses derived from outer or inner retinal photoreception in HON patients having mild-to moderate visual dysfunction are not quantitatively different from age-matched controls. However, an association between the degree of visual field loss and the half-max intensity of the cone response suggests that more advanced stages of disease may lead to impaired pupil light reflexes.
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Affiliation(s)
- Aki Kawasaki
- Department of Ophthalmology, University of Lausanne, Fondation Asile des Aveugles, Hôpital Ophtalmique Jules Gonin, Avenue de France 15, 1004 Lausanne, Switzerland.
| | - Sylvie Collomb
- Department of Ophthalmology, University of Lausanne, Fondation Asile des Aveugles, Hôpital Ophtalmique Jules Gonin, Avenue de France 15, 1004 Lausanne, Switzerland.
| | - Lorette Léon
- Department of Ophthalmology, University of Lausanne, Fondation Asile des Aveugles, Hôpital Ophtalmique Jules Gonin, Avenue de France 15, 1004 Lausanne, Switzerland.
| | - Mirjam Münch
- Solar Energy and Building Physics Laboratory, ENAC, Swiss Federal Institute of Technology Lausanne, Station 18, 1015 Lausanne, Switzerland.
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