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Jolly JK, Matsumoto C, Hamilton R. The IPS and ISCEV joint guidelines for full-field stimulus testing. Doc Ophthalmol 2024; 148:1-2. [PMID: 38353842 DOI: 10.1007/s10633-024-09966-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Affiliation(s)
- J K Jolly
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK.
| | - C Matsumoto
- Department of Ophthalmology, Kindai University, Osakasayama, Japan
| | - R Hamilton
- Department of Clinical Physics and Bioengineering, Royal Hospital for Children, NHS Greater Glasgow and Clyde, Glasgow, UK
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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2
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Kaggwa MM, Prat S, Davids A, Robbins A, Erb B, Mamak M, Chaimowitz GA, Olagunju AT. Electroretinography and suicidal behaviors: a systematic review. BMC Psychiatry 2023; 23:948. [PMID: 38102572 PMCID: PMC10724949 DOI: 10.1186/s12888-023-05453-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/10/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Electroretinogram (ERG) is one of the tools used to investigate the electrophysiological underpinnings of mental health illnesses and major clinical phenomena (e.g., suicide) to improve their diagnosis and care. While multiple studies have reported specific ERG changes among individuals with suicidal behaviors, we know of no review that has been done to characterize their findings to inform future research. METHODS This review included available literature concerning ERG and suicidal behaviors. The paper's first section briefly overviews the theoretical basis of ERG and neurotransmitters involved in suicidal behaviors. The second section describes the findings of a review of studies reporting ERG findings among individuals with suicidal behaviors. RESULTS Most reviewed studies reported normal amplitude and implicit time of the a-waves, but the latency in individuals with suicidal behaviors was lower than normal. Additionally, the b-waves amplitude was reduced, but the implicit time and latency were increased. The b-a amplitude ratio and oscillatory potential were decreased. CONCLUSION Despite identifying certain ERG correlates with suicidal behaviors in the existing studies, there is a need for adequately powered and methodologically robust studies to advance clinical translation.
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Affiliation(s)
- Mark Mohan Kaggwa
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
- Forensic Psychiatry Program, St. Joseph's Healthcare, Hamilton, ON, Canada.
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda.
| | - Sebastien Prat
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Forensic Psychiatry Program, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - Arianna Davids
- Forensic Psychiatry Program, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - Amara Robbins
- Forensic Psychiatry Program, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - Bailea Erb
- Forensic Psychiatry Program, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - Mini Mamak
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Forensic Psychiatry Program, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - Gary Andrew Chaimowitz
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Forensic Psychiatry Program, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - Andrew T Olagunju
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Forensic Psychiatry Program, St. Joseph's Healthcare, Hamilton, ON, Canada
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, 5000, Australia
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3
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Dhillon HK, Agarkar S, Vijaya1 L, Bhende M, Baskaran M, Jaichandran VV. Examination under anesthesia: Preferred Practice. Indian J Ophthalmol 2023; 71:3438-3445. [PMID: 37870002 PMCID: PMC10752321 DOI: 10.4103/ijo.ijo_3259_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 06/18/2023] [Accepted: 06/22/2023] [Indexed: 10/24/2023] Open
Abstract
Pediatric ocular examinations are often a challenge in the outpatient setting due to limited cooperation of the child. Hence an evaluation under anesthesia (EUA) or sedation is important for a holistic ophthalmic examination. It can be combined with short procedures, such as suture removal and corneal scrappings, both for diagnosis and for the management of several ophthalmic disorders. It can also be performed before planning a surgical intervention to record the baseline characters and formulate or refine a surgical plan. Every EUA must be used as a chance to perform a complete ophthalmic examination rather than perform a single task such as recording the intraocular pressure. This article aims to provide a protocol that can be followed for a complete EUA.
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Affiliation(s)
- Hennaav Kaur Dhillon
- Department of Pediatric Ophthalmology and Strabismus, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Sumita Agarkar
- Department of Pediatric Ophthalmology and Strabismus, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Lingam Vijaya1
- Department of Pediatric Ophthalmology and Strabismus, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Muna Bhende
- Shri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Mani Baskaran
- Smt Jadhavbai Nathmal Singhvee Glaucoma Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - VV Jaichandran
- Department of Anaesthesia, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
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4
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Constable PA, Lim JKH, Thompson DA. Retinal electrophysiology in central nervous system disorders. A review of human and mouse studies. Front Neurosci 2023; 17:1215097. [PMID: 37600004 PMCID: PMC10433210 DOI: 10.3389/fnins.2023.1215097] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 07/17/2023] [Indexed: 08/22/2023] Open
Abstract
The retina and brain share similar neurochemistry and neurodevelopmental origins, with the retina, often viewed as a "window to the brain." With retinal measures of structure and function becoming easier to obtain in clinical populations there is a growing interest in using retinal findings as potential biomarkers for disorders affecting the central nervous system. Functional retinal biomarkers, such as the electroretinogram, show promise in neurological disorders, despite having limitations imposed by the existence of overlapping genetic markers, clinical traits or the effects of medications that may reduce their specificity in some conditions. This narrative review summarizes the principal functional retinal findings in central nervous system disorders and related mouse models and provides a background to the main excitatory and inhibitory retinal neurotransmitters that have been implicated to explain the visual electrophysiological findings. These changes in retinal neurochemistry may contribute to our understanding of these conditions based on the findings of retinal electrophysiological tests such as the flash, pattern, multifocal electroretinograms, and electro-oculogram. It is likely that future applications of signal analysis and machine learning algorithms will offer new insights into the pathophysiology, classification, and progression of these clinical disorders including autism, attention deficit/hyperactivity disorder, bipolar disorder, schizophrenia, depression, Parkinson's, and Alzheimer's disease. New clinical applications of visual electrophysiology to this field may lead to earlier, more accurate diagnoses and better targeted therapeutic interventions benefiting individual patients and clinicians managing these individuals and their families.
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Affiliation(s)
- Paul A. Constable
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Jeremiah K. H. Lim
- Discipline of Optometry, School of Allied Health, University of Western Australia, Perth, WA, Australia
| | - Dorothy A. Thompson
- The Tony Kriss Visual Electrophysiology Unit, Clinical and Academic Department of Ophthalmology, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
- UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
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5
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Heath Jeffery RC, Thompson JA, Lo J, Lamey TM, McLaren TL, De Roach JN, Azamanov DN, McAllister IL, Constable IJ, Chen FK. SIBLING CONCORDANCE IN SYMPTOM ONSET AND ATROPHY GROWTH RATES IN STARGARDT DISEASE USING ULTRA-WIDEFIELD FUNDUS AUTOFLUORESCENCE. Retina 2022; 42:1545-1559. [PMID: 35344533 PMCID: PMC9301984 DOI: 10.1097/iae.0000000000003477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To investigate concordance in symptom onset, area of dark autofluorescence (DAF), and growth rate (GR) between Stargardt disease siblings at an age-matched time point. METHODS In this retrospective longitudinal study of sibling pairs with identical biallelic ABCA4 variants, age at symptom onset, best-corrected visual acuity, atrophy area, and effective radius of DAF on ultra-widefield fundus autofluorescence were recorded. Absolute intersibling differences for both eyes were compared with absolute interocular differences using the Mann-Whitney test. RESULTS Overall 39 patients from 19 families were recruited. In 16 families, age-matched best-corrected visual acuity and DAF were compared between siblings. In 8 families, DAF GR was compared. The median (range) absolute difference in age at symptom onset between siblings was 3 (0-35) years. Absolute intersibling differences in age-matched best-corrected visual acuity were greater than interocular differences ( P = 0.01). Similarly, absolute intersibling differences in DAF area and radius were greater than interocular differences ( P = 0.04 for area and P = 0.001 for radius). Differences between absolute interocular and intersibling GR were not statistically significant ( P = 0.44 for area GR and P = 0.61 for radius GR). CONCLUSION There was significant discordance in age-matched best-corrected visual acuity and DAF beyond the expected limits of interocular asymmetry. Lack of significant intersibling differences in GR warrants further investigation.
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Affiliation(s)
- Rachael C. Heath Jeffery
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Australia
- Department of Ophthalmology, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Jennifer A. Thompson
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Johnny Lo
- School of Science, Edith Cowan University, Perth, Western Australia, Australia
| | - Tina M. Lamey
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Australia
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Terri L. McLaren
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Australia
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - John N. De Roach
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Australia
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Dimitar N. Azamanov
- Department of Diagnostic Genomics, PathWest, Perth, Western Australia, Australia
| | - Ian L. McAllister
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Australia
| | - Ian J. Constable
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Australia
| | - Fred K. Chen
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Australia
- Department of Ophthalmology, Royal Perth Hospital, Perth, Western Australia, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Victoria, Australia; and
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Message from the editor. Doc Ophthalmol 2022; 144:163-164. [PMID: 35594007 DOI: 10.1007/s10633-022-09877-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Robson AG, Frishman LJ, Grigg J, Hamilton R, Jeffrey BG, Kondo M, Li S, McCulloch DL. ISCEV Standard for full-field clinical electroretinography (2022 update). Doc Ophthalmol 2022; 144:165-177. [PMID: 35511377 PMCID: PMC9192408 DOI: 10.1007/s10633-022-09872-0] [Citation(s) in RCA: 200] [Impact Index Per Article: 100.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 03/14/2022] [Indexed: 11/26/2022]
Abstract
The full-field electroretinogram (ERG) is a mass electrophysiological response to diffuse flashes of light and is used widely to assess generalized retinal function. This document, from the International Society for Clinical Electrophysiology of Vision (ISCEV), presents an updated and revised ISCEV Standard for clinical ERG testing. Minimum protocols for basic ERG stimuli, recording methods and reporting are specified, to promote consistency of methods for diagnosis, monitoring and inter-laboratory comparisons, while also responding to evolving clinical practices and technology. The main changes in this updated ISCEV Standard for clinical ERGs include specifying that ERGs may meet the Standard without mydriasis, providing stimuli adequately compensate for non-dilated pupils. There is more detail about analysis of dark-adapted oscillatory potentials (OPs) and the document format has been updated and supplementary content reduced. There is a more detailed review of the origins of the major ERG components. Several tests previously tabulated as additional ERG protocols are now cited as published ISCEV extended protocols. A non-standard abbreviated ERG protocol is described, for use when patient age, compliance or other circumstances preclude ISCEV Standard ERG testing.
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Affiliation(s)
- Anthony G Robson
- Department of Electrophysiology, Moorfields Eye Hospital, 162 City Road, London, EC1V2PD, UK.
- Institute of Ophthalmology, University College London, London, UK.
| | | | - John Grigg
- Save Sight Institute Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Ruth Hamilton
- Department of Clinical Physics and Bioengineering, Royal Hospital for Children, NHS Greater Glasgow and Clyde, Glasgow, UK
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Brett G Jeffrey
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, National Institutes of Health, Bethesda, MD, 20892-1860, USA
| | - Mineo Kondo
- Mie University Graduate School of Medicine, Tsu, Japan
| | - Shiying Li
- Department of Ophthalmology, Xiang'an Hospital of Xiamen University, Fujian, China
- Eye Institute of Xiamen University (EIXU), Fujian, China
| | - Daphne L McCulloch
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Canada
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8
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Dalma-Weiszhausz J, Chacón-Camacho O, Chevez-Barrios P, Zenteno JC, Franco-Cárdenas V, García-Montaño LA, Pérez-Bravo J, García-Montalvo IA, Jiménez-Sierra JM, Dalma A. AUTOSOMAL DOMINANT MÜLLER CELL SHEEN DYSTROPHY: Clinical, Histopathologic, and Genetic Assessment in an Extended Family With Long Follow-Up. Retina 2022; 42:981-991. [PMID: 35125479 DOI: 10.1097/iae.0000000000003413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Autosomal dominant Müller cell dystrophy is a rare condition we described in 1991. It is characterized by a striking sheen appearance on the retinal surface with progressive retinal changes leading to disorganization and atrophy with a decreased b-wave electroretinograms. MATERIALS AND METHODS We examined 45 members of a 4-generation family. Fifteen subjects from three generations were found with the disease, without gender predilection. Seven patients underwent ophthalmic examination including fundus examination, intravenous fluorescein angiogram, spectral-domain optical coherence tomography, and electroretinogram. Six patients have a 30-year follow-up. Histopathology examination was performed on eyes of the eldest patient. Whole exome sequencing was done in four affected subjects. RESULTS Findings include a decreased visual acuity, abnormal cellophane-like sheen of the vitreoretinal interface, a "plush" nerve fiber layer, and characteristic macular changes. Electroretinogram showed a selective b-wave diminution. Intravenous fluorescein angiogram presented perifoveal hyperfluorescence and capillary leakage. Spectral-domain optical coherence tomography revealed cavitations involving inner and later outer retinal layers with later disorganization. Histopathologic findings included Müller cell abnormalities with cystic disruption of inner retinal layers, pseudoexfoliation in anterior segment, and amyloidosis of extraocular vessels. Pedigree analysis suggests an autosomal dominant inheritance with late onset. DNA analysis demonstrated a previously undescribed heterozygous missense p.Glu109Val mutation in transthyretin. CONCLUSION To the best of our knowledge, this is the first family reported with this disorder. Our data support the hypothesis that autosomal dominant Müller cell dystrophy is a distinct retinal dystrophy affecting Müller cells. Mutations in transthyretin gene may manifest as a predominantly retinal disorder.
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Affiliation(s)
- José Dalma-Weiszhausz
- Dr. Alejandro Dalma y Asociados, SC Mexico City, Mexico
- Retina Department, Asociación para Evitar la Ceguera en México, Mexico City, Mexico
| | - Oscar Chacón-Camacho
- Genetics Department, Instituto de Oftalmología "Conde de Valenciana", Mexico City, Mexico . Mr. García-Montaño is now with the Department of Cell Biology and Physiology, Brain Tumor Translational Laboratory, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
- Carrera Médico Cirujano, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México
| | | | - Juan C Zenteno
- Genetics Department, Instituto de Oftalmología "Conde de Valenciana", Mexico City, Mexico . Mr. García-Montaño is now with the Department of Cell Biology and Physiology, Brain Tumor Translational Laboratory, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
- Biochemistry Department, Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico; and
| | - Valentina Franco-Cárdenas
- Dr. Alejandro Dalma y Asociados, SC Mexico City, Mexico
- Retina Department, Asociación para Evitar la Ceguera en México, Mexico City, Mexico
- Genetics Department, Instituto de Oftalmología "Conde de Valenciana", Mexico City, Mexico . Mr. García-Montaño is now with the Department of Cell Biology and Physiology, Brain Tumor Translational Laboratory, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
- Carrera Médico Cirujano, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
- Biochemistry Department, Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico; and
- División de Estudios de Posgrado e Investigación, Tecnológico Nacional de México Campus Oaxaca (TECNM/ITO), Oaxaca, Mexico
| | - Leopoldo A García-Montaño
- Genetics Department, Instituto de Oftalmología "Conde de Valenciana", Mexico City, Mexico . Mr. García-Montaño is now with the Department of Cell Biology and Physiology, Brain Tumor Translational Laboratory, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
- División de Estudios de Posgrado e Investigación, Tecnológico Nacional de México Campus Oaxaca (TECNM/ITO), Oaxaca, Mexico
| | - Jehieli Pérez-Bravo
- Genetics Department, Instituto de Oftalmología "Conde de Valenciana", Mexico City, Mexico . Mr. García-Montaño is now with the Department of Cell Biology and Physiology, Brain Tumor Translational Laboratory, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - Iván A García-Montalvo
- División de Estudios de Posgrado e Investigación, Tecnológico Nacional de México Campus Oaxaca (TECNM/ITO), Oaxaca, Mexico
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Contactless measurements of retinal activity using optically pumped magnetometers. Neuroimage 2021; 243:118528. [PMID: 34464740 DOI: 10.1016/j.neuroimage.2021.118528] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/20/2021] [Accepted: 08/27/2021] [Indexed: 11/23/2022] Open
Abstract
Optically pumped magnetometers (OPMs) have been adopted for the measurement of brain activity. Without the need to be cooled to cryogenic temperatures, an array of these sensors can be placed more flexibly, which allows for the recording of neuronal structures other than neocortex. Here we use eight OPM sensors to record human retinal activity following flash stimulation. We compare this magnetoretinographic (MRG) activity to the simultaneously recorded electroretinogram of the eight participants. The MRG shows the familiar flash-evoked potentials (a-wave and b-wave) and shares a highly significant amount of information with the electroretinogram (both in a simultaneous and separate measurement). We conclude that OPM sensors have the potential to become a contactless alternative to fiber electrodes for the measurement of retinal activity. Such a contactless solution can benefit both clinical and neuroscientific settings.
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Wang P, Jia X, Xiao X, Li S, Long Y, Liu M, Li Y, Li J, Xu Y, Zhang Q. An Early Diagnostic Clue for COL18A1- and LAMA1-Associated Diseases: High Myopia With Alopecia Areata in the Cranial Midline. Front Cell Dev Biol 2021; 9:644947. [PMID: 34249907 PMCID: PMC8267009 DOI: 10.3389/fcell.2021.644947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 05/20/2021] [Indexed: 11/13/2022] Open
Abstract
Background High myopia with alopecia areata in the occipital region has been observed in patients with Knobloch syndrome caused by COL18A1 mutations. This study investigated other possible genetic causes of high myopia in patients with alopecia areata in the cranial midline. Methods Six patients with early onset high myopia and alopecia areata in the cranial midline were recruited. Targeted high-throughput sequencing was performed on the proband’s DNA to detect potential pathogenic variants. Cosegregation analysis was performed for available family members. Minigene assay and RNA Sequencing were used to validate the abnormality of possible splicing change and gross deletion. Ophthalmological and neuroimaging examinations were performed. Results Eight novel and one known loss-of-function mutants were detected in all six patients, including a gross deletion detected by RNA sequencing. Four COL18A1 mutants in three patients with scalp leisure in the occipital region; and five LAMA1 mutations in three patients with scalp leisure in the parietal region. Further assessments indicated that patients with COL18A1 mutations had Knobloch syndrome, and the patients with LAMA1 mutations had Poretti–Boltshauser syndrome. Conclusion Our study found that early onset high myopia with midline alopecia areata could be caused not only by mutations of the COL18A1 gene but also by mutations in the LAMA1 gene. To our knowledge, we are the first to observe scalp defects in patients with LAMA1 mutations. High myopia with alopecia areata in the cranial midline could be treated as an early diagnostic clue for ophthalmologists to consider the two kinds of rare diseases.
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Affiliation(s)
- Panfeng Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xiaoyun Jia
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xueshan Xiao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Shiqiang Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yuxi Long
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Mengchu Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yongyu Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jun Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yan Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Reproductive Medicine, Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qingjiong Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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11
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Clinical electrophysiology of vision-commentary on current status and future prospects. Eye (Lond) 2021; 35:2341-2343. [PMID: 34045684 PMCID: PMC8376889 DOI: 10.1038/s41433-021-01592-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/17/2021] [Accepted: 04/30/2021] [Indexed: 11/25/2022] Open
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12
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Pappalardo J, Heath Jeffery RC, Thompson JA, Chelva E, Pham Q, Constable IJ, McLaren TL, Lamey TM, De Roach JN, Chen FK. A novel phenotype in a family with autosomal dominant retinal dystrophy due to c.1430A > G in retinoid isomerohydrolase (RPE65) and c.37C > T in bestrophin 1 (BEST1). Doc Ophthalmol 2021; 143:61-73. [PMID: 33512609 DOI: 10.1007/s10633-021-09819-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 01/08/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE The c.1430A > G (Asp477Gly) variant in RPE65 has been reported in Irish and Scottish families with either an autosomal dominant retinal dystrophy (adRD) that resembles choroideremia, a vitelliform macular dystrophy or an isolated macular atrophy. We report novel features on multimodal imaging and the natural history of a family harbouring this variant in combination with the BEST1 c.37C > T (Arg13Cys) variant. METHODS Members of a family with an adRD were examined clinically to ascertain phenotype and underwent genetic testing. Multimodal imaging included widefield colour fundus photography, quantitative autofluorescence (qAF) and spectral domain optical coherence tomography. Electrophysiology and microperimetry were also performed. RESULTS Vision loss was attributed to foveal atrophy in the proband and choroidal neovascularisation and a vitello-eruptive lesion in one affected son. Peripheral retinal white dots corresponding to subretinal deposits were seen in three patients. The median qAF8 values in the proband (I:1) were low (40 and 101 in OD and OS) at age 79. Similarly, the qAF8 values for the middle son (II:2) were also low (100 and 87 in ODS and OS) at age 60. Electrophysiology showed disproportionate reduction in Arden ratio prior to the gradual loss of full-field responses. Microperimetry demonstrated an enlarging scotoma in the proband. CONCLUSIONS The coexistence of the pathogenic BEST1 c.37C > T variant may modify clinical features observed in RPE65 adRD. This study expands our understanding of RPE65 adRD as a retinoid cycle disorder supported by the reduced qAF, fine white retinal dots and corresponding subretinal deposits on OCT in affected members.
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Affiliation(s)
- Juanita Pappalardo
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, 2 Verdun Street, Nedlands, WA, Australia
| | - Rachael C Heath Jeffery
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, 2 Verdun Street, Nedlands, WA, Australia.,Department of Ophthalmology, Royal Perth Hospital, Perth, WA, Australia
| | - Jennifer A Thompson
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Enid Chelva
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Quang Pham
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, 2 Verdun Street, Nedlands, WA, Australia
| | - Ian J Constable
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, 2 Verdun Street, Nedlands, WA, Australia
| | - Terri L McLaren
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, 2 Verdun Street, Nedlands, WA, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Tina M Lamey
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, 2 Verdun Street, Nedlands, WA, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - John N De Roach
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, 2 Verdun Street, Nedlands, WA, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Fred K Chen
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, 2 Verdun Street, Nedlands, WA, Australia. .,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia. .,Department of Ophthalmology, Royal Perth Hospital, Perth, WA, Australia. .,Department of Ophthalmology, Perth Children's Hospital, Nedlands, WA, Australia.
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13
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Pappalardo J, Heath Jeffery RC, Thompson JA, Charng J, Chelva ES, Constable IJ, McLaren TL, Lamey TM, De Roach JN, Chen FK. Progressive sector retinitis pigmentosa due to c.440G>T mutation in SAG in an Australian family. Ophthalmic Genet 2020; 42:62-70. [PMID: 33047631 DOI: 10.1080/13816810.2020.1832533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Heterozygous c.440 G > T mutation in the S-antigen visual arrestin (SAG) gene has been described as a cause of autosomal dominant retinitis pigmentosa (adRP) in a series of patients of Hispanic origin. This study presents the early and late clinical features and disease progression rates in an Australian family with SAG adRP. MATERIALS AND METHODS An observational case series of four family members with adRP. They were examined clinically, with multi-modal retinal imaging and electroretinography (ERG) to ascertain phenotype. Disease progression rate was measured using optical coherence tomography (OCT) and fundus autofluorescence (FAF). A retinal dystrophy panel was used for the proband and cascade testing with targeted Sanger sequencing was conducted in other available family members. RESULTS The proband presented at 36 years of age with profoundly reduced full-field ERG responses despite a sector RP phenotype. This progressed to a classic RP pattern over several decades leaving a small residual island of central visual field. The horizontal span of the residual outer nuclear layer and the area of hyperautofluorescent ring contracted at a rate of 8-11% and 9-14% per year, respectively. DNA sequencing confirmed the segregation of SAG c.440 G > T mutation with disease. CONCLUSION SAG adRP presents with a reduced full-field ERG response consistent with a rod-cone dystrophy in mid-life despite a sector RP phenotype. Centripetal progression of the disease into the macula can be tracked by OCT and FAF imaging.
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Affiliation(s)
- Juanita Pappalardo
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia , Nedlands, Australia
| | - Rachael C Heath Jeffery
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia , Nedlands, Australia
| | - Jennifer A Thompson
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital , Perth, Australia
| | - Jason Charng
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia , Nedlands, Australia
| | - Enid S Chelva
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital , Perth, Australia
| | - Ian J Constable
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia , Nedlands, Australia
| | - Terri L McLaren
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia , Nedlands, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital , Perth, Australia
| | - Tina M Lamey
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia , Nedlands, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital , Perth, Australia
| | - John N De Roach
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia , Nedlands, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital , Perth, Australia
| | - Fred K Chen
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia , Nedlands, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital , Perth, Australia.,Department of Ophthalmology, Royal Perth Hospital , Perth, Australia.,Department of Ophthalmology, Perth Children's Hospital , Nedlands, Australia
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Bach M, Meroni C, Heinrich SP. ERG shrinks by 10% when reducing dark adaptation time to 10 min, but only for weak flashes. Doc Ophthalmol 2020; 141:57-64. [PMID: 31997114 PMCID: PMC7347516 DOI: 10.1007/s10633-020-09751-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 01/17/2020] [Indexed: 01/10/2023]
Abstract
PURPOSE To compare dark-adapted (DA) ERG between 10, 15 and 20 min of dark adaptation (DA). METHODS In a counterbalanced random block design, 40 healthy adult subjects were dark-adapted for 10, 15 or 20 min before we recorded ERGs to nine flash strengths from 0.001 to 10.0 cd s/m2 (dilated pupils) with a DTL-like electrode. Before and between sessions, the room was lit. Apart from choosing a wider range of stimulus strengths, and adding shorter DA times, the recordings fully complied with the ISCEV ERG Standard, namely using corneal electrodes, mydriasis and a standard DA sequence. RESULTS The a-wave amplitude was not affected by any adaptation condition. For the b-wave amplitude, effects of reduced DA time are stronger for weaker flashes: Reducing DA from 20 to 10 min had no measurable effect on the DA 3 ERG, but reduced the DA 0.01 b-wave significantly (p < 0.0001) to 87 ± 2% (mean ± SEM). The DA 0.001 b-wave (not part of the ISCEV ERG Standard) was more affected (down to 72 ± 4%). There was a small, but significant, increase, only for weak flashes, in a- and b-wave peak times for 20 compared to 10-min dark adaptation time. CONCLUSION Reducing dark adaptation time from 20 to 10 min in normal participants has no effect on the ISCEV DA 3 and DA 10 ERG. The reduction in DA 0.01 ERGs to 87 ± 2% agrees with Hamilton and Graham (Doc Ophthalmol 133:11-19, 2016. https://doi.org/10.1007/s10633-016-9554-x ) who found 90 ± 2% and with Asakawa et al. (Doc Ophthalmol 139:33-44, 2019. https://doi.org/10.1007/s10633-019-09693-8 ) who found 83%. Pending verification in pathophysiological states, the current results suggest that one might be able to correct for the 10% amplitude loss when gaining 10 min through shortened DA.
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Affiliation(s)
- Michael Bach
- Eye Center, Medical Center, University of Freiburg, Killianstr. 5, 79106, Freiburg, Germany.
- Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Cornelia Meroni
- Eye Center, Medical Center, University of Freiburg, Killianstr. 5, 79106, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sven P Heinrich
- Eye Center, Medical Center, University of Freiburg, Killianstr. 5, 79106, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
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15
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Kazakos CT, Karageorgiou V. Retinal Changes in Schizophrenia: A Systematic Review and Meta-analysis Based on Individual Participant Data. Schizophr Bull 2020; 46:27-42. [PMID: 31626695 PMCID: PMC7145676 DOI: 10.1093/schbul/sbz106] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Retinal assessment has indicated the presence of neuronal loss in neurodegenerative disorders, but its role in schizophrenia remains unclear. We sought to synthesize the available evidence considering 3 noninvasive modalities: optical coherence tomography, electroretinography, and fundus photography, and examine their diagnostic accuracy based on unpublished individual participant data, when provided by the primary study authors. METHODS We searched MEDLINE, SCOPUS, clinicaltrials.gov, PSYNDEX, Cochrane Controlled Register of Trials (CENTRAL), WHO International Clinical Trials Registry Platform, and Google Scholar, up to October 30, 2018. Authors were contacted and invited to share anonymized participant-level data. Aggregate data were pooled using random effects models. Diagnostic accuracy meta-analysis was based on multiple cutoffs logistic generalized linear mixed modeling. This study was registered with PROSPERO, number CRD42018109344. RESULTS Pooled mean differences of peripapillary retinal nerve fiber layer thickness in micrometer between 694 eyes of 432 schizophrenia patients and 609 eyes of 358 controls, from 11 case-control studies, with corresponding 95% confidence intervals (CIs) by quadrant were the following: -4.55, 95% CI: -8.28, -0.82 (superior); -6.25, 95% CI: -9.46, -3.04 (inferior); -3.18, 95% CI: -5.04, -1.31 (nasal); and -2.7, 95% CI: -4.35, -1.04 (temporal). Diagnostic accuracy, based on 4 studies, was fair to poor, unaffected by age and sex; macular area measurements performed slightly better. CONCLUSION The notion of structural and functional changes in retinal integrity of patients with schizophrenia is supported with current evidence, but diagnostic accuracy is limited. The potential prognostic, theranostic, and preventive role of retinal evaluation remains to be examined.
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Affiliation(s)
- Charalampos T Kazakos
- Independent Researcher, Athens, Greece,To whom correspondence should be addressed; tel: +30-694-5351827, fax: +30-210-3618503, e-mail:
| | - Vasilios Karageorgiou
- Second Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
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16
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The photopic negative response of the Light-adapted 3.0 ERG in clinical settings. Doc Ophthalmol 2019; 140:115-128. [DOI: 10.1007/s10633-019-09723-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 09/16/2019] [Indexed: 11/27/2022]
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Kelbsch C, Strasser T, Chen Y, Feigl B, Gamlin PD, Kardon R, Peters T, Roecklein KA, Steinhauer SR, Szabadi E, Zele AJ, Wilhelm H, Wilhelm BJ. Standards in Pupillography. Front Neurol 2019; 10:129. [PMID: 30853933 PMCID: PMC6395400 DOI: 10.3389/fneur.2019.00129] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 01/31/2019] [Indexed: 12/31/2022] Open
Abstract
The number of research groups studying the pupil is increasing, as is the number of publications. Consequently, new standards in pupillography are needed to formalize the methodology including recording conditions, stimulus characteristics, as well as suitable parameters of evaluation. Since the description of intrinsically photosensitive retinal ganglion cells (ipRGCs) there has been an increased interest and broader application of pupillography in ophthalmology as well as other fields including psychology and chronobiology. Color pupillography plays an important role not only in research but also in clinical observational and therapy studies like gene therapy of hereditary retinal degenerations and psychopathology. Stimuli can vary in size, brightness, duration, and wavelength. Stimulus paradigms determine whether rhodopsin-driven rod responses, opsin-driven cone responses, or melanopsin-driven ipRGC responses are primarily elicited. Background illumination, adaptation state, and instruction for the participants will furthermore influence the results. This standard recommends a minimum set of variables to be used for pupillography and specified in the publication methodologies. Initiated at the 32nd International Pupil Colloquium 2017 in Morges, Switzerland, the aim of this manuscript is to outline standards in pupillography based on current knowledge and experience of pupil experts in order to achieve greater comparability of pupillographic studies. Such standards will particularly facilitate the proper application of pupillography by researchers new to the field. First we describe general standards, followed by specific suggestions concerning the demands of different targets of pupil research: the afferent and efferent reflex arc, pharmacology, psychology, sleepiness-related research and animal studies.
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Affiliation(s)
- Carina Kelbsch
- Pupil Research Group, Centre for Ophthalmology, University Hospitals Tübingen, Tübingen, Germany
| | - Torsten Strasser
- Pupil Research Group, Centre for Ophthalmology, University Hospitals Tübingen, Tübingen, Germany
| | - Yanjun Chen
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, AL, United States
| | - Beatrix Feigl
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
- School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
- Queensland Eye Institute, Brisbane, QLD, Australia
| | - Paul D. Gamlin
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Randy Kardon
- Neuro-Ophthalmology Division, University of Iowa and Iowa City VA Healthcare System, Iowa City, LA, United States
| | - Tobias Peters
- Pupil Research Group, Centre for Ophthalmology, University Hospitals Tübingen, Tübingen, Germany
| | - Kathryn A. Roecklein
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Stuart R. Steinhauer
- VA Pittsburgh Healthcare System, VISN 4 MIRECC, University Drive C, Pittsburgh, PA, United States
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Elemer Szabadi
- Developmental Psychiatry, University of Nottingham, Nottingham, United Kingdom
| | - Andrew J. Zele
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, QLD, Australia
| | - Helmut Wilhelm
- Pupil Research Group, Centre for Ophthalmology, University Hospitals Tübingen, Tübingen, Germany
| | - Barbara J. Wilhelm
- Pupil Research Group, Centre for Ophthalmology, University Hospitals Tübingen, Tübingen, Germany
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18
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Abstract
Full-field electroretinography (ERG) belongs to the gold-standard of electrophysiological test systems in ophthalmology and reflects the sum response of the entire retina to light stimulation. The assessment of the retinal function is a fundamental diagnostic technique not only in the clinical ophthalmology it is also indispensable in the ophthalmic research, in particular, in therapeutic approaches where the in vivo follow up of the benefit after treatment is absolutely necessary. Several current therapeutic approaches have demonstrated long-lasting amelioration in respective disease models and show promise for a successful translation to human patients. In this chapter we provide electroretinography protocols of experimental data which may serve as informative features for upcoming gene therapeutic approaches and clinical trials.
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Mari Z, Sagliocco L, Bodis-Wollner I. Retinocortical Gain in the Foveal Pathway: The Effect of Spatial Frequency and Stimulus Size. ACTA ACUST UNITED AC 2016; 32:67-74. [PMID: 11360723 DOI: 10.1177/155005940103200205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The amplitude and the phase of the simultaneously recorded steady-state pattern electroretinogram (PERG) and visual evoked potential (VEP) were evaluated in humans as a function of the vertical diameter (D) of unidimensional Gabor stimuli. In the other dimension, parallel to the horizontal gratings, the patterns all had constant diameter (see Methods and Materials). Spatial frequencies (SFs) of 1 cycle per degree (cpd) and 5.3 cpd were counterphase modulated at a rate of 6.8 Hz. After off-line artifact rejection, the response was subject to Fast Fourier Transformation (FFT). Amplitude and phase of the first and second harmonics of both ERG and VEP were displayed for each SF and stimulus diameter. Both ERG and VEP amplitude were found to increase as a function of D. Using trend analysis we found that ERG amplitude increased linearly as a function of D. VEP amplitude was found to be both linear and cubic, as a function of D. We calculated the ratio of VEP amplitude and ERG amplitude at each D and termed it retinocortical gain (G). G normalized to stimulus area was high for small D and decreased with D independently of SF. Unity gain occurred at stimulus sizes of 6° to 7°. ERG phase was found to be more negative at 5.3 cpd than at 1 cpd. Although no significant difference was found between VEP phases at the two SFs tested, neither ERG nor VEP phase changed as a function of D. The results suggest that retinocortical gain is highest for the foveally centered low spatial frequency small patch Gabors. The results provide support for the notion of the “foveal window” in human vision.
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Affiliation(s)
- Z Mari
- Department of Neurology, State University of New York, Health Science Center at Brooklyn, New York, USA
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20
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Lapkovska A, Palmowski-Wolfe AM, Todorova MG. Comparing DTL microfiber and Neuroline skin electrode in the Mini Ganzfeld ERG. BMC Ophthalmol 2016; 16:137. [PMID: 27491453 PMCID: PMC4974799 DOI: 10.1186/s12886-016-0311-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 07/28/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In infant ERG recordings skin electrodes frequently result in a better compliance. In order to assess the quality of such recordings, we compared the recording characteristics of DTL microfiber and Neuroline surface electrodes using a modified ISCEV protocol in the Mini Ganzfeld ERG. METHODS A prospective cohort study on healthy adult subjects was conducted at the Department of Ophthalmology, University of Basel, Switzerland. Thirty healthy volunteers were tested. The microfiber electrode (DTL Plus Electrode) was placed across the cornea, above the lower eyelid. The Neuroline skin electrode was placed on the surface of the lower lid on the opposite eye. The eye on which each electrode type was placed was randomised. Amplitudes of the rod, standard combined, standard flash cone, light-adapted 3.0 Hz flicker and red cone responses were analysed, as well as their respective implicit times. RESULTS Both electrode recordings showed the same waveform characteristics. Responses with the Neuroline electrode were significantly weaker than those from the DTL electrode. Amplitudes of the rod, standard combined, standard flash cone, light-adapted 3.0 Hz flicker and red cone responses were up to four times larger when recorded with the DTL electrode (p < 0.005, ANOVA). Implicit times of the red cone ERGs were slightly faster for the Neuroline skin electrode recordings (p ≤ 0.039). CONCLUSIONS Comparison of full-field ERG recordings with microfiber DTL and Neuroline skin electrodes showed that DTL electrodes produce larger ERGs. Hence, we provide evidence that both electrode types allow successful full-field ERG recording, although separate normative data for both electrodes are necessary.
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Affiliation(s)
- Anastasia Lapkovska
- Department of Ophthalmology, University of Basel, Mittlere Strasse 91, CH-4031, Basel, Switzerland
| | - Anja M Palmowski-Wolfe
- Department of Ophthalmology, University of Basel, Mittlere Strasse 91, CH-4031, Basel, Switzerland
| | - Margarita G Todorova
- Department of Ophthalmology, University of Basel, Mittlere Strasse 91, CH-4031, Basel, Switzerland.
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Decsi T, Koletzko B. Role of Long-Chain Polyunsaturated Fatty Acids in Early Human Neurodevelopment. Nutr Neurosci 2016; 3:293-306. [DOI: 10.1080/1028415x.2000.11747327] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hamilton R, Graham K. Effect of shorter dark adaptation on ISCEV standard DA 0.01 and DA 3 skin ERGs in healthy adults. Doc Ophthalmol 2016; 133:11-9. [DOI: 10.1007/s10633-016-9554-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 07/04/2016] [Indexed: 12/01/2022]
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Carbamylated erythropoietin mediates retinal neuroprotection in streptozotocin-induced early-stage diabetic rats. Graefes Arch Clin Exp Ophthalmol 2015; 253:1263-72. [DOI: 10.1007/s00417-015-2969-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 01/14/2015] [Accepted: 02/10/2015] [Indexed: 11/28/2022] Open
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Hamilton R, Al Abdlseaed A, Healey J, Neveu MM, Brown L, Keating D, McBain VA, Sculfor D, Thompson DA. Multi-centre variability of ISCEV standard ERGs in two normal adults. Doc Ophthalmol 2015; 130:83-101. [PMID: 25720529 DOI: 10.1007/s10633-014-9471-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 11/12/2014] [Indexed: 10/23/2022]
Abstract
BACKGROUND The reproducibility of an individual's full-field ERG between centres has not previously been investigated. METHODS ERGs were recorded using both silver thread and skin electrodes from the same two normal adult subjects at 15 UK centres using routine, local protocols and a highly standardised, 'ISCEV-specified' protocol matching the values specified in the ISCEV standard; where the ISCEV standard allows options, a single value was chosen. RESULTS Inter-ocular differences were small, and amplitudes were smaller for skin than silver thread electrodes. No centre produced outlying data points, and ERGs across all 15 centres were remarkably similar. Amplitude variability was less for local protocols (using LED flashes) than for the ISCEV-specified protocol using xenon flashes (22 vs. 24 %, p = 0.01), but peak time variability was less for the ISCEV-specified protocol (6.1 vs. 7.4 %, p = 0.001). Only the DA 0.01 ERG correlated with photometric variability. The bifidity of the DA 3 a-wave doubled its peak time variability compared with the DA 10 a-wave. CONCLUSIONS Inter-centre amplitude variability was typically within clinically significant thresholds, suggesting that inter-centre variability with suitable standardisation may not add more to total variability than inter-subject variability. Variability improvements gained by the tighter specifications of the ISCEV-specified protocol were possibly more than lost due to imprecisions of xenon flashtubes. Peak time variability was far lower than amplitude variability, corresponding with acceptable variability of biochemical assays. These results represent a vindication of the existence of an ERG standard and suggest that further standardisation would lend itself to greater reproducibility of ERGs worldwide.
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Affiliation(s)
- R Hamilton
- Department of Clinical Physics, Royal Hospital for Sick Children, NHS Greater Glasgow and Clyde, University of Glasgow, Dalnair Street, Glasgow, G3 8SJ, UK,
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ISCEV Standard for full-field clinical electroretinography (2015 update). Doc Ophthalmol 2014; 130:1-12. [PMID: 25502644 DOI: 10.1007/s10633-014-9473-7] [Citation(s) in RCA: 987] [Impact Index Per Article: 98.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 12/02/2014] [Indexed: 11/27/2022]
Abstract
This document, from the International Society for Clinical Electrophysiology of Vision (ISCEV), presents an updated and revised ISCEV Standard for full-field clinical electroretinography (ffERG or simply ERG). The parameters for Standard flash stimuli have been revised to accommodate a variety of light sources including gas discharge lamps and light emitting diodes. This ISCEV Standard for clinical ERGs specifies six responses based on the adaptation state of the eye and the flash strength: (1) Dark-adapted 0.01 ERG (rod ERG); (2) Dark-adapted 3 ERG (combined rod-cone standard flash ERG); (3) Dark-adapted 3 oscillatory potentials; (4) Dark-adapted 10 ERG (strong flash ERG); (5) Light-adapted 3 ERG (standard flash "cone" ERG); and (6) Light-adapted 30 Hz flicker ERG. ISCEV encourages the use of additional ERG protocols for testing beyond this minimum standard for clinical ERGs.
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Bagheri A, Persano Adorno D, Rizzo P, Barraco R, Bellomonte L. Empirical mode decomposition and neural network for the classification of electroretinographic data. Med Biol Eng Comput 2014; 52:619-28. [PMID: 24923413 DOI: 10.1007/s11517-014-1164-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 05/23/2014] [Indexed: 11/25/2022]
Abstract
The processing of biosignals is increasingly being utilized in ambulatory situations in order to extract significant signals' features that can help in clinical diagnosis. However, this task is hampered by the fact that biomedical signals exhibit a complex behavior characterized by strong nonlinear and non-stationary properties that cannot always be perceived by simple visual examination. New processing methods need be considered. In this context, we propose a signal processing method, based on empirical mode decomposition and artificial neural networks, to analyze electroretinograms, i.e., the retinal response to a light flash, with the aim to detect and classify retinal diseases. The present application focuses on two retinal pathologies: achromatopsia, which is a cone disease, and congenital stationary night blindness, which affects the photoreceptoral signal transmission. The results indicate that, under suitable conditions, the method proposed here has the potential to provide a powerful tool for routine clinical examinations, since it is able to recognize with high level of confidence the eventual presence of one of the two pathologies.
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Affiliation(s)
- Abdollah Bagheri
- Laboratory for Nondestructive Evaluation and Structural Health Monitoring Studies, Department of Civil and Environmental Engineering, University of Pittsburgh, 3700 O'Hara Street, Pittsburgh, PA, 15261, USA
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Abstract
PURPOSE High myopia (HM) is one of the leading causes of irreversible blindness because of its associated complications. Early-onset HM (eoHM) that presents before primary school age may be genetically determined, whereas late-onset HM (loHM) is affected by genetic and environmental factors. Identification of signs that differentiate eoHM from loHM may provide valuable clues toward understanding the molecular basis of HM. METHODS In this study, 42 subjects with HM were recruited, including 32 eoHM (onset age, ≤5 years) and 10 loHM (onset age, 12.4 ± 2.5 years). Clinical data from these two groups were compared, including best visual acuity, refraction, axial length, and electroretinography. RESULTS The mean amplitudes of rod b-wave, maximum a-wave, maximum b-wave, cone a-wave, and cone b-wave of patients with eoHM were 179 ± 72 μv, -158 ± 63 μv, 345 ± 105 μv, -20 ± 11 μv, and 42 ± 21 μv, respectively, whereas those of patients with loHM were 252 ± 77 μv, -235 ± 60 μv, 464 ± 65 μv, -36 ± 9 μv, and 104 ± 26 μv, respectively (p < 0.001). Patients with eoHM had significantly reduced responses of cones and rods, especially cones, as compared with patients with loHM. The cone-rod responses in patients with loHM were within normal range. CONCLUSIONS The findings suggest that cone-rod dysfunction may be a sign for eoHM compared with loHM.
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Birch DG. Surrogate electroretinographic markers for assessing therapeutic efficacy in the retina. Expert Rev Mol Diagn 2014; 4:693-703. [PMID: 15347262 DOI: 10.1586/14737159.4.5.693] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Visual acuity remains the primary surrogate marker for clinical trials in ophthalmology (and the primary outcome for most US Food and Drug Administration applications) due to its long history, ease of measurement and clear relationship to clinically meaningful characteristics of daily life. However, treatment trials are being planned for diseases that are currently untreatable where visual acuity may not be the most appropriate outcome measure. Specialized electroretinographic tests can be powerful surrogate markers in such trials. The selection of outcome measures and surrogate markers depends in part on whether the goal is to preserve remaining vision in a progressive retinal degeneration or to improve vision in an eye that has already undergone extensive degeneration. Among the electroretinographic tests available are those involving the whole retina (full-field electroretinographic), the posterior pole (pattern electroretinographic) or focal areas within the macula (multifocal electroretinographic). The advantages and disadvantages of each will be discussed along with selected applications of each test to a specific category of disease.
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Affiliation(s)
- David G Birch
- Retina Foundation of the Southwest, 9900 N. Central Expressway, No. 400, Dallas, TX 75231, USA.
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Béjar-Cornejo F, Robredo-Torres V. Electrorretinograma estandarizado en pacientes sometidos a vitrectomía por retinopatía diabética proliferativa avanzada. REVISTA MEXICANA DE OFTALMOLOGÍA 2014. [DOI: 10.1016/j.mexoft.2014.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Borràs E, de Sousa Dias M, Hernan I, Pascual B, Mañé B, Gamundi MJ, Delás B, Carballo M. Detection of novel genetic variation in autosomal dominant retinitis pigmentosa. Clin Genet 2013; 84:441-52. [PMID: 23534816 DOI: 10.1111/cge.12151] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 03/22/2013] [Accepted: 03/22/2013] [Indexed: 02/03/2023]
Abstract
We explored an approach to detect disease-causing sequence variants in 448 candidate genes from five index cases of autosomal dominant retinitis pigmentosa (adRP) by sequence DNA capture and next-generation DNA sequencing (NGS). Detection of sequence variants was carried out by sequence capture NimbleGen and NGS in a SOLiD platform. After filtering out variants previously reported in genomic databases, novel potential adRP-causing variants were validated by dideoxy capillary electrophoresis (Sanger) sequencing and co-segregation in the families. A total of 55 novel sequence variants in the coding or splicing regions of adRP candidate genes were detected, 49 of which were confirmed by Sanger sequencing. Segregation of these variants in the corresponding adRP families showed three variants present in all the RP-affected members of the family. A novel mutation, p.L270R in IMPDH1, was found to be disease causing in one family. In another family a variant, p.M96T in the NRL gene was detected; this variant was previously reported as probably causing adRP. However, the previously reported p.A76V mutation in NRL as a cause of RP was excluded by co-segregation in the family. We discuss the benefits and limitations of our approach in the context of mutation detection in adRP patients.
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Barraco R, Persano Adorno D, Brai M, Tranchina L. A comparison among different techniques for human ERG signals processing and classification. Phys Med 2013; 30:86-95. [PMID: 23590981 DOI: 10.1016/j.ejmp.2013.03.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2012] [Revised: 01/23/2013] [Accepted: 03/19/2013] [Indexed: 11/16/2022] Open
Abstract
Feature detection in biomedical signals is crucial for deepening our knowledge about the involved physiological processes. To achieve this aim, many analytic approaches can be applied but only few are able to deal with signals whose time dependent features provide useful clinical information. Among the biomedical signals, the electroretinogram (ERG), that records the retinal response to a light flash, can improve our comprehension of the complex photoreceptoral activities. The present study is focused on the analysis of the early response of the photoreceptoral human system, known as a-wave ERG-component. This wave reflects the functional integrity of the photoreceptors, rods and cones, whose activation dynamics are not yet completely understood. Moreover, since in incipient photoreceptoral pathologies eventual anomalies in a-wave are not always detectable with a "naked eye" analysis of the traces, the possibility to discriminate pathologic from healthy traces, by means of appropriate analytical techniques, could help in clinical diagnosis. In the present paper, we discuss and compare the efficiency of various techniques of signal processing, such as Fourier analysis (FA), Principal Component Analysis (PCA), Wavelet Analysis (WA) in recognising pathological traces from the healthy ones. The investigated retinal pathologies are Achromatopsia, a cone disease and Congenital Stationary Night Blindness, affecting the photoreceptoral signal transmission. Our findings prove that both PCA and FA of conventional ERGs, don't add clinical information useful for the diagnosis of ocular pathologies, whereas the use of a more sophisticated analysis, based on the wavelet transform, provides a powerful tool for routine clinical examinations of patients.
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Affiliation(s)
- R Barraco
- Dipartimento di Fisica e Chimica, Università di Palermo and CNISM, Viale delle Scienze, Ed. 18, I-90128 Palermo, Italy
| | - D Persano Adorno
- Dipartimento di Fisica e Chimica, Università di Palermo and CNISM, Viale delle Scienze, Ed. 18, I-90128 Palermo, Italy.
| | - M Brai
- Dipartimento di Fisica e Chimica, Università di Palermo and CNISM, Viale delle Scienze, Ed. 18, I-90128 Palermo, Italy
| | - L Tranchina
- Laboratorio di Fisica e Tecnologie Relative - UniNetLab, Università di Palermo, Viale delle Scienze, Ed. 18, I-90128 Palermo, Italy
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Itoh Y, Maehara S, Itoh N, Yamashita K, Izumisawa Y. Electroretinography recordings using a light emitting diode active corneal electrode in healthy beagle dogs. J Vet Sci 2013; 14:77-84. [PMID: 23388429 PMCID: PMC3615236 DOI: 10.4142/jvs.2013.14.1.77] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2010] [Revised: 03/27/2012] [Accepted: 04/04/2012] [Indexed: 11/20/2022] Open
Abstract
Electroretinography (ERG) is a well-established diagnostic procedure for objectively evaluating retinal function. In this study, ERG in beagle dogs, which are a popular experimental animal, was performed to determine the normal range of ERG variables and assess differences between the left and right eyes. ERG findings including rod, combined rod-cone, single-flash cone, and 30-Hz flicker responses were recorded with an LED-electrode in 43 sedated beagle dogs. The subjects were divided into young (< 1 year old), adult (1 ˜ 5 years old), and senile animals (≥ 6 years old). Normal ERG ranges were obtained. Significant differences in b-wave amplitude along with b/a ratio of the combined rod-cone response were found between the young and adult animals as well as young and senile dogs. No significant differences were observed between the left and right eyes. ERG variables in beagle dogs differed by age due to age-related retinal changes. Thus, we propose that normal ERG ranges should be determined according to age in each clinic and laboratory using its own equipment because each institution usually has different systems or protocols for ERG testing.
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Affiliation(s)
- Yoshiki Itoh
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, Hokkaido 069-8501, Japan
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Zheng Y, Gu Q, Xu X. Inhibition of ocular neovascularization by a novel peptide derived from human placenta growth factor-1. Acta Ophthalmol 2012; 90:e512-23. [PMID: 22994140 DOI: 10.1111/j.1755-3768.2012.02476.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate the effect of ZY1, a novel 21-amino acid peptide from human placenta growth factor-1 (PlGF-1), against ocular neovascularization, and to study its possible toxicity to the retina and the underlying mechanism of antiangiogenic effect. METHODS MTS assays, a modified Boyden chamber and Matrigel(™) were used to evaluate the effect of ZY1 on the proliferation, migration and tube formation of RF/6A rhesus macaque choroid-retina endothelial cells induced by vascular endothelial growth factor (VEGF) in vitro. The antiangiogenic effect of ZY1 was also studied with corneal micropocket angiogenesis assays and oxygen-induced retinopathy (OIR) assays in mice. Electrophysiological tests and histological examinations were used to study the possible toxicity of ZY1 against mouse neuroretina. Competitive ELISA and Western blotting were performed to elucidate the underlying mechanism of ZY1. RESULTS ZY1 inhibited VEGF-induced RF/6A proliferation, migration and tube formation. It also inhibited ocular neovascularization when applied to the corneal micropocket angiogenesis assays and OIR assays in mice. Electrophysiological tests and histological examinations revealed no evident functional or morphologic abnormalities in mouse neuroretina after ZY1 injection. ZY1 competed for binding to VEGFR-1 against PlGF and VEGF and inhibited VEGFR-1/ERK/AKT activation. CONCLUSION It is concluded that the novel peptide ZY1 is an effective inhibitor of ocular pathologic angiogenesis and may provide a promising alternative for ocular antiangiogenic therapy.
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Affiliation(s)
- Ying Zheng
- Department of Ophthalmology, The First People's Hospital, Shanghai Jiaotong University, Shanghai, China
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Church ML, Norman JC. Electroretinogram responses of the normal thoroughbred horse sedated with detomidine hydrochloride. Vet Ophthalmol 2012; 15 Suppl 2:77-83. [PMID: 22498137 DOI: 10.1111/j.1463-5224.2012.01022.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE The main objective was to record electroretinogram (ERG) parameters of normal thoroughbred mares using the HMsERG, a mini-Ganzfeld electroretinographic unit, and a contact lens electrode. The second objective was to determine whether IV detomidine hydrochloride at 0.015 mg/kg is consistently an effective choice for sedation of horses undergoing this ERG protocol. METHODS The study population consisted of 30 normal thoroughbred mares. ERG data were harvested using a protocol that included three different light intensities (10, 3000, and 10,000 mcd s/m(2)) and a 30-Hz flicker at 3000 mcd s/m(2). RESULTS Mean, median, standard deviation, and estimated normal ranges using the 5-95% of the data for a- and b-wave implicit times (IT), amplitudes (AMP), and b/a ratios were reported. Scotopic results at low intensity (10 mcd s/m(2)) had estimated ranges for b-wave IT of 41.8-72.9 ms and AMP of 19.8-173.3 μV. Middle intensity (3000 mcd s/m(2)) a-wave IT was 13.2-14.7 ms with a-wave AMP of 68.4-144 μV; the b-wave IT was 28.7-41.5 ms with b-wave AMP of 105.7-271.5 μV; and the b/a ratio was 0.95-2.71. The high-intensity (10,000 mcd s/m(2)) average recordings showed an a-wave IT of 13-14.9 ms, a-wave AMP of 85.7-186.8 μV; b-wave IT of 26.6-45.4 ms, b-wave AMP of 104.7-250.6 μV; and a b/a wave ratio of 0.7-2.0. The 30-Hz cone flicker showed an IT of 22.8-28.9 ms and AMP of 44.1-117.1 μV. CONCLUSIONS Results of normal thoroughbred ERG responses are reported. The protocol proved to be simple and safe and provided consistent results.
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Affiliation(s)
- Melanie L Church
- Eye Care for Animals, 13034 W Rancho Santa Fe Blvd, Suite 102, Avondale, AZ 85392, USA.
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Schatz A, Wilke R, Strasser T, Gekeler F, Messias A, Zrenner E. Assessment of "non-recordable" electroretinograms by 9 Hz flicker stimulation under scotopic conditions. Doc Ophthalmol 2011; 124:27-39. [PMID: 22179598 DOI: 10.1007/s10633-011-9302-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Accepted: 12/05/2011] [Indexed: 11/27/2022]
Abstract
To refine methods of electroretinographical (ERG) recording for the analysis of low retinal potentials under scotopic conditions in advanced retinal degenerative diseases. Standard Ganzfeld ERG equipment (Diagnosys LLC, Cambridge, UK) was used in 27 healthy volunteers (mean age 28 ± SD 8.5 years) to define the stimulation protocol. The protocol was then applied in clinical routine and 992 recordings were obtained from patients (mean age 40.6 ± 18.3 years) over a period of 5 years. A blue stimulus with a flicker frequency of 9 Hz was specified under scotopic conditions to preferentially record rod-driven responses. A range of stimulus strengths (0.0000012-6.32 scot. cd s/m² and 6-14 ms flash duration) was tested for maximal amplitudes and interference between rods and cones. Analysis of results was done by standard Fourier Transformation and assessment of signal-to-noise ratio. Optimized stimulus parameters were found to be a time-integrated luminance of 0.012 scot. cd s/m² using a blue (470 nm) flash of 10 ms duration at a repetition frequency of 9 Hz. Characteristic stimulus strength versus amplitude curves and tests with stimuli of red or green wavelength suggest a predominant rod-system response. The 9 Hz response was found statistically distinguishable from noise in 38% of patients with otherwise non-recordable rod responses according to International Society for Clinical Electrophysiology of Vision standards. Thus, we believe this protocol can be used to record ERG potentials in patients with advanced retinal diseases and in the evaluation of potential treatments for these patients. The ease of implementation in clinical routine and of statistical evaluation providing an observer-independent evaluation may further facilitate its employment.
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Affiliation(s)
- Andreas Schatz
- Centre for Ophthalmology, University of Tübingen, Schleichstraße 12-16, 72076 Tübingen, Germany.
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Barraco R, Persano Adorno D, Brai M. An approach based on wavelet analysis for feature extraction in the a-wave of the electroretinogram. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2011; 104:316-324. [PMID: 21689860 DOI: 10.1016/j.cmpb.2011.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2010] [Revised: 01/28/2011] [Accepted: 05/08/2011] [Indexed: 05/30/2023]
Abstract
Most biomedical signals are non-stationary. The knowledge of their frequency content and temporal distribution is then useful in a clinical context. The wavelet analysis is appropriate to achieve this task. The present paper uses this method to reveal hidden characteristics and anomalies of the human a-wave, an important component of the electroretinogram since it is a measure of the functional integrity of the photoreceptors. We here analyse the time-frequency features of the a-wave both in normal subjects and in patients affected by Achromatopsia, a pathology disturbing the functionality of the cones. The results indicate the presence of two or three stable frequencies that, in the pathological case, shift toward lower values and change their times of occurrence. The present findings are a first step toward a deeper understanding of the features of the a-wave and possible applications to diagnostic procedures in order to recognise incipient photoreceptoral pathologies.
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Affiliation(s)
- R Barraco
- Dipartimento di Fisica, Università di Palermo & CNISM Viale delle Scienze Ed. 18, 90128 Palermo, Italy.
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Neveu MM, Dangour A, Allen E, Robson AG, Bird AC, Uauy R, Holder GE. Electroretinogram measures in a septuagenarian population. Doc Ophthalmol 2011; 123:75-81. [PMID: 21814827 DOI: 10.1007/s10633-011-9282-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Accepted: 07/11/2011] [Indexed: 01/23/2023]
Abstract
This study reports electroretinogram (ERG) data in a septuagenarian population. Fifty healthy adults without diabetes or dementia aged 70-79 years underwent standardised electrophysiological testing incorporating current ISCEV Standards as baseline assessment for the OPAL (Older People And n-3 Long-chain polyunsaturated fatty acids) study. These data were compared with those from 53 healthy adults aged 20-50 years. Amplitudes and peak times of the major components were assessed. There were no significant differences in amplitude or peak time between sexes or between eyes. ERG amplitudes were 25-40% smaller and peak-times were longer in the older compared with the younger age group. In all participants, the bright flash ERG b-wave amplitude had the highest variability; the bright flash ERG a-wave peak time had the lowest. ERGs in a septuagenarian age group show 25-40% lower amplitude than those of a 20 to 50-year-old group and are of longer peak time. With an increasingly ageing population involved in clinical trials, and the potential use of ERG in the assessment both of efficacy and safety in forthcoming therapeutic interventions, it is important that the effects of age are given adequate consideration.
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Affiliation(s)
- Magella M Neveu
- Electrophysiology Department, Moorfields Eye Hospital, and Department of Nutrition and Public Health Intervention Research, London School of Hygiene and Tropical Medicine, 162 City Road, London, EC1V 2PD, UK
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Barraco R, Persano Adorno D, Brai M. ERG signal analysis using wavelet transform. Theory Biosci 2011; 130:155-63. [PMID: 21487824 DOI: 10.1007/s12064-011-0124-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2009] [Accepted: 02/14/2011] [Indexed: 11/28/2022]
Abstract
The wavelet analysis is a powerful tool for analyzing and detecting features of signals characterized by time-dependent statistical properties, as biomedical signals. The identification and the analysis of the components of these signals in the time-frequency domain, give meaningful information about the physiological mechanisms that govern them. This article presents the results of the wavelet analysis applied to the a-wave component of the human electroretinogram. In order to deepen and improve our knowledge about the behavior of the early photoreceptoral response, including the possible activation of interactions and correlations among the photoreceptors, we have detected and identified the stable time-frequency components of the a-wave, using six representative values of luminance. The results indicate the occurrence of three frequencies lying in the range 20-200 Hz. The lowest one is attributed to the summed activities of the photoreceptors. The others are weaker and at low luminance one of them does not occur. We relate them to the response of the rods and the cones whose aggregate activities are non-linear and typically exhibit self-organization under selective stimuli. The identification of the stable frequency components and of their times of occurrence helps us to shine light about the complex mechanisms governing the a-wave. The present results are promising toward the assessment of more refined model concerning the photoreceptoral activities.
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Affiliation(s)
- R Barraco
- Dipartimento di Fisica and CNISM-CNR, Viale delle Scienze, Ed.18, Palermo, Italy.
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Kim HD, Park JY, Ohn YH. Clinical applications of photopic negative response (PhNR) for the treatment of glaucoma and diabetic retinopathy. KOREAN JOURNAL OF OPHTHALMOLOGY 2010; 24:89-95. [PMID: 20379458 PMCID: PMC2851008 DOI: 10.3341/kjo.2010.24.2.89] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2009] [Accepted: 03/15/2010] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To determine the clinical utility of using photopic negative response (PhNR) by comparing the parameters for normal, primary open angle glaucoma (POAG) and diabetic retinopathy (DR). METHODS Electroretinography (UTAS E-3000) was performed in 12 normal, 12 POAG, and 12 DR subjects. Amplitudes and implicit times for PhNR were compared among the three groups. The mean deviation (MD) and pattern standard deviation (PSD) were evaluated using standard automated perimetry (SAP). The mean retinal nerve fiber layer (RNFL) thickness and cup-disc ratio were measured using optical coherence tomography. RESULTS The a-waves and b-waves were not different among the three groups. However, compared to normal subjects, the PhNR amplitudes were reduced, and the PhNR implicit times were prolonged in the POAG and DR patients (p<0.001, p<0.001). The MD and RNFL thickness were correlated with the amplitudes and implicit times for the PhNR. CONCLUSIONS PhNR may be useful for the detection of inner retinal dysfunction, which is seen in patients who have glaucoma or diabetic retinopathy.
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Affiliation(s)
- Hoon Dong Kim
- Department of Ophthalmology, Soonchunhyang University College of Medicine, Bucheon, Korea
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Barboni MTS, Ventura DF, Kremers J. Absence of ocular interaction in flicker ERG responses reflecting cone opponent and luminance signals. Doc Ophthalmol 2010; 121:69-75. [PMID: 20358391 DOI: 10.1007/s10633-010-9229-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2009] [Accepted: 03/18/2010] [Indexed: 11/25/2022]
Abstract
The aim of the study was to investigate whether there is an ocular interaction in the flicker ERG responses reflecting luminance and cone opponency in normal human subjects. Flicker ERGs were recorded from one dilated eye of 10 healthy volunteers. Each subject was tested twice: once with and once without occluding the opposite eye. Red and green LEDs were modulated in counterphase in a Ganzfeld stimulator. ERG responses were recorded for different ratios of the modulation in the red and green LEDs and at 12 and 36 Hz. The amplitudes and phases of the fundamental components were compared between the conditions with and without occlusion. The 12-Hz flicker ERGs reflected activity of the cone opponent channel, whereas the 36-Hz data reflected luminance activity. There were no significant differences between the conditions with and without occluding the opposite eye for any of the stimulus protocols. Ocular interaction is absent in flicker ERGs reflecting cone opponent and luminance activity.
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Renault F, Flores-Guevara R, Renaud C, Richard P, Vermersch AI, Gold F. Visual neurophysiological dysfunction in infants exposed to hydroxychloroquine in utero. Acta Paediatr 2009; 98:1500-3. [PMID: 19500079 DOI: 10.1111/j.1651-2227.2009.01379.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM Hydroxychloroquine therapy during pregnancy is thought to be safe for foetuses. Normal visual function has been showed on clinical grounds in infants exposed in utero to hydroxychloroquine, but there are few visual neurophysiological data. Our study was designed to assess retina and visual pathways using electroretinogram and visual evoked potentials in a series of infants born to mothers treated by hydroxychloroquine for connective tissue diseases. METHODS Twenty-one infants (3-7 months of age) were consecutively examined between June 2002 and May 2007. Full-field electroretinogram was recorded by contact lens electrodes and visual evoked potentials were recorded by occipital surface electrodes using flash stimulation in mesopic condition. Analysis was focused on the amplitudes and latencies of the a- and b-waves of electroretinogram and the latency of the P(100) component of visual evoked potentials. RESULTS Electroretinogram abnormalities were detected in six infants, associated with delayed visual evoked potentials in four of them. CONCLUSION Early electroretinogram and visual evoked potentials testing evidenced neurophysiological visual disturbances in a subset of infants born to mothers treated by hydroxychloroquine. Systematic clinical and neurophysiological vision testing during childhood is needed to detect possible consequences of antenatal exposure to hydroxychloroquine.
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Affiliation(s)
- F Renault
- Unité de neurophysiologie clinique, Hôpital Armand-Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France.
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Ozkul Y, Gurler B, Bozlar S, Uckardes A, Karadede S. Flash visual evoked potentials and electroretinograms in migraine. Neuroophthalmology 2009. [DOI: 10.1076/noph.25.3.143.7137] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Lorda-Sanchez I, Ibañez A, Sanz R, Trujillo MJ, Anabitarte M, Querejeta ME, Rodriguez de Alba M, Gimenez A, Infantes F, Ramos C, Garcia-Sandoval B, Ayuso C. Choroideremia, sensorineural deafness, and primary ovarian failure in a woman with a balanced X-4 translocation. Ophthalmic Genet 2009. [DOI: 10.1076/1381-6810(200009)2131-zft185] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
OBJECTIVES To evaluate the auditory, vestibular, and retinal characteristics of a large American DFNA11 pedigree with autosomal dominant progressive sensorineural hearing loss that first impacts the low- and mid-frequency auditory range. The pedigree (referred to as the HL2 family) segregates a myosin VIIA (MYO7A) mutation in exon 17 at DNA residue G2164C (MYO7A) that seems to be influenced by a genetic modifier that either rescues or exacerbates the MYO7A alteration. DNA analysis to examine single-nucleotide polymorphisms in 2 candidate modifier genes (ATP2B2 and Wolfram syndrome 1 [WFS1]) is summarized in this report. STUDY DESIGN Family study. RESULTS The degree of low- and mid-frequency hearing loss in HL2 family members segregating the MYO7A mutation varies from mild to more severe, with approximately the same number of HL2 family members falling at each end of the severity spectrum. The extent of hearing loss in HL2 individuals can vary between family generations. Differences in the degree of hearing loss in MYO7A HL2 family members may be mirrored by vestibular function in at least 2 of these same individuals. The single-nucleotide polymorphisms examined within ATP2B2 and WFS1 did not segregate with the mild versus more severe auditory phenotype. CONCLUSION The severity of the auditory and vestibular phenotypes in MYO7A HL2 family members may run in parallel, suggesting a common modifier gene within the inner ear. The putative MYO7A genetic modifier is likely to represent a common polymorphism that is not linked tightly to the MYO7A mutation on the MYO7A allele.
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Electrophysiology. Ophthalmology 2009. [DOI: 10.1016/b978-0-323-04332-8.00082-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Kim HD, Park SH, Park SE, Ohn YH. Photopic Negative Response (PhNR) in Normal Subjects. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2009. [DOI: 10.3341/jkos.2009.50.10.1531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Hoon Dong Kim
- Department of Ophthalmology, College of Medicine, Soonchunhyang University, Bucheon, Korea
| | - Sang Hyouk Park
- Department of Ophthalmology, College of Medicine, Soonchunhyang University, Gumi, Korea
| | - Su-Eun Park
- Department of Ophthalmology, Gangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea
| | - Young-Hoon Ohn
- Department of Ophthalmology, College of Medicine, Soonchunhyang University, Bucheon, Korea
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ISCEV Standard for full-field clinical electroretinography (2008 update). Doc Ophthalmol 2008; 118:69-77. [PMID: 19030905 DOI: 10.1007/s10633-008-9155-4] [Citation(s) in RCA: 671] [Impact Index Per Article: 41.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2008] [Accepted: 10/29/2008] [Indexed: 10/21/2022]
Abstract
This document, from the International Society for Clinical Electrophysiology of Vision (ISCEV), presents an updated and revised ISCEV Standard for clinical electroretinography (ERG). The parameters for flash stimulation and background adaptation have been tightened, and responses renamed to indicate the flash strength (in cd x s x m(-2)). The ISCEV Standard specifies five responses: (1) Dark-adapted 0.01 ERG (rod response); (2) Dark-adapted 3.0 ERG (combined rod-cone response); (3) Dark-adapted 3.0 oscillatory potentials; (4) Light-adapted 3.0 ERG (cone response); (5) Light-adapted 3.0 flicker (30 Hz flicker). An additional Dark-adapted 10.0 ERG or Dark-adapted 30.0 ERG response is recommended.
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Chao HM, Chen SJ, Hsu WM, Lee FL, Chen KH. Siderosis Oculi: Visual Dysfunctions Even After Iron Removal: A Role of OCT. Cutan Ocul Toxicol 2008; 25:131-40. [PMID: 16835148 DOI: 10.1080/15569520600695702] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Four males with sidersosis oculi were reviewed. Vitreous/anterior chamber angle irons (cases 1 and 3) were misdiagnosed initially and discovered later. In case 2, the retina-incarcerated iron was long ignored. Exceptionally in case 4, the iron was encapsulated by using optical coherence tomography (OCT). Preoperatively, in cases 1 and 4, the injured eye's vision, electro-oculogram, and electroretinogram were reduced compared with the other eye. In three cases, field defects were relevant to their iron locations. Postremoval, iron-impaired retinal functions didn't obviously improve. Early iron removal seems vital. OCT identified iron encapsulation, ameliorating iron toxicity. Consistently, field defect in case 4 was nonprogressive.
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Affiliation(s)
- Hsiao-Ming Chao
- Department of Opthamology, Taipei Veterans General Hospital, Taipei, Taiwan.
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Iino Y, Fujimaki T, Fujiki K, Murakami A. A novel mutation (967-970+2)delAAAGGT in the choroideremia gene found in a Japanese family and related clinical findings. Jpn J Ophthalmol 2008; 52:289-297. [PMID: 18773267 DOI: 10.1007/s10384-008-0564-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2007] [Accepted: 02/22/2008] [Indexed: 10/21/2022]
Abstract
PURPOSE To investigate the choroideremia (CHM) gene of one affected male and one obligate carrier in a Japanese family with choroideremia, and to characterize the related clinical features. METHODS We examined one affected man and one carrier woman from a Japanese family. Genomic DNA was extracted from leukocytes of peripheral blood collected from the affected man and his daughter, who is an obligate carrier of choroideremia. Exons 1-15 of the CHM gene were amplified by polymerase chain reaction (PCR) and directly sequenced. We performed ophthalmic examinations including best-corrected visual acuity, slit-lamp examination, fundus examination, electroretinography, and Goldmann perimetry. RESULTS A novel (967-970+2)delAAAGGT mutation was detected in the CHM gene. The affected man was hemizygous and had night-blindness, chorioretinal atrophy spreading from the posterior pole to the mid-periphery, and bareness of the sclera. His daughter was a heterozygous carrier who had chorioretinal atrophy and mottled appearance of the retinal pigment epithelium. CONCLUSION A novel (967-970+2)delAAAGGT mutation existed in the CHM gene of a Japanese family with choroideremia.
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Affiliation(s)
- Yutaka Iino
- Department of Ophthalmology, Juntendo University School of Medicine, Tokyo, Japan.
| | - Takuro Fujimaki
- Department of Ophthalmology, Juntendo University School of Medicine, Tokyo, Japan
| | - Keiko Fujiki
- Department of Ophthalmology, Juntendo University School of Medicine, Tokyo, Japan
| | - Akira Murakami
- Department of Ophthalmology, Juntendo University School of Medicine, Tokyo, Japan
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