Empirical model of electro-oculogram

The slow light and dark oscillation of the clinical electro-oculogram

BACKGROUND

The standing potential of the eye exhibits a slow damped oscillation under light and dark conditions that continues for at least 80 minutes. However, our understanding of the relationship between the slow dark and light oscillation has not been previously studied. The aim of this study was to explore through regression analysis a model of these oscillations in order to establish if they may have the same underlying cellular generators.

METHODS

Healthy participants undertook recordings of the standing potential using the electro-oculogram for 100 minutes. To explore the light oscillation, participants (n = 8) were dilated and performed an extended electro-oculogram protocol consisting of 15 minutes dark adaptation and 85 minutes of white light adaptation at 100 cd/m² . For the dark oscillation, participants (n = 11) undertook the electro-oculogram for 100 minutes in complete darkness. Both sessions began with pre-adaptation to 30 cd/m² of white light for five minutes. Non-parametric statistics were used to evaluate all data.

RESULTS

Ratios of the dark and light oscillations showed a significantly greater dampening of the dark oscillation compared to the light oscillation (p < 0.000). Regression analysis using a five-factor damped sine function revealed significant differences in the parameters governing the dampening (p = 0.005) and period (p = 0.009) of the functions (R² > 0.874). There were no significant differences in the dark trough amplitude.

CONCLUSION

The results support a different underlying physiological mechanism for the light and dark oscillation of the clinical electro-oculogram. Future work will need to establish how the dark oscillation and dark trough of the clinical electro-oculogram arise.

Alcohol- and light-induced electro-oculographic responses: variability and clinical utility

The alcohol-induced electro-oculographic (EOG) response has been proposed by Arden as an indicator of retinal pigment epithelial (RPE) integrity. We have evaluated the consistency of the alcohol-EOG with respect to clinical applicability and compared this response to the ISCEV-standard EOG. We recorded, in a group of normal subjects (n=29, 14 men with mean age 42+/-11 years and 15 women with mean age 36+/-13 years), the alcohol response to a single oral dose of ethanol at 160 mg/kg (as 40 proof vodka, drunk in 15 s after 12 h of fasting), followed by an ISCEV-standard EOG 90 min after alcohol administration. Blood alcohol levels were monitored at regular intervals with a breath analyzer. We found a wide range of amplitudes in both light and alcohol responses among participants, from minimal to large values. Subjects had a wide range of blood alcohol concentrations from 0.02 to 0.10%; near the time of the response peak, but there was no relationship between alcohol levels and peak/baseline ratios. In addition, there was no relationship between alcohol peak/baseline ratio and the Arden ratio. Neither the alcohol nor the light response parameters showed any relationship with age or gender. Some of the inter-individual variability in the EOG response to alcohol may reflect variable absorption of oral alcohol. The alcohol-induced EOG has too broad a range of responses to be useful clinically for the one-time evaluation of individual patients. We have similar concerns regarding clinical applications of the standard light-induced EOG.

Retinal pigment epithelium response and the use of the EOG and Arden Ratio in depression

Supersensitivity to light in depression has been observed with both neuroendocrine and ophthalmological assessment methods. The biological defect underlying this abnormality may be localized in either the photoreceptors, the retinal pigmented epithelium, or some interaction of the two. The present study assessed responses of the retinal pigmented epithelium (RPE). All subjects underwent thorough ophthalmological and mood assessments. The electrooculogram (EOG) was used to measure standing potentials of the RPE in response to light and dark in 20 normal controls and 20 unmedicated depressed patients. Both groups were matched for age, sex, time of day for the procedure, and prior lighting history. Reproducibility of the EOG measure on two independent occasions for 13 control subjects had an intrasubject reliability coefficient of 0.70. The mean +/- SD Arden Ratio (light peak/dark trough) of the control group (2.13 +/- 0.42) compared to the depressed group (2.28 +/- 0.72) showed no statistical difference. There was, however, a significant difference between groups in response to darkness; depressed patients had a lower standing potential in the dark compared to controls, suggesting supersensitivity to light. No difference between groups was detected in standing potentials at baseline or in response to light. Supersensitivity to light in depression may be related to abnormal function of the RPE, but the inherent reliability of the EOG precludes the use of this instrument in pursuing this hypothesis.

The electro-oculogram in human retinal detachment

Thirteen patients with retinal detachment and surgical reattachment were studied with preoperative and multiple postoperative electro-oculograms. The light rise was reduced to a mean of 1.17 with detachment but recovered in 77% to a 1.87 ratio, the equivalent of the control eye. This recovery was complete within 66 days in 80% of patients who eventually did return to normal. This rapid recovery parallels the rapid return of anatomical, biochemical, and electrophysiological function demonstrated in experimental detachment.

Normal values in clinical electrooculography. IV. Analysis of two dimensionless EOG parameters and their relation to other variables

Two EOG parameters - The Arden ratio (A) and an expression devised by Gliem (G) - from a sample of normal human subjects are studied. Their relations to the EOG potential and time parameters and to sex, age, pupillary diameter, degree of iris pigmentation, refractive error and axial length, ocular protrusion and interpupillary distance were assessed. Right eye and left eye distributions were congruent, although individual differences were sometimes appreciable, especially in the case of G. The two ratios were positively correlated and both showed a negative correlation to the interval between the dark trough and the light peak. Correlations to the EOG potential parameters, especially the light induced potential rise of the dark adapted eye, were also established. In the case of A, a higher level was disclosed in the male half of the sample. A negative age correlation, predominant in the female part of the sample, characterized both ratios. The two ratios were positively correlated to the pupil diameter, negatively correlated to the degree of refractive errror, and positively correlated to the degree of ocular protrusion. The consequences for the clinical EOG test are discussed, and it is concluded that the present EOG procedure is a qualitative rather than a quantitative test.