Chapter 2 Retinal pigment epithelial cell contributions to the electroretinogram and electrooculogram

Detection of retinal dysfunction induced by HCN channel inhibitors using multistep light stimulus and long-duration light stimulus ERG in rats

Ivabradine, a hyperpolarization-activated cyclic nucleotide-gated (HCN) channel inhibitor, has been reported to induce photosensitivity-related visual disturbances such as phosphene in humans. Ivabradine-induced visual disturbances are caused by inhibition of HCN channels in the retina, and the mechanisms have been verified using HCN channel knockout mice and electroretinography (ERG). However, in rats, classical ERG using single flash light stimulus with standard analyses of waveform amplitude and latency has not revealed abnormal retinal function after administration of ivabradine. To verify whether retinal dysfunction after ivabradine administration was detectable in rats, we performed ERG using multistep flash light stimulation at the time when plasma concentration of ivabradine was high. Furthermore, the mechanism of the change in the waveform that appeared after the b-wave was investigated. Ivabradine and cilobradine, a selective HCN channel inhibitor, were administered subcutaneously to rats at 4-40 mg/kg as a single dose, and flash or long-duration ERG recordings at each light stimulus luminance were conducted 1.5 h after administration. Plasma and retinal concentrations of both compounds were measured immediately after the ERG recordings. In the flash ERG, prolongation of a- and/or b-wave latencies were detected at each light stimulus, and dose-dependent waveform changes after the b-wave were recorded at the specific light stimulus luminance for both compounds. These ERG changes increased in response to increasing plasma and retinal concentrations for both ivabradine and cilobradine. In the long-duration light stimulus ERG, a change in the waveform of the b-wave trough and attenuation of the c-wave were recorded, suggesting that the feedback control in the photoreceptor cells may be inhibited. This study revealed that the retinal dysfunction by HCN channel inhibitors in rats can be detected by multistep light stimulus ERG. Additionally, we identified that the inhibition of feedback current and the sustained responses in the photoreceptor cells cause the retinal dysfunction of HCN channel inhibitors in rats.

Diabetes-Induced Changes of the Rat ERG in Relation to Hyperglycemia and Acidosis

PURPOSE

To understand the mechanism of changes in the c-wave of the electroretinogram (ERG) in diabetic rats, and to explore how glucose manipulations affect the c-wave.

METHODS

Vitreal ERGs were recorded in control and diabetic Long-Evans rats, 3-60 weeks after IP vehicle or streptozotocin. A few experiments were performed on Brown Norway rats. Voltage responses to current pulses were used to measure the transepithelial resistance of the retinal pigment epithelium (RPE).

RESULTS

During development of diabetes the b-wave amplitude progressively decreased to about half of the initial amplitude after a year. In contrast, the c-wave was strongly affected from the very beginning (3 weeks) of diabetes. In control rats, the c-wave was cornea-positive at lower illuminations but was cornea-negative at higher (photopic) illumination. In diabetics, the whole amplitude-intensity curve was shifted toward negativity. The magnitude of this shift was markedly affected by acute glucose manipulations in diabetics but not in controls. Increased blood glucose made the c-wave more negative, and decreased blood glucose with insulin had the opposite effect. Experimentally induced acidification of the retina had a small effect that was different from diabetes, shifting the c-wave toward positivity, slightly in controls and more noticeably in diabetics. One reason for the significant negativity of the diabetic ERG was a decrease of the cornea-positive response of the RPE due to a decrease of the transepithelial resistance.

CONCLUSIONS

The ERG c-wave is more negative in diabetics than in control animals, and is far more sensitive to changes in blood glucose. The increased negativity is largely if not entirely due to changes in the transepithelial resistance of the RPE, an electrical analog of the breakdown of the blood-retinal barrier observed in other studies. The sensitivity of the c-wave to glucose in diabetics may also be due to changes in transepithelial resistance.

Using Micro-Electrode-Array Recordings and Retinal Disease Models to Elucidate Visual Functions: Simultaneous Recording of Local Electroretinograms and Ganglion Cell Action Potentials Reveals the Origin of Retinal Oscillatory Potentials

BACKGROUND

The electroretinogram (ERG) is an essential diagnostic tool for visual function, both in clinical and research settings. Here, we establish an advanced in vitro approach to assess cell-type-specific ERG signal components.

METHODS

Retinal explant cultures, maintained under entirely controlled conditions, were derived from wild-type mice and rd10 rod- and cpfl1 cone-degeneration mouse models. Local micro-ERG (µERG) and simultaneous ganglion cell (GC) recordings were obtained from the retinal explants using multi-electrode arrays. Band-pass filtering was employed to distinguish photoreceptor, bipolar cell, amacrine cell (AC), and GC responses.

RESULTS

Scotopic and photopic stimulation discriminated between rod and cone responses in wild-type and mutant retina. The 25 kHz sampling rate allowed the visualization of oscillatory potentials (OPs) in extraordinary detail, revealing temporal correlations between OPs and GC responses. Pharmacological isolation of different retinal circuits found that OPs are generated by inner retinal AC electrical synapses. Importantly, this AC activity helped synchronise GC activity.

CONCLUSION

Our µERG protocol simultaneously records the light-dependent activities of the first-, second-, and third-order neurons within the native neuronal circuitry, providing unprecedented insights into retinal physiology and pathophysiology. This method now also enables complete in vitro retinal function testing of therapeutic interventions, providing critical guidance for later in vivo investigations.

Use of an alternating current amplifier when recording the ERG c-wave to evaluate the function of retinal pigment epithelial cells in rats

PURPOSE

We studied the conditions under which c-waves of the electroretinogram (ERG), that represent retinal pigment epithelium (RPE) function, were detectable using an alternating current (AC) amplifier and whether the c-wave recorded using an AC amplifier was useful for evaluating RPE function.

METHODS

We recorded ERG responses in rats to 5 s stimuli under the conditions in which the low-cut frequency and the stimulus luminance were varied. In addition, changes in ERGs were studied after intravenous injection of sodium iodate (SI) to induce RPE degeneration.

RESULTS

The c-wave was detected clearly when the frequency of the low-cut filter was set at 0.01 Hz and light stimulus luminances were ≥ - 1.0 log cd/m². The c-wave was attenuated earlier than other waves (e.g., a-wave and b-wave) after SI administration.

CONCLUSIONS

The c-wave was easily detectable using an AC amplifier with the low-cut filter set at 0.01 Hz. Using the AC amplifier may allow easier c-wave recording, compared with the conventional use of a direct current (DC) amplifier, and could be useful for evaluating RPE function.

Soft Bioelectronics Based on Nanomaterials

Recent advances in nanostructured materials and unconventional device designs have transformed the bioelectronics from a rigid and bulky form into a soft and ultrathin form and brought enormous advantages to the bioelectronics. For example, mechanical deformability of the soft bioelectronics and thus its conformal contact onto soft curved organs such as brain, heart, and skin have allowed researchers to measure high-quality biosignals, deliver real-time feedback treatments, and lower long-term side-effects in vivo. Here, we review various materials, fabrication methods, and device strategies for flexible and stretchable electronics, especially focusing on soft biointegrated electronics using nanomaterials and their composites. First, we summarize top-down material processing and bottom-up synthesis methods of various nanomaterials. Next, we discuss state-of-the-art technologies for intrinsically stretchable nanocomposites composed of nanostructured materials incorporated in elastomers or hydrogels. We also briefly discuss unconventional device design strategies for soft bioelectronics. Then individual device components for soft bioelectronics, such as biosensing, data storage, display, therapeutic stimulation, and power supply devices, are introduced. Afterward, representative application examples of the soft bioelectronics are described. A brief summary with a discussion on remaining challenges concludes the review.

Functional alterations of retinal neurons and vascular involvement progress simultaneously in the Psammomys obesus model of diabetic retinopathy

To investigate the progression of diabetic retinopathy (DR) in a new diurnal animal model, we monitored clinically the DR in Psammomys obesus (P. obesus) during 7 months using electroretinography (ERG) and imaging techniques. After the onset of DR, all ERG components decreased progressively. In scotopic conditions, by 3-months of disease progression, the diabetic P. obesus displayed a significant decrease in amplitude of b-max, b-wave responses, and mixed b-waves. While mixed a-wave decreased between 4 and 7 months. Significant differences of OP2 appeared following 1 month of disease. In photopic conditions, we noticed a decrease in the a-wave at 2 months, while it took more than 5 months in b-wave amplitude. The photopic negative response (PhNR) and the i-wave amplitudes decreased following 4 and 5 months. OP1 and OP2 were the first to be altered and a significant decrease in the amplitude started after 3 months. Finally, 30 Hz-flicker and photopic S-cone were impaired after 2 and 3 months, respectively. The assessment of the eye fundus of the retina revealed an abnormal vascular architecture appeared at Months 6 and 7. In addition, we noticed exudates in the superior periphery of the retina at the same stage. The retina thickness showed a significant reduction at Month 7. Our results indicate that the clinical correlates of human DR are present in diabetic P. obesus. The depressed of ERGs, disruption of retinal architecture, and the appearance of exudates may reflect vascular and neuronal damage throughout the retina as are seen in the advanced stages of human DR.

Loss of the K+ channel Kv2.1 greatly reduces outward dark current and causes ionic dysregulation and degeneration in rod photoreceptors

Vertebrate retinal photoreceptors signal light by suppressing a circulating "dark current" that maintains their relative depolarization in the dark. This dark current is composed of an inward current through CNG channels and NCKX transporters in the outer segment that is balanced by outward current exiting principally from the inner segment. It has been hypothesized that Kv2.1 channels carry a predominant fraction of the outward current in rods. We examined this hypothesis by comparing whole cell, suction electrode, and electroretinographic recordings from Kv2.1 knockout (Kv2.1-/-) and wild-type (WT) mouse rods. Single cell recordings revealed flash responses with unusual kinetics, and reduced dark currents that were quantitatively consistent with the measured depolarization of the membrane resting potential in the dark. A two-compartment (outer and inner segment) physiological model based on known ionic mechanisms revealed that the abnormal Kv2.1-/- rod photoresponses arise principally from the voltage dependencies of the known conductances and the NCKX exchanger, and a highly elevated fraction of inward current carried by Ca2+ through CNG channels due to the aberrant depolarization. Kv2.1-/- rods had shorter outer segments than WT and dysmorphic mitochondria in their inner segments. Optical coherence tomography of knockout animals demonstrated a slow photoreceptor degeneration over a period of 6 mo. Overall, these findings reveal that Kv2.1 channels carry 70-80% of the non-NKX outward dark current of the mouse rod, and that the depolarization caused by the loss of Kv2.1 results in elevated Ca2+ influx through CNG channels and elevated free intracellular Ca2+, leading to progressive degeneration.

Transient Increase and Delay of Multifocal Electroretinograms Following Laser Photocoagulations for Diabetic Macular Edema

Background: The acute physiological changes induced by focal retinal photocoagulation (PC) have been largely unexplored. Methods: This was a case-series study. We recorded multifocal electroretinograms (mfERGs) just before PC, and mfERGs were also recorded 5′, 15′, one hour, 24 h, and one week after the PCs. Transient changes of mfERGs were analyzed in eyes which underwent PCs to treat diabetic macular edema. The mfERGs recorded from the predominantly irradiated area and that from non-irradiated areas were analyzed separately. Results: Fifteen eyes of 15 patients were included in this study. The mfERGs elicited from non-irradiated areas did not change after PC, but the mfERGs elicited from the irradiated area changed with time; the amplitude was larger at 60′ than that before (p < 0.05) and at 5′ after PC (p < 0.01) and significantly smaller at 24 h and 1 week than that before and at 60′ after the PC (p < 0.01). The implicit time was significantly prolonged after PC. mfERG on irradiated area with the severe diabetic change was less altered after PCs. Conclusions: The transient increase in the amplitude at 60′ likely resulted from a biological amplification of partially damaged cells adjacent to the PC spots. The mfERGs manifested the dynamic alterations of the retinal function following PCs.

No flow through the vitreous humor: How strong is the evidence?

When analyzing vitreal drug delivery, or the pharmacological effects of drugs on intraocular pressure, or when interpreting outflow facility measurements, it is generally accepted that the fluid in the vitreous humor is stagnant. It is accepted that for all practical purposes, the aqueous fluid exits the eye via anterior pathways only, and so there is negligible if any posteriorly directed flow of aqueous through the vitreous humor. This assumption is largely based on the interpretation of experimental data from key sources including Maurice (1957), Moseley (1984), Gaul and Brubaker (1986), Maurice (1987) and Araie et al. (1991). However, there is strong independent evidence suggesting there is a substantial fluid flow across the retinal pigment epithelium from key sources including Cantrill and Pederson (1984), Chihara and Nao-i, Tsuboi (1985), Dahrouj et al. (2014), Smith and Gardiner (2017) and Smith et al. (2019). The conflicting evidence creates a conundrum-how can both interpretations be true? This leads us to re-evaluate the evidence. We demonstrate that the data believed to be supporting no aqueous flow through the vitreous are in fact compatible with a significant normal aqueous flow. We identify strong and independent lines of evidence supporting fluid flow across the RPE, including our new outflow model for the eye. On balance it appears the current evidence favors the view that there is normally a significant aqueous flow across the RPE in vivo. This finding suggests that past and future analyses of outflow facility, interpretations of some drug distributions and the interpretation of some drug effects on eye tissues, may need to be revised.

Temporal whole field sawtooth flicker without a spatial component elicits a myopic shift following optical defocus irrespective of waveform direction in chicks

Purpose

Myopia (short-sightedness) is the commonest visual disorder and greatest risk factor for sight threatening secondary pathologies. Myopia and hyperopia can be induced in animal models by rearing with optical lens defocus of opposite sign. The degree of refractive compensation to lens-induced defocus in chicks has been shown to be modified by directionally drifting sawtooth spatio-temporal luminance diamond plaids, with Fast-ON sawtooth spatio-temporal luminance profiles inhibiting the myopic shift in response to negative lenses, and Fast-OFF profiles inhibiting the hyperopic shift in response to positive lenses. What is unknown is whether similar sign-of-defocus dependent results produced by spatio-temporal modulation of sawtooth patterns could be achieved by rearing chicks under whole field low temporal frequency sawtooth luminance profiles at 1 or 4 Hz without a spatial component, or whether such stimuli would indiscriminately elicit a myopic shift such as that previously shown with symmetrical (or near-symmetrical) low frequency flicker across a range of species.

Methods

Hatchling chicks (n = 166) were reared from days five to nine under one of three defocus conditions (No Lens, +10D lens, or -10D lens) and five light conditions (No Flicker, 1 Hz Fast-ON/Slow-OFF sawtooth flicker, 4 Hz Fast-ON/Slow-OFF sawtooth flicker, 1 Hz Fast-OFF/Slow-ON sawtooth flicker, or 4Hz Fast-OFF/Slow-ON sawtooth flicker). The sawtooth flicker was produced by light emitting diodes (white LEDs, 1.2 -183 Lux), and had no measurable dark phase. Biometrics (refraction and ocular axial dimensions) were measured on day nine.

Results

Both 1 Hz and 4 Hz Fast-ON and Fast-OFF sawtooth flicker induced an increase in vitreous chamber depth that was greater in the presence of negative compared to positive lens defocus. Both sawtooth profiles at both temporal frequencies inhibited the hyperopic shift in response to +10D lenses, whilst full myopic compensation (or over-compensation) in response to -10D lenses was observed.

Conclusions

Whole field low temporal frequency Fast-ON and Fast-OFF sawtooth flicker induces a generalized myopic shift, similar to that previously shown for symmetrical sine-wave and square-wave flicker. Our findings highlight that temporal modulation of retinal ON/OFF pathways per se (without a spatial component) is insufficient to produce strong sign-of-defocus dependent effect.

Modulating GLUT1 expression in retinal pigment epithelium decreases glucose levels in the retina: impact on photoreceptors and Müller glial cells

The retina is one of the most metabolically active tissues in the body and utilizes glucose to produce energy and intermediates required for daily renewal of photoreceptor cell outer segments. Glucose transporter 1 (GLUT1) facilitates glucose transport across outer blood retinal barrier (BRB) formed by the retinal pigment epithelium (RPE) and the inner BRB formed by the endothelium. We used conditional knockout mice to study the impact of reducing glucose transport across the RPE on photoreceptor and Müller glial cells. Transgenic mice expressing Cre recombinase under control of the Bestrophin1 ( Best1) promoter were bred with Glut1^flox/flox mice to generate Tg-Best1-Cre:Glut1^flox/flox mice ( RPEΔGlut1). The RPEΔGlut1 mice displayed a mosaic pattern of Cre expression within the RPE that allowed us to analyze mice with ~50% ( RPEΔGlut1_m) recombination and mice with >70% ( RPEΔGlut1_h) recombination separately. Deletion of GLUT1 from the RPE did not affect its carrier or barrier functions, indicating that the RPE utilizes other substrates to support its metabolic needs thereby sparing glucose for the outer retina. RPEΔGlut1_m mice had normal retinal morphology, function, and no cell death; however, where GLUT1 was absent from a span of RPE greater than 100 µm, there was shortening of the photoreceptor cell outer segments. RPEΔGlut1_h mice showed outer segment shortening, cell death of photoreceptors, and activation of Müller glial cells. The severe phenotype seen in RPEΔGlut1_h mice indicates that glucose transport via the GLUT1 transporter in the RPE is required to meet the anabolic and catabolic requirements of photoreceptors and maintain Müller glial cells in a quiescent state.

Noninvasive Electroretinographic Procedures for the Study of the Mouse Retina

Overall retinal function can be monitored by recording the light-evoked response of the eye at the corneal surface. The major components of the electroretinogram (ERG) provide important information regarding the functional status of many retinal cell types including rod photoreceptors, cone photoreceptors, bipolar cells, and the retinal pigment epithelium (RPE). The ERG can be readily recorded from mice, and this unit describes procedures for mouse anesthesia and the use of stimulation and recording procedures for measuring ERGs that reflect the response properties of different retinal cell types. Through these, the mouse ERG provides a noninvasive approach to measure multiple aspects of outer retinal function, including the status of the initial rod and cone pathways, rod photoreceptor deactivation, rod dark adaptation, the photoreceptor-to-bipolar cell synapse, and the RPE. © 2018 by John Wiley & Sons, Inc.

Scotopic vision in the monkey is modulated by the G protein-coupled receptor 55

The endogenous cannabinoid system plays important roles in the retina of mice and monkeys via their classic CB1 and CB2 receptors. We have previously reported that the G protein-coupled receptor 55 (GPR55), a putative cannabinoid receptor, is exclusively expressed in rod photoreceptors in the monkey retina, suggesting its possible role in scotopic vision. To test this hypothesis, we recorded full-field electroretinograms (ERGs) after the intravitreal injection of the GPR55 agonist lysophosphatidylglucoside (LPG) or the selective GPR55 antagonist CID16020046 (CID), under light- and dark-adapted conditions. Thirteen vervet monkeys (Chlorocebus sabaeus) were used in this study: four controls (injected with the vehicle dimethyl sulfoxide, DMSO), four injected with LPG and five with CID. We analyzed amplitudes and latencies of the a-wave (photoreceptor responses) and the b-wave (rod and cone system responses) of the ERG. Our results showed that after injection of LPG, the amplitude of the scotopic b-wave was significantly higher, whereas after the injection of CID, it was significantly decreased, compared to the vehicle (DMSO). On the other hand, the a-wave amplitude, and the a-wave and b-wave latencies, of the scotopic ERG responses were not significantly affected by the injection of either compound. Furthermore, the photopic ERG waveforms were not affected by either drug. These results support the hypothesis that GPR55 plays an instrumental role in mediating scotopic vision.

Osmotic Induction of Angiogenic Growth Factor Expression in Human Retinal Pigment Epithelial Cells

BACKGROUND

Although systemic hypertension is a risk factor of age-related macular degeneration, antihypertensive medications do not affect the risk of the disease. One condition that induces hypertension is high intake of dietary salt resulting in increased blood osmolarity. In order to prove the assumption that, in addition to hypertension, high osmolarity may aggravate neovascular retinal diseases, we determined the effect of extracellular hyperosmolarity on the expression of angiogenic cytokines in cultured human retinal pigment epithelial (RPE) cells.

METHODOLOGY/PRINCIPAL FINDINGS

Hyperosmolarity was induced by the addition of 100 mM NaCl or sucrose to the culture medium. Hypoxia and oxidative stress were induced by the addition of the hypoxia mimetic CoCl2 and H2O2, respectively. Alterations in gene expression were determined with real-time RT-PCR. Secretion of bFGF was evaluated by ELISA. Cell viability was determined by trypan blue exclusion. Nuclear factor of activated T cell 5 (NFAT5) expression was knocked down with siRNA. Hyperosmolarity induced transcriptional activation of bFGF, HB-EGF, and VEGF genes, while the expression of other cytokines such as EGF, PDGF-A, TGF-β1, HGF, and PEDF was not or moderately altered. Hypoxia induced increased expression of the HB-EGF, EGF, PDGF-A, TGF-β1, and VEGF genes, but not of the bFGF gene. Oxidative stress induced gene expression of HB-EGF, but not of bFGF. The hyperosmotic expression of the bFGF gene was dependent on the activation of p38α/β MAPK, JNK, PI3K, and the transcriptional activity of NFAT5. The hyperosmotic expression of the HB-EGF gene was dependent on the activation of p38α/β MAPK, ERK1/2, and JNK. The hyperosmotic expression of bFGF, HB-EGF, and VEGF genes was reduced by inhibitors of TGF-β1 superfamily activin receptor-like kinase receptors and the FGF receptor kinase, respectively. Hyperosmolarity induced secretion of bFGF that was reduced by inhibition of autocrine/paracrine TGF-β1 signaling and by NFAT5 siRNA, respectively. Hyperosmolarity decreased the viability of the cells; this effect was not altered by exogenous bFGF and HB-EGF. Various vegetable polyphenols (luteolin, quercetin, apigenin) inhibited the hyperosmotic expression of bFGF, HB-EGF, and NFAT5 genes.

CONCLUSION

Hyperosmolarity induces transcription of bFGF and HB-EGF genes, and secretion of bFGF from RPE cells. This is in part mediated by autocrine/paracrine TGF-β1 and FGF signaling. It is suggested that high intake of dietary salt resulting in osmotic stress may aggravate neovascular retinal diseases via stimulation of the production of angiogenic factors in RPE cells, independent of hypertension.

Standardized full-field electroretinography in the Green Monkey (Chlorocebus sabaeus)

Full-field electroretinography is an objective measure of retinal function, serving as an important diagnostic clinical tool in ophthalmology for evaluating the integrity of the retina. Given the similarity between the anatomy and physiology of the human and Green Monkey eyes, this species has increasingly become a favorable non-human primate model for assessing ocular defects in humans. To test this model, we obtained full-field electroretinographic recordings (ERG) and normal values for standard responses required by the International Society for Clinical Electrophysiology of Vision (ISCEV). Photopic and scotopic ERG recordings were obtained by full-field stimulation over a range of 6 log units of intensity in dark-adapted or light-adapted eyes of adult Green Monkeys (Chlorocebus sabaeus). Intensity, duration, and interval of light stimuli were varied separately. Reproducible values of amplitude and latency were obtained for the a- and b-waves, under well-controlled adaptation and stimulus conditions; the i-wave was also easily identifiable and separated from the a-b-wave complex in the photopic ERG. The recordings obtained in the healthy Green Monkey matched very well with those in humans and other non-human primate species (Macaca mulatta and Macaca fascicularis). These results validate the Green Monkey as an excellent non-human primate model, with potential to serve for testing retinal function following various manipulations such as visual deprivation or drug evaluation.

Measuring rodent electroretinograms to assess retinal function

Electroretinography is a noninvasive technique used to measure the electrical activity of neurons in the retina. Electroretinogram (ERG) waveforms can be used to quantify retinal function in normal and diseased rodents. In particular, the functions of rod and cone pathways can be isolated. Inner retinal neuronal functioning, such as bipolar cell activity or ganglion cell activity, can also be measured. In this chapter we describe the common full-field ERG techniques of scoptic flash, photopic flash, and flicker used to isolate and compare rod-driven and cone-driven function.

Light-evoked responses of the retinal pigment epithelium: changes accompanying photoreceptor loss in the mouse

Mutations in genes expressed in the retinal pigment epithelium (RPE) underlie a number of human inherited retinal disorders that manifest with photoreceptor degeneration. Because light-evoked responses of the RPE are generated secondary to rod photoreceptor activity, RPE response reductions observed in human patients or animal models may simply reflect decreased photoreceptor input. The purpose of this study was to define how the electrophysiological characteristics of the RPE change when the complement of rod photoreceptors is decreased. To measure RPE function, we used an electroretinogram (dc-ERG)-based technique. We studied a slowly progressive mouse model of photoreceptor degeneration (Prph(Rd2/+)), which was crossed onto a Nyx(nob) background to eliminate the b-wave and most other postreceptoral ERG components. On this background, Prph(Rd2/+) mice display characteristic reductions in a-wave amplitude, which parallel those in slow PIII amplitude and the loss of rod photoreceptors. At 2 and 4 mo of age, the amplitude of each dc-ERG component (c-wave, fast oscillation, light peak, and off response) was larger in Prph(Rd2/+) mice than predicted by rod photoreceptor activity (Rm(P3)) or anatomical analysis. At 4 mo of age, the RPE in Prph(Rd2/+) mice showed several structural abnormalities including vacuoles and swollen, hypertrophic cells. These data demonstrate that insights into RPE function can be gained despite a loss of photoreceptors and structural changes in RPE cells and, moreover, that RPE function can be evaluated in a broader range of mouse models of human retinal disease.

Electrophysiology in pigment epithelial changes

The c-wave of the ERG and the slow SP variations reflect mainly the activity of the pigment epithelium. However, both potentials are dependent upon the photoreceptors and/or the inner retina as well. In pigment epithelial abnormalities the c-wave is reduced or abolished, and the slow SP variations, d.c. recorded directly or investigated with the EOG, reduced or abolished as well.

Interpretation of the mouse electroretinogram

The mouse electroretinogram (ERG) consists of a complex set of signals or "waves" generated by multiple types of retinal cell. The origins of these waves are reviewed briefly for the C57BL/6J mouse. The differences in the properties of these waves are described for 34 strains of mice and 11 F1 hybrid mice, as is the way that inter-strain genetic polymorphisms can be exploited in order to help pin-point the genes responsible for ERG differences. There are certain technical difficulties, some subtle, that can arise in recording the ERG and these are classified and illustrated in order to facilitate their diagnosis. Forward genetic screens are described, along with abnormal mice that have been generated in a large screen. Several means are suggested for determining if a mouse having an abnormal ERG is a mutant.

Ca2+-activated Cl- current from human bestrophin-4 in excised membrane patches

Bestrophins are a newly discovered family of Cl⁻ channels, some members of which are activated by intracellular Ca²⁺. So far, all studies were carried out with whole-cell recordings from plasmid-transfected cultured cells, so it is unclear whether Ca²⁺ activates bestrophin through a metabolic mechanism or in a more direct way. We report here experiments that addressed this question with excised, inside-out membrane patches. We chose human bestrophin-4 (hBest4) for heterologous expression because it gave particularly large Cl⁻ currents when expressed, thus allowing detection even in excised membrane patches. hBest4 gave a negligible Cl⁻ current in a Ca²⁺-free solution on the cytoplasmic (bath) side, but produced a Cl⁻ current that was activated by Ca²⁺ in a dose-dependent manner, with a K_1/2 of 230 nM. Thus, Ca²⁺ appears to activate the bestrophin Cl⁻ channel without going through a freely diffusible messenger or through protein phosphorylation. Because the activation and deactivation kinetics were very slow, however, we cannot exclude the involvement of a membrane-associated messenger.

Recovery of rod-mediated a-wave during light-adaptation in mGluR6-deficient mice

The purpose of this study was to compare the a-waves of mGluR6-deficient mice (KO) to that of wild-type mice (WT), and to determine whether the light-adapted electroretinogram of the KO mice originate exclusively from cones. Dark-adapted a-waves were recorded under the same conditions from both types of mice. With a 96-cd/m(2) background, the a-wave from both types of mice showed a rapid recovery over a 50-min period. The analysis of the a-waves in KO mice indicated that the recovery was determined mainly by the rod component. The light-adapted b-wave of WT mice showed no corresponding recovery. We conclude that rod contribution must be considered in the analyses of the light-adapted a-waves of KO mice.

The electro-oculogram

The retinal pigment epithelium (RPE) lying distal to the retina regulates the extracellular environment and provides metabolic support to the outer retina. RPE abnormalities are closely associated with retinal death and it has been claimed several of the most important diseases causing blindness are degenerations of the RPE. Therefore, the study of the RPE is important in Ophthalmology. Although visualisation of the RPE is part of clinical investigations, there are a limited number of methods which have been used to investigate RPE function. One of the most important is a study of the current generated by the RPE. In this it is similar to other secretory epithelia. The RPE current is large and varies as retinal activity alters. It is also affected by drugs and disease. The RPE currents can be studied in cell culture, in animal experimentation but also in clinical situations. The object of this review is to summarise this work, to relate it to the molecular membrane mechanisms of the RPE and to possible mechanisms of disease states.

Functional abnormalities in the retinal pigment epithelium of CFTR mutant mice

In response to light, the mouse retinal pigment epithelium (RPE) generates a series of slow changes in potential that are referred to as the c-wave, fast oscillation (FO) and light peak (LP) of the electroretinogram (ERG). While the FO is known to reflect a Cl(-) conductance generated at the basal membrane of the RPE, the specific channel (s) underlying this potential has not been identified. In the present study we examined two strains of mice with cftr mutations to define the contribution that cystic fibrosis transmembrane regulator (CFTR)-mediated Cl(-) conductance makes to the mouse ERG. Responses obtained from cftr(Delta508/Delta508) mice exhibited an overall reduction in all components generated by the RPE in response to light without alteration of the luminance response function. Responses obtained from cftr(-/-) mice were also reduced in amplitude. These results illustrate the usefulness of ERG analysis of mice deficient in ion channels that are expressed in the RPE, and indicate that CFTR contributes to the generation of RPE-driven ERG components, but that it is not the sole generator of any one of these components.

Light-evoked responses of the mouse retinal pigment epithelium

In response to light, the retinal pigment epithelium (RPE) generates a series of slow potentials that can be recorded as the c-wave, fast oscillation (FO), and light peak (LP) of the electroretinogram (ERG). As these potentials can be related to specific cellular events, they provide information about RPE function and how that may be altered by disease or experimental manipulation. In the present study we describe a noninvasive means for recording the light-evoked responses of the mouse RPE and use this to define the stimulus-response properties of the major components in three inbred strains of mice (BALBc/ByJ, C57BL/6J, and 129/SvJ) and two mouse mutants that reduce activity in the rod pathway. All of the major ERG components generated by the RPE are readily measured in the mouse. In albino strains (BALBc/ByJ and 129/SvJ) the intensity-response functions for the c-wave, FO, and LP are shifted toward lower intensities in comparison to those for C57BL/6J mice. Each of these components was markedly reduced in mice lacking transducin in which rod phototransduction is interrupted, indicating that they reflect primarily rod photoreceptor activity. All components were observed in no b-wave (nob) mutant mice, indicating that inner retinal activity does not make a major contribution to these potentials. Further studies of mutant mice will allow us to define the functional consequences of gene manipulation on RPE function and to evaluate specific hypotheses regarding the generation of ERG components.

Structure-function analysis of the bestrophin family of anion channels

The bestrophins are a newly described family of anion channels unrelated in primary sequence to any previously characterized channel proteins. The human genome codes for four bestrophins, each of which confers a distinctive plasma membrane conductance on transfected 293 cells. Extracellular treatment with methanethiosulfonate ethyltrimethylammonium (MTSET) of a series of substitution mutants that eliminate one or more cysteines from human bestrophin1 demonstrates that cysteine 69 is the single endogenous cysteine responsible for MTSET inhibition of whole-cell current. Cysteines introduced between positions 78-99 and 223-226 are also accessible to external MTSET, with MTSET modification at positions 79, 80, 83, and 90 producing a 2-6-fold increase in whole-cell current. The latter set of four cysteine-substitution mutants define a region that appears to mediate allosteric control of channel activity. Mapping of transmembrane topography by insertion of N-linked glycosylation sites and tobacco etch virus protease cleavage sites provides evidence for cytosolic N and C termini and an unexpected transmembrane topography with at least three extracellular loops that include positions 60-63, 212-227, and 261-267. These experiments provide the first structural analysis of the bestrophin channel family.

Hyperosmolarity and electroretinogram (ERG) potentials in isolated rat retinas: possible implications in diabetic models

In this report, the effects of increases in the osmolarity of media superfusing isolated rat retinas on the a-wave, b-wave and oscillatory potentials of the electroretinogram (ERG) were examined. Osmolarity of the media was raised from 310 milliosmoles (control) to 340 and 370 milliosmoles by addition of NaCl or sucrose. Increases in osmolarity led to rapid decreases in the amplitudes of the b-wave and oscillatory potentials with little change in the amplitude of the a-wave. Excellent recovery of the ERG potentials was observed when control conditions were restored. The implications of these effects of an hyperosomotic load on ERG potentials in vitro are discussed with regard to a possible role of this load in models of experimental diabetes.

The vitelliform macular dystrophy protein defines a new family of chloride channels

Vitelliform macular dystrophy (VMD/Best disease; MIM*153700) is an early-onset autosomal dominant disorder in which accumulation of lipofuscin-like material within and beneath the retinal pigment epithelium is associated with a progressive loss of central vision. Bestrophin, the protein product of the VMD gene, has four predicted transmembrane domains. There are multiple bestrophin homologues in the human, Drosophila, and Caenorhabditis elegans genomes, but no function has previously been ascribed to these proteins, and they show no detectable homology to other proteins of known function. Using heterologous expression, we show here that human, Drosophila, and C. elegans bestrophins form oligomeric chloride channels, and that human bestrophin is sensitive to intracellular calcium. Each of 15 missense mutations asscociated with VMD greatly reduces or abolishes the membrane current. Four of these mutant bestrophins were coexpressed with the wild type and each dominantly inhibited the wild-type membrane current, consistent with the dominant nature of the disease. These experiments establish the existence of a new chloride channel family and VMD as a channelopathy.

On-bipolar cells and depolarising third-order neurons as the origin of the ERG-b-wave in the RCS rat

In the retinas of Royal College of Surgeons (RCS) rats light induces an increase in distal extracellular potassium irrespective of the age, between days 19-24 and days 29-35 postpartum, but by days 29-35 the ERG b-wave has become reduced. The synaptic blocker 2-amino-4-phosphonobutyric acid (APB) causes the abolition of both the b-wave and the potassium increase at any age. MgCl2 greatly reduces the b-wave at all ages and abolishes the potassium increase in older rats, but in younger rats the potassium increase is enlarged. Since this increase occurs in the absence of the b-wave it is unlikely that the on-bipolar cells are the only sources of the b-wave. Because the NMDA receptor blocker ketamine reduces the b-wave, third order neurons, which possess NMDA receptors, could contribute to the b-wave.

The c-wave of the electroretinogram recorded under clinical conditions from rabbits

To determine whether large and repeatable c-waves can be recorded from rabbits with equipment already in use in clinical electroretinographic laboratories, the Burian-Allen electrode, connected bipolarly or monopolarly, was used to record electroretinograms from pigmented rabbits. The Jet electrode was also used. The c-waves elicited by long-duration (4-second) stimuli were compared to those elicited by stroboscopic stimuli. In addition, the c-waves recorded with direct-coupled amplification were compared to those recorded with condenser-coupled amplification (one-half-amplitude bandpass=0.1 Hz). The b-wave amplitude was not altered by the amplifier coupling or by the two stimulus durations. The largest c-waves were elicited by 4-second-duration stimuli and recorded with direct-coupled amplification. Although the c-wave amplitude was reduced by stroboscopic stimuli and by condenser coupling, large and repeatable c-waves were elicited by stroboscopic stimuli and recorded with condenser-coupled amplification. A comparison of stimulus duration and amplifier coupling showed that the stimulus duration was more important in recording large-amplitude c-waves. Similar results were obtained with the Jet electrode. We conclude that repeatable and large c-waves can be elicited by a stroboscopic stimuli and can be recorded with condenser-coupled amplification with good low-frequency response from rabbits.

Two neuronal retinal components of the electroretinogram c-wave

Although the rising phase of the b-wave seems to be generated mainly in the rod bipolar cells and the cone on-bipolar cells, the slow component of the electroretinogram, the c-wave, evidently originates in the Müller cells and the pigment epithelium. The c-wave has three components. One cornea-positive component derives from the pigment epithelium, while a distal cornea-negative component (slow PIII) and a proximal slow component originate in the Müller cells. This third proximal component of the c-wave differs between mammalian species: it is negative in the rat retina, positive in the rabbit and human retina and may be lacking in the cat retina.

Electrical responses from diabetic retina

Diabetic retinopathy has long been considered to be a retinal manifestation of systemic diabetic angiopathy. Indeed, it is therapeutically true. However, the prolongation of OP peak latency in diabetic eyes without any angiographic evidence of angiopathy leads us to presume that certain neuronal disorders occur early in diabetic eyes. Even though we cannot neglect the possibility that the prolongation of the OP peak latency may derive from undetectable retinal hypoperfusion, it is still far from conventional diabetic angiopathy. Rather, the status should be properly termed "intraretinal diabetic neuropathy" in that the neurones are the disturbed cells to cause visual dysfunction. Thereafter, the OP amplitude diminishes as retinopathy advances, probably depending on the degree of retinal circulatory disturbance. Marked diminution of the OP amplitude predicts rapid progression and poor prognosis of retinopathy. Diabetic retinal pigment epitheliopathy as manifested by one of our non-photic EOG responses is another kind of early ocular involvement of diabetes. Because its mechanisms are not yet known, so far we have not succeeded in correlating it to any kind of subjective visual index. Routine fundus inspection or fluorescent fundus angiography is incapable of detecting the compromised neural retina and/or retinal pigment epithelial integrity and thus the electrophysiology of vision has the edge in ophthalmology.

Functional recovery of retina after sodium iodate injection in mice

ERGs and the azide responses were recorded from mice before and periodically up to 6 weeks after retinal pigment epithelium (RPE) damage by iodate injection to follow the recovery of retinal pigment epithelium and retinal function. At 14 days postinjection, there was a partial recovery of the maximal b-wave amplitude and the azide response but no further recovery was found after 14 days. The retinal sensitivity showed a slow recovery, and at 6 weeks postinjection did not differ from the pre-iodate sensitivity. These findings correlated with histological observations. We concluded that the recovery in ERGs resulted from RPE recovery and the large patchy area of recovered retina functioned normally.

The influence of MgCl2 and APB on the light-induced potassium changes and the ERG b-wave of the isolated superfused rat retina

The ERG and the extracellular potassium concentration, [K+]o, of the isolated superfused rat retina were measured in a physiological solution and in solutions containing 10 mM MgCl2 or 100 mu M APB. MgCl2 nearly abolished the b-wave, but the light-induced distal [K+]o increase was enlarged from 0.13 +/- 0.05 to 0.28 +/- 0.08 mM. There was also an increase in the light-induced [K+]o in the proximal retina. APB abolished the b-wave completely, and the distal light-induced [K+]o increase was then replaced by a [K+]o decrease. Upon return to the control solution, there was a larger transitory [K+]o increase than under control conditions, and this occurred before the b-wave had returned. Under these experimental conditions, the distal [K+]o increase could not be correlated with the b-wave, and so the Muller cells are unlikely to be the main source of the rising phase of the b-wave. More probable sources of the b-wave are the on-bipolar cells with their metabotropic and ionotropic receptors, with only the latter apparently being blocked by MgCl2. The extracellular [K+]o changes, however, had an influence upon the slow potentials of the ERG.

The c-wave of the electroretinogram possesses a third component from the proximal retina

ERG and light-induced extracellular potassium ([K+]o) changes have been measured in isolated retinas of both Rana esculenta and Rana temporaria. The conditions of the preparations have been varied. Isolated frog retinas kept receptor side-upward in a moist chamber without perfusion showed the well-known slow PIII in the ERG. Retinas superfused from the receptor side, with O2 enrichment at their vitreal surface, however, exhibit a slow cornea-positive potential in the ERG. The slow ERG-potentials relate to different light-induced potassium changes in the proximal retina. There was a long lasting and larger proximal potassium increase in adequately maintained retinas but a smaller and shorter one in preparations lacking superfusion and oxygen. There was no significant difference between the size of potassium decrease around receptors of retinas superfused from their vitreal side and those superfused from receptor side. A reduction of slow PIII should therefore not be responsible for the slow cornea-positive potential. The long lasting and larger (by 59%) potassium increase in the proximal retina may counteract the potential in the Müller cells caused by the potassium decrease around receptors and thereby cancel slow PIII and generate a third component of the electroretinogram c-wave.

Electrophysiological signs of retinal dopamine deficiency in recently diagnosed Parkinson's disease and a follow up study

Electrophysiological studies, including electrooculogram (EOG), and simultaneously recorded flash and pattern evoked electroretinograms (FERG and PERG) and visually evoked potentials (FVEP and PVEP) were made in 1988 on 10 newly diagnosed untreated Parkinson's patients at Stage 1 of the Hoehn and Yahr scale. Follow up studies were made on five out of the 10 patients when their disease had progressed to Stage 2 during 1993. The earliest and only sign of abnormality detected in the Stage 1 of Parkinson's patients in 1988 was a delay in the time to reach the peak light rise in the EOG. When the disease had progressed to Stage 2, not only a delay in the time to reach the peak light rise but also a reduction in the amplitude of the peak light rise in the EOG, together with changes in PERG, FERG and PVEPs were demonstrable. These changes observed in PERG, FERG and PVEPs were generally consistent with those reported by previous studies. It is suggested that the reason for the susceptibility of pigment epithelial function to dopamine deficiency in Parkinson's disease may be due to the pigment epithelium being at the extremity of the diffusion pathway from dopamine release sites at the inner plexiform layer.

Fundus pigmentation and the electroretinographic luminance-response function

Dark-adapted and light-adapted electroretinographic luminance-response functions were recorded from subjects with light or dark fundus pigmentation based on digitized fundus photographs. For dark- and light-adapted electroretinograms, subjects with dark fundi had smaller b-wave amplitudes at all luminance levels. There was no significant difference in b-wave implicit time for the dark-adapted electroretinogram, but there was a significant difference for the light-adapted ERG between the two groups. The results suggest that fundus pigmentation should be considered in the interpretation of electroretinogram results. A possible mechanism for the influence of fundus pigmentation on b-wave amplitude is based on increased resistance associated with melanin.

Voltage-dependent currents in isolated cells of the turtle retinal pigment epithelium

The electrophysiological properties of isolated turtle retinal pigment epithelial cells (RPE cells) were investigated using the whole-cell patch-clamp technique. Most RPE cells exhibited a voltage-dependent outward current activated by depolarization beyond about -43 mV that inactivated during a 500-ms voltage step. Tail current measurements indicated that the conductance underlying this current was potassium selective. This current inactivated with prolonged depolarization and was abolished or reduced by extracellular quinidine, barium, tetraethylammonium (TEA) and 4-aminopyridine (4-AP). Steady-state inactivation of the voltage-dependent outward current revealed a time-independent outwardly rectifying current/voltage relationship in many cells. In addition, many cells had an outward current that activated slowly upon depolarization beyond about +40 mV and appeared to reverse near 0 mV in both 3 mM KCl and 30 mM KCl external solutions. This current was often observed in the presence of potassium channel blockers. Hyperpolarizing pulses commonly evoked inward currents that activated slowly and did not inactivate. These currents were commonly observed when fluoride was absent from the pipette, and only occasionally when fluoride was the major pipette anion. Tail current measurements indicated that this current was somewhat anion selective. These currents may play important roles in the homeostatic and phagocytic functions of RPE cells in their interactions with the neural retina.

Comparison of pharmacological agents (aspartate vs. aminophosphonobutyric plus kynurenic acids) to block synaptic transmission from retinal photoreceptors in frog

The combination of aminophosphonobutyric plus kynurenic acids (APB/Kyn) was compared to aspartate with respect to its ability to block synaptic transmission from photoreceptors. Like aspartate, APB/Kyn blocks photoreceptor synaptic transmission, as monitored by the b- and d-waves of the electroretinogram, by the proximal negative response and M-wave of the proximal retina, and by the light-evoked increase in extracellular K+ concentration in the inner plexiform layer. Unlike aspartate, APB/Kyn has relatively minor effects on retinal resistance, light-evoked changes in K+ and Ca2+ concentrations in the subretinal space, light-evoked changes in subretinal space volume, resting extracellular concentrations of K+ and Ca2+ in the proximal and distal retina, and the c-wave. Effects of APB/Kyn are generally more reversible than effects of Asp. A disadvantage of APB/Kyn is that the a-wave usually becomes smaller and slower. Overall, APB/Kyn disrupts the retina less than aspartate. Therefore, in some situations in which blockade of photoreceptor synaptic transmission is desired, the use of APB/Kyn may be preferable to that of aspartate.

Effects of hemicholinium-3 on the pigmented rabbit retina and pigment epithelium

Hemicholinium-3 effects on the albino rabbit neural retina have been described, but effects on the retinal pigment epithelium (RPE) have not been closely examined. We have studied retinal morphology and function in Dutch belted (pigmented) rabbits after single intravitreal injections of Hemicholinium-3 or saline. DC electroretinogram recordings show a decrease in a, b, and c-wave amplitudes, with the c-wave affected first. Experiments with sodium iodate show that the early decrease in the c-wave results from a loss of the RPE component of the c-wave, rather than the retinal Slow PIII component. After two days, ophthalmoscopic abnormalities of the fundus are severe in a large area with pigmentary changes. A sharp boundary appears between normally pigmented and depigmented fundus, indicative of a critical threshold for damage. The RPE contains clumped melanin. Pigmented cells are seen away from the basement membrane, an early histological observation temporally correlated with a loss of barrier function seen in fluorescein angiograms. After 10 days, apparent proliferation of non-pigmented RPE cells coincides with re-establishment of the barrier. Rod photoreceptor outer segments are lost 4-7 days after injection in the depigmented regions of the fundus, but outer segments are spared in normally pigmented fundus areas. This regional pattern is distinct from that seen in albino rabbit retina where outer segment loss is fairly uniform. We conclude that Hemicholinium-3 affects the RPE in pigmented rabbits in addition to known effects on retinal cholinergic neurons and photoreceptor disc synthesis.

Electrophysiological consequences of retinal hypoxia

Experiments on cats show that electrical activity of the inner (proximal) retina is unaffected during systemic hypoxia as long as arterial oxygen tension (PaO2) is above 40 mm Hg. This is due to effective regulation of inner retinal tissue PO2 by the retinal circulation. In contrast, some electrical signals generated in the outer (distal) retina begin to change when PaO2 falls below 70-80 mmHg. The outer retinal responses are generated by the retinal pigment epithelium, but their susceptibility to hypoxia results primarily from their dependence on photoreceptors. Photoreceptor metabolism is sensitive to hypoxia because of the high oxygen consumption of photoreceptors and their reliance on the choroidal circulation, which cannot regulate PO2 in the outer retina. Retinal electrophysiology and oxygen distribution are altered by acutely elevated intraocular pressure just as by hypoxia. These results raise the question as to how inner retinal function can be preserved when outer retinal function is altered. The explanations proposed relate to (1) differences in conditions of light adaptation in different studies, (2) the possible inappropriateness of the previous measurements in the inner retina for revealing photoreceptor dysfunction, and (3) a possible preservation of photoreceptor electrical responses when their metabolism is altered. Comparison of cat and human studies suggests that the human retina is affected in much the same way during hypoxia as the cat retina, but further experiments are required for an understanding of the role of hypoxia in human disease.

Properties of the human cone system electroretinogram during light adaptation

Changes in the response characteristics of the flash electroretinogram (ERG) of the human cone system were studied during the time course of adaptation to a cone-isolating ganzfeld background. During light adaptation, the amplitudes of the b- and i-waves increased, while the implicit time of the b-wave decreased. The amplitude of the a-wave and the implicit times of the a- and i-waves did not change systematically during light adaptation. Luminance-response functions for b-wave amplitude were obtained at discrete times following background onset and were analyzed using the hyperbolic equation R/R(max) = L(n)/(L(n) + K(n)). The increase in b-wave amplitude was characterized by increases in R(max), K, and n. The decrease in b-wave implicit time was of a similar magnitude at all flash luminances. The amplitude increase of the i-wave only occurred at moderate flash luminances. The results provide a basis for optimizing the clinical recording of cone-isolated single-flash ERGs.

Contributions to the electroretinogram of currents originating in proximal retina

We have investigated responses in proximal retina of the cat that contribute to two kinds of electroretinogram (ERG) recordings: (1) the pattern ERG, a light-adapted response and (2) the threshold and near threshold ERG, a dark-adapted response (Sieving et al., 1986a, 1986b; Sieving & Steinberg, 1985). In intraretinal, extracellular recordings, two negative-going responses were identified that are maximal around the inner plexiform layer, and distinct from PII, which is maximal in distal retina: under light-adapted conditions, a spatially tuned response at light and light offset, the "M-wave" (previously described in cold-blooded animals by Karwoski & Proenza (1977, 1980)), and under dark-adapted conditions, the scotopic threshold response, or "STR," a response at light onset. The results under dark-adapted conditions are examined in more detail here. The STR is a very sensitive response whose threshold is 1.5-2.0 log units below that of the dc-component of PII and therefore well below the threshold of the a-, b-, and c-waves. It saturates about 2.4 log units below rod saturation. The STR contributes a negative-going potential to the dark-adapted ERG that is dominant near threshold; while PII (dc-component and b-wave) contributes a positive-going potential that is dominant at higher intensities (Sieving et al., 1986b). Investigation of the mechanism of the proximal retinal responses that contribute to the ERG supports of K(+)-Müller cell hypothesis of their origin.

C-wave versus electrooculogram in diseases of the retinal pigment epithelium

The c-wave and the electrooculogram (EOG) are retinal potentials predominantly generated by the pigment epithelium. In most diseases both parameters show a parallel decrease in amplitude. However, in patients with dominant drusen, and cone dystrophies, and in clinically nonaffected members of families suffering from vitelliform macula degeneration, the EOG is close to normal whereas the c-wave shows a reduced amplitude. These findings suggest a higher sensitivity of the generators of the c-wave compared with those responsible for the EOG. Thus the direct current electroretinogram provides additional diagnostic information.