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Riboni-Verri G, Chen BS, McMurran CE, Halliwell GJ, Brown JWL, Coles AJ, Cunniffe NG. Visual outcome measures in clinical trials of remyelinating drugs. BMJ Neurol Open 2024; 6:e000560. [PMID: 38389586 PMCID: PMC10882304 DOI: 10.1136/bmjno-2023-000560] [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: 10/16/2023] [Accepted: 01/15/2024] [Indexed: 02/24/2024] Open
Abstract
One of the most promising approaches to delay, prevent or reverse disability progression in multiple sclerosis (MS) is to enhance endogenous remyelination and limit axonal degeneration. In clinical trials of remyelinating drugs, there is a need for reliable, sensitive and clinically relevant outcome measures. The visual pathway, which is frequently affected by MS, provides a unique model system to evaluate remyelination of acute and chronic MS lesions in vivo and non-invasively. In this review, we discuss the different measures that have been used and scrutinise visual outcome measure selection in current and future remyelination trials.
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Affiliation(s)
- Gioia Riboni-Verri
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- Cambridge Clinical Vision Laboratory, University of Cambridge, Cambridge, UK
| | - Benson S Chen
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- Cambridge Clinical Vision Laboratory, University of Cambridge, Cambridge, UK
| | - Christopher E McMurran
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- Cambridge Clinical Vision Laboratory, University of Cambridge, Cambridge, UK
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Gregory J Halliwell
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - J William L Brown
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- Clinical Outcomes Research Unit (CORe), University of Melbourne, Melborune, Melborune, Australia
| | - Alasdair J Coles
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- Cambridge Clinical Vision Laboratory, University of Cambridge, Cambridge, UK
| | - Nick G Cunniffe
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- Cambridge Clinical Vision Laboratory, University of Cambridge, Cambridge, UK
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White KM, Livnat I, Frambach CR, Doan J, Mehta UV, Yuh C, Palma AM, Jameson KA, Kenney MC, Mehta MC, Boisvert CJ, Crow WR, Browne AW. Quantitative cone contrast threshold testing in patients with differing pathophysiological mechanisms causing retinal diseases. Int J Retina Vitreous 2023; 9:9. [PMID: 36732855 PMCID: PMC9893567 DOI: 10.1186/s40942-023-00442-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 01/10/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Cone contrast threshold testing (CCT) provides quantitative measurements of color and contrast function to reveal changes in vision quality that are not standard endpoints in clinical trials. We utilize CCT to measure visual function in patients with multiple sclerosis (MS), age-related macular degeneration (AMD), epiretinal membrane (ERM), and retinal vein occlusion (RVO). METHODS Retrospective data was gathered from 237 patients of the Gavin Herbert Eye Institute. Subjects included 17 patients with MS, 45 patients with AMD, 41 patients with ERM, 11 patients with RVO, and 123 healthy controls. Patients underwent the primary measurement outcome, CCT testing, as well as Sloan visual acuity test and spectral domain optical coherence tomography during normal care. RESULTS Color and contrast deficits were present in MS patients regardless of history of optic neuritis. AMD with intermediate or worse disease demonstrated reduced CCT scores. All 3 stages of ERM demonstrated cone contrast deficits. Despite restoration of visual acuity, RVO-affected eyes demonstrated poorer CCT performance than unaffected fellow eyes. CONCLUSIONS CCT demonstrates color and contrast deficits for multiple retinal diseases with differing pathophysiology. Further prospective studies of CCT in other disease states and with larger samples sizes is warranted.
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Affiliation(s)
- Kayla M. White
- grid.266093.80000 0001 0668 7243School of Medicine, University of California, Irvine, CA 92617 USA ,grid.67105.350000 0001 2164 3847Case Western Reserve University Ophthalmology, 10900 Euclid Ave, Cleveland, OH 44106 USA
| | - Itamar Livnat
- grid.266093.80000 0001 0668 7243Department of Ophthalmology, Gavin Herbert Eye Institute, University of California, Irvine, CA 92617 USA
| | - Caroline R. Frambach
- grid.266093.80000 0001 0668 7243School of Medicine, University of California, Irvine, CA 92617 USA
| | - John Doan
- grid.30760.320000 0001 2111 8460Medical College of Wisconsin, Wauwatosa, WI 53226 USA ,Kaiser Permanente Santa Clara Internal Medicine, Santa Clara, CA 95051 USA
| | - Urmi V. Mehta
- grid.266093.80000 0001 0668 7243Department of Ophthalmology, Gavin Herbert Eye Institute, University of California, Irvine, CA 92617 USA ,grid.268203.d0000 0004 0455 5679Western University of Health Sciences, Pomona, CA 91766 USA
| | - Clara Yuh
- grid.266093.80000 0001 0668 7243University of California, Irvine, CA 92617 USA ,grid.268203.d0000 0004 0455 5679Western University of Health Sciences, Pomona, CA 91766 USA
| | - Anton M. Palma
- grid.266093.80000 0001 0668 7243Institute for Clinical and Translational Sciences University, Department of Physical Medicine and Rehabilitation, University of California, Irvine, CA 92617 USA
| | - Kimberly A. Jameson
- grid.266093.80000 0001 0668 7243Institute for Mathematical Behavioral Sciences, University of California, Irvine, CA 92617 USA
| | - M. Cristina Kenney
- grid.266093.80000 0001 0668 7243Department of Ophthalmology, Gavin Herbert Eye Institute, University of California, Irvine, CA 92617 USA ,grid.266093.80000 0001 0668 7243Center for Translational Vision Research, University of California, Irvine, CA 92617 USA
| | - Mitul C. Mehta
- grid.266093.80000 0001 0668 7243Department of Ophthalmology, Gavin Herbert Eye Institute, University of California, Irvine, CA 92617 USA
| | - Chantal J. Boisvert
- grid.266093.80000 0001 0668 7243Department of Ophthalmology, Gavin Herbert Eye Institute, University of California, Irvine, CA 92617 USA ,grid.26009.3d0000 0004 1936 7961Duke Eye Center, Department of Ophthalmology, Duke University School of Medicine, Durham, NC 27705 USA
| | - Wade R. Crow
- grid.266093.80000 0001 0668 7243Department of Ophthalmology, Gavin Herbert Eye Institute, University of California, Irvine, CA 92617 USA
| | - Andrew W. Browne
- grid.266093.80000 0001 0668 7243Department of Ophthalmology, Gavin Herbert Eye Institute, University of California, Irvine, CA 92617 USA ,grid.266093.80000 0001 0668 7243Center for Translational Vision Research, University of California, Irvine, CA 92617 USA ,grid.266093.80000 0001 0668 7243Department of Biomedical Engineering, University of California, Irvine, CA 92617 USA ,grid.266093.80000 0001 0668 7243Institute for Clinical and Translational Sciences University, Department of Physical Medicine and Rehabilitation, University of California, Irvine, CA 92617 USA
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Decleva D, Vidal KS, Kreuz AC, de Menezes PAHL, Ventura DF. Alterations of color vision and pupillary light responses in age-related macular degeneration. Front Aging Neurosci 2023; 14:933453. [PMID: 36688155 PMCID: PMC9849391 DOI: 10.3389/fnagi.2022.933453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 11/24/2022] [Indexed: 01/06/2023] Open
Abstract
Introduction Age-related macular degeneration (AMD) is the leading cause of irreversible central vision loss in developed countries and one of the leading causes of blindness. In this work, we evaluated color vision and the pupil light reflex (PLR) to assess visual function in patients with early and neovascular AMD (NVAMD) compared with the control group. Methods We recruited 34 early patients with dry AMD and classified them into two groups following AREDS: 13 patients with NVAMD and 24 healthy controls. Controls and patients with early dry AMD had visual acuity (VA) best or equal to 20/25 (0.098 logMAR). Color vision was assessed in controls and patients with early dry AMD using the Cambridge Color Test (CCT) 2.0 through the Trivector protocol. The PLR was evaluated using a Ganzfeld, controlled by the RETI-port system. The stimuli consisted of 1s blue (470 nm) and red (631 nm) light flashes presented alternately at 2-min intervals. To assess the cone contribution, we used a red flash at 2.4 log cd.m-2, with a blue background at 0.78 log cd.m-2. For rods, we used 470-nm flashes at -3 log cd.m-2, and for the melanopsin function of ipRGCs, we used 470 nm at 2.4 log cd.m-2. Results Patients with early dry AMD had reduced color discrimination in all three axes: protan (p = 0.0087), deutan (p = 0.0180), and tritan (p = 0.0095) when compared with the control group. The PLR has also been affected in patients with early dry AMD and patients with NVAMD. The amplitude for the melanopsin-driven response was smaller in patients with early dry AMD (p = 0.0485) and NVAMD (p = 0.0035) than in the control group. The melanopsin function was lower in patients with NVAMD (p = 0.0290) than the control group. For the rod-driven response, the latency was lower in the NVAMD group (p = 0.0041) than in the control group. No changes were found in cone-driven responses between the control and AMD groups. Conclusion Patients with early dry AMD present diffusely acquired color vision alteration detected by CCT. Rods and melanopsin contributions for PLR are affected in NVAMD. The CCT and the PLR may be considered sensitive tests to evaluate and monitor functional changes in patients with AMD.
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Affiliation(s)
- Diego Decleva
- Department of Experimental Psychology, Institute of Psychology, University of São Paulo, São Paulo, Brazil,Neuroscience and Behavior Graduate Studies Program, Institute of Psychology, University of São Paulo, São Paulo, Brazil,*Correspondence: Diego Decleva,
| | - Kallene Summer Vidal
- Department of Experimental Psychology, Institute of Psychology, University of São Paulo, São Paulo, Brazil,Prevent Senior Health Operator, São Paulo, Brazil,Service of Interdisciplinary Neuromodulation, Laboratory of Neurosciences (LIM-27), Institute of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil,Young Medical Leadership Program of National Academy of Medicine in Brazil, Rio de Janeiro, Brazil
| | - Andre Carvalho Kreuz
- Neuroscience and Behavior Graduate Studies Program, Institute of Psychology, University of São Paulo, São Paulo, Brazil
| | | | - Dora Fix Ventura
- Department of Experimental Psychology, Institute of Psychology, University of São Paulo, São Paulo, Brazil,Neuroscience and Behavior Graduate Studies Program, Institute of Psychology, University of São Paulo, São Paulo, Brazil
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Fars J, Fernandes TP, Huchzermeyer C, Kremers J, Paramei GV. Chromatic discrimination measures in mature observers depend on the response window. Sci Rep 2022; 12:9072. [PMID: 35641546 PMCID: PMC9156755 DOI: 10.1038/s41598-022-13129-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 05/20/2022] [Indexed: 11/09/2022] Open
Abstract
Our past anecdotal evidence prompted that a longer response window (RW) in the Trivector test (Cambridge Colour Test) improved mature observers’ estimates of chromatic discrimination. Here, we systematically explored whether RW variation affects chromatic discrimination thresholds measured by the length of Protan, Deutan and Tritan vectors. We employed the Trivector test with three RWs: 3 s, 5 s, and 8 s. Data of 30 healthy normal trichromats were stratified as age groups: ‘young’ (20–29 years), ‘middle-aged’ (31–48 years), and ‘mature’ (57–64 years). We found that for the ‘young’ and ‘middle-aged’, the thresholds were comparable at all tested RWs. However, the RW effect was apparent for the ‘mature’ observers: their Protan and Tritan thresholds decreased at 8-s RW compared to 3-s RW; moreover, their Tritan threshold decreased at 5-s RW compared to 3-s RW. Elevated discrimination thresholds at shorter RWs imply that for accurate performance, older observers require longer stimulus exposure and are indicative of ageing effects manifested by an increase in critical processing duration. Acknowledging low numbers in our ‘middle-aged’ and ‘mature’ samples, we consider our study as pilot. Nonetheless, our findings encourage us to advocate a RW extension in the Trivector protocol for testing mature observers, to ensure veridical measures of their chromatic discrimination by disentangling these from other ageing effects—slowing down of both motor responses and visual processing.
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Affiliation(s)
- Julien Fars
- Department of Ophthalmology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany.
| | - Thiago P Fernandes
- Department of Psychology, Federal University of Paraiba, Cidade Universitaria S/N, Joao Pessoa, 58051-900, Brazil
| | - Cord Huchzermeyer
- Department of Ophthalmology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Jan Kremers
- Department of Ophthalmology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Galina V Paramei
- Department of Psychology, Liverpool Hope University, Hope Park, Liverpool, L16 9JD, UK.
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Vidal KSM, Decleva D, Barboni MTS, Nagy BV, de Menezes PAH, Aher A, Coutinho AM, Squarzoni P, Faria DDP, Duran FLDS, Buchpiguel CA, Kremers J, Filho GB, Ventura DF. The Association Between Acquired Color Deficiency and PET Imaging of Neurodegeneration in Mild Cognitive Impairment and Alzheimer Disease. Invest Ophthalmol Vis Sci 2022; 63:20. [PMID: 35579902 PMCID: PMC9123488 DOI: 10.1167/iovs.63.5.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate color vision changes and retinal processing of chromatic and luminance pathways in subjects with Alzheimer disease (AD) and mild cognitive impairment (MCI) compared with a matched control group and whether such changes are associated with impaired brain glucose metabolism and β-amyloid deposition in the brain. Methods We evaluated 13 patients with AD (72.4 ± 7.7 years), 23 patients with MCI (72.5 ± 5.5 years), and 18 controls of comparable age (P = 0.44) using Cambridge color test and the heterochromatic flicker ERG (HF-ERG). The Cambridge color test was performed using the trivector protocol to estimate the protan, deutan and tritan color confusion axes. HF-ERG responses were measured at a frequency of 12 Hz, which ERGs reflect chromatic activity, and at 36 Hz, reflecting luminance pathway. A study subsample was performed using neuropsychological assessments and positron emission tomography. Results Patients with AD presented higher mean values indicating poorer color discrimination for protan (P = 0.04) and deutan (P = 0.001) axes compared with the controls. Along the tritan axis, both patients with AD and patients with MCI showed decreased color vision (P = 0.001 and P = 0.001) compared with controls. The analyses from the HF-ERG protocol revealed no differences between the groups (P = 0.31 and P = 0.41). Diffuse color vision loss was found in individuals with signs of neurodegeneration (protan P = 0.002, deutan P = 0.003 and tritan P = 0.01), but not in individuals with signs of β-amyloid deposition only (protan P = 0.39, deutan P = 0.48, tritan P = 0.63), regardless of their clinical classification. Conclusions Here, patients with AD and patients with MCI present acquired color vision deficiency that may be linked with impaired brain metabolism.
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Affiliation(s)
- Kallene Summer Moreira Vidal
- Laboratory of Vision, Institute of Psychology, University of São Paulo, São Paulo, Brazil.,Prevent Senior Private Health Operator, São Paulo, Brazil.,Young medical Leadership Program of National Academy of Medicine in Brazil, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Diego Decleva
- Laboratory of Vision, Institute of Psychology, University of São Paulo, São Paulo, Brazil
| | - Mirella Telles Salgueiro Barboni
- Laboratory of Vision, Institute of Psychology, University of São Paulo, São Paulo, Brazil.,Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Balàzs Vince Nagy
- Department of Mechatronics, Optics and Mechanical Engineering Informatics, University of Technology and Economics, Budapest, Hungary
| | | | - Avinash Aher
- Section for Retinal Physiology, University Hospital Erlangen, Erlangen, Germany
| | - Artur Martins Coutinho
- Laboratory of Psychiatric Neuroimaging (LIM 21), Department of Psychiatry, Medical School (FMUSP), University of São Paulo, São Paulo, Brazil.,Laboratory of Nuclear Medicine (LIM-43), Department of Radiology and Oncology, Medical School (FMUSP), University of São Paulo, São Paulo, Brazil
| | - Paula Squarzoni
- Laboratory of Psychiatric Neuroimaging (LIM 21), Department of Psychiatry, Medical School (FMUSP), University of São Paulo, São Paulo, Brazil.,Núcleo de Apoio à Pesquisa em Neurociência Aplicada (NAPNA), Universidade de São Paulo, São Paulo, Brazil
| | - Daniele de Paula Faria
- Laboratory of Nuclear Medicine (LIM-43), Department of Radiology and Oncology, Medical School (FMUSP), University of São Paulo, São Paulo, Brazil
| | - Fabio Luis de Souza Duran
- Laboratory of Psychiatric Neuroimaging (LIM 21), Department of Psychiatry, Medical School (FMUSP), University of São Paulo, São Paulo, Brazil.,Núcleo de Apoio à Pesquisa em Neurociência Aplicada (NAPNA), Universidade de São Paulo, São Paulo, Brazil
| | - Carlos Alberto Buchpiguel
- Laboratory of Nuclear Medicine (LIM-43), Department of Radiology and Oncology, Medical School (FMUSP), University of São Paulo, São Paulo, Brazil
| | - Jan Kremers
- Section for Retinal Physiology, University Hospital Erlangen, Erlangen, Germany
| | - Geraldo Busatto Filho
- Laboratory of Psychiatric Neuroimaging (LIM 21), Department of Psychiatry, Medical School (FMUSP), University of São Paulo, São Paulo, Brazil.,Núcleo de Apoio à Pesquisa em Neurociência Aplicada (NAPNA), Universidade de São Paulo, São Paulo, Brazil
| | - Dora Fix Ventura
- Laboratory of Vision, Institute of Psychology, University of São Paulo, São Paulo, Brazil.,Núcleo de Apoio à Pesquisa em Neurociência Aplicada (NAPNA), Universidade de São Paulo, São Paulo, Brazil
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Joly S, Mdzomba JB, Rodriguez L, Morin F, Vallières L, Pernet V. B cell-dependent EAE induces visual deficits in the mouse with similarities to human autoimmune demyelinating diseases. J Neuroinflammation 2022; 19:54. [PMID: 35197067 PMCID: PMC8867627 DOI: 10.1186/s12974-022-02416-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 02/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the field of autoimmune demyelinating diseases, visual impairments have extensively been studied using the experimental autoimmune encephalomyelitis (EAE) mouse model, which is classically induced by immunization with myelin oligodendrocyte glycoprotein peptide (MOG35-55). However, this model does not involve B cells like its human analogs. New antigens have thus been developed to induce a B cell-dependent form of EAE that better mimics human diseases. METHODS The present study aimed to characterize the visual symptoms of EAE induced with such an antigen called bMOG. After the induction of EAE with bMOG in C57BL/6J mice, visual function changes were studied by electroretinography and optomotor acuity tests. Motor deficits were assessed in parallel with a standard clinical scoring method. Histological examinations and Western blot analyses allowed to follow retinal neuron survival, gliosis, microglia activation, opsin photopigment expression in photoreceptors and optic nerve demyelination. Disease effects on retinal gene expression were established by RNA sequencing. RESULTS We observed that bMOG EAE mice exhibited persistent loss of visual acuity, despite partial recovery of electroretinogram and motor functions. This loss was likely due to retinal inflammation, gliosis and synaptic impairments, as evidenced by histological and transcriptomic data. Further analysis suggests that the M-cone photoreceptor pathway was also affected. CONCLUSION Therefore, by documenting visual changes induced by bMOG and showing similarities to those seen in diseases such as multiple sclerosis and neuromyelitis optica, this study offers a new approach to test protective or restorative ophthalmic treatments.
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Affiliation(s)
- Sandrine Joly
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Regenerative Medicine Unit, University Hospital Center of Quebec, Laval University, Quebec City, QC Canada
| | - Julius Baya Mdzomba
- Regenerative Medicine Unit, University Hospital Center of Quebec, Laval University, Quebec City, QC Canada
- Department of Molecular Medicine, Faculty of Medicine, Laval University, Quebec City, QC Canada
| | - Léa Rodriguez
- Regenerative Medicine Unit, University Hospital Center of Quebec, Laval University, Quebec City, QC Canada
- Department of Molecular Medicine, Faculty of Medicine, Laval University, Quebec City, QC Canada
| | - Françoise Morin
- Department of Molecular Medicine, Faculty of Medicine, Laval University, Quebec City, QC Canada
- Neuroscience Unit, University Hospital Center of Quebec, Laval University, Quebec City, QC Canada
| | - Luc Vallières
- Department of Molecular Medicine, Faculty of Medicine, Laval University, Quebec City, QC Canada
- Neuroscience Unit, University Hospital Center of Quebec, Laval University, Quebec City, QC Canada
| | - Vincent Pernet
- Regenerative Medicine Unit, University Hospital Center of Quebec, Laval University, Quebec City, QC Canada
- Department of Molecular Medicine, Faculty of Medicine, Laval University, Quebec City, QC Canada
- Center for Experimental Neurology (ZEN), University of Bern, Bern, Switzerland
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Sahli Haus 1, UG Büro 1, Freiburgstrasse 14, 3010 Bern, Switzerland
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Fernandes Costa M, Dutra Henriques L, Côrrea Pinho O. Development of a Spatio-temporal Contrast Sensitivity Test for Clinical Use. J Ophthalmic Vis Res 2022; 17:69-77. [PMID: 35194498 PMCID: PMC8850854 DOI: 10.18502/jovr.v17i1.10172] [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: 04/22/2020] [Accepted: 03/11/2021] [Indexed: 11/24/2022] Open
Abstract
PURPOSE We developed a contrast sensitivity test that considers an integrative approach of spatial and temporal frequencies to evaluate the psychophysical channels in processing two-dimensional stimulus for clinical use. Our new procedure provides a more efficient isolation of the magnocellular and parvocellular visual pathways supporting spatiotemporal contrast sensitivity processing. METHODS We evaluated 36 participants of both sexes aged 18-30 years with 20/20 or better best-corrected visual acuity. Two spatial frequencies (0.5 cycles per degree [cpd] and 10 cpd), being in one of the three temporal frequencies (0.5 cycle per second [cps], 7.5 cps, and 15 cps), were presented in a high-resolution gamma corrected monitor. A two-alternative forced-choice procedure was conducted, and the staircase method was used to calculate the contrast sensitivity. Reliability was assessed using a retest procedure within a month ( ± 5 days) under the same conditions. RESULTS Results showed statistical significance in 0.5 cpd and 10 cpd spatial frequencies for 0.5 cps (F = 77.36; p < 0.001), 7.5 cps (F = 778.37; p < 0.001), and 15 cps (F = 827.23; p < 0.001) with a very high (η² = 0.89) effect size. No statistical differences were found between the first and second sessions for all spatial frequencies. For reliability, a significantly high correlation and high internal consistency were found in all spatiotemporal conditions. The limits were calculated for normality. CONCLUSION We developed an approach to investigate the spatiotemporal integration of contrast sensitivity designed for clinical purposes. The relative contribution of the low spatial frequencies/high temporal frequencies and the high spatial frequencies/low temporal frequencies of the psychophysical channels can also be evaluated separately.
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Affiliation(s)
- Marcelo Fernandes Costa
- Laboratório da Visão, Departamento de Psicologia Experimental, Instituto de Psicologia, Universidade de São Paulo, São Paulo, Brazil
- Núcleo de Neurociências Aplicada, Universidade de São Paulo, São Paulo, Brazil
| | - Leonardo Dutra Henriques
- Laboratório da Visão, Departamento de Psicologia Experimental, Instituto de Psicologia, Universidade de São Paulo, São Paulo, Brazil
| | - Otávio Côrrea Pinho
- Laboratório da Visão, Departamento de Psicologia Experimental, Instituto de Psicologia, Universidade de São Paulo, São Paulo, Brazil
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Barreiro-González A, Sanz MT, Carratalà-Boscà S, Pérez-Miralles F, Alcalá C, España-Gregori E, Casanova B. Dyschromatopsia in multiple sclerosis reflects diffuse chronic neurodegeneration beyond anatomical landmarks. Acta Neurol Belg 2021; 121:1767-1775. [PMID: 33044738 DOI: 10.1007/s13760-020-01516-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 09/28/2020] [Indexed: 10/23/2022]
Abstract
To formulate and validate a dyschromatopsia linear regression model in patients with multiple sclerosis (MS). 64 MS patients (50 to formulate the model and 14 for its validation) underwent neurological (Expanded Disability Status Scale, EDSS), color vision (Farnsworth D15 test), and peripapillary retinal nerve fiber layer (pRNFL) and retinal evaluation with spectral-domain optical coherence tomography (SD-OCT). Neuroradiological examination permitted to obtain brain parenchymal fraction (BPF) and cervical spinal cord volume (SC). Ophthalmic parameters were calculated as the average of both non-optic neuritis (ON) eyes, and in case the patient had previous ON, the value of the fellow non-ON eye was taken. The influence of sex, age, disease duration, and history of disease-modifying treatment (first- or second-line DMT) was tested as covariables that could influence color perception. Color confusion index (log CCI) correlated with pRNFL (r = - 0.322, p = 0.009), ganglion cell layer (GCL, r = - 0.321, p = 0.01), BPF (r = - 0.287, p = 0.021), SC volume (r = - 0.33, p = 0.008), patients' age (r = 0.417, p = 0.001), disease duration (r = 0.371, p = 0.003), and EDSS (r = 0.44, p = 0.001). The following CCI equation was obtained: log (CCI) = 0.316-0.224 BPF - 0.187 SC volume (mm3) + 0.226 age (years) + 0.012 disease duration (years) - 0.372 GCL (µm). CCI correlates with MS clinical and paraclinical established biomarkers suggesting chronic diffuse neurodegeneration in MS operates at brain, SC, and retina linking all three compartments. Color vision outcome can be calculated through the aforementioned variables for clinical and research purposes.
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Affiliation(s)
- Antonio Barreiro-González
- Ophthalmology Department, University and Polytechnic Hospital La Fe, Avenida Fernando Abril Martorell 106, 46026, Valencia, Spain.
| | - Maria T Sanz
- Departamento de Didáctica de La Matemática, Universidad de Valencia, Valencia, Spain
| | - Sara Carratalà-Boscà
- Neurology Department, University and Polytechnic Hospital La Fe, Valencia, Spain
| | | | - Carmen Alcalá
- Neurology Department, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Enrique España-Gregori
- Ophthalmology Department, University and Polytechnic Hospital La Fe, Avenida Fernando Abril Martorell 106, 46026, Valencia, Spain
- Surgery Department, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Bonaventura Casanova
- Neurology Department, University and Polytechnic Hospital La Fe, Valencia, Spain
- Medicine Department, Faculty of Medicine, University of Valencia, Valencia, Spain
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Anssari N, Vosoughi R, Mullen K, Mansouri B. Selective Colour Vision Deficits in Multiple Sclerosis at Different Temporal Stages. Neuroophthalmology 2019; 44:16-23. [PMID: 32076444 DOI: 10.1080/01658107.2019.1615960] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 05/01/2019] [Accepted: 05/03/2019] [Indexed: 10/26/2022] Open
Abstract
Multiple sclerosis (MS) without optic neuritis causes color-vision deficit but the evidence for selective color deficits in parvocellular-Red/Green (PC-RG) and koniocellular-Blue/Yellow (KC-BY) pathways is inconclusive. We investigated selective color-vision deficits at different MS stages. Thirty-one MS and twenty normal participants were tested for achromatic, red-green and blue-yellow sinewave-gratings (0.5 and 2 cycles-per-degree (cpd)) contrast orientation discrimination threshold. Red-green mean threshold at 0.5cpd in established-MS and blue-yellow mean threshold in all MS participants were abnormal. These findings show blue-yellow versus red-green color test is useful in differentiating MS chronicity, which helps to better understand the mechanism of colour-vision involvement in MS.
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Affiliation(s)
- Neda Anssari
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Canada
| | - Reza Vosoughi
- Section of Neurology, Department of Internal Medicine, University of Manitoba, Winnipeg, Canada
| | - Kathy Mullen
- Department of Ophthlmology, McGill University, Montreal, Canada
| | - Behzad Mansouri
- Section of Neurology, Department of Internal Medicine, University of Manitoba, Winnipeg, Canada
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Hasrod N, Rubin A. The Cambridge Colour Test: Reliability of discrimination trivectors in colour space. AFRICAN VISION AND EYE HEALTH 2019. [DOI: 10.4102/aveh.v78i1.451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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11
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de Loureiro TMG, Brodeur K, Schade G, Brito FAC, Salomao RC, Miquilini L, Bonci DMO, Baran LCP, Hauzman E, Goulart PRK, Cortes MIT, Ventura DF, Fitzgerald MEC, Souza GS. Effect of the Decrease in Luminance Noise Range on Color Discrimination of Dichromats and Trichromats. Front Behav Neurosci 2018; 12:292. [PMID: 30532699 PMCID: PMC6265314 DOI: 10.3389/fnbeh.2018.00292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 11/12/2018] [Indexed: 11/23/2022] Open
Abstract
Color vision assessment can be done using pseudoisochromatic stimuli, which has a luminance noise to eliminate brightness differences between the target and background of the stimulus. It is not clear the influence of the luminance noise on color discrimination. We investigated the effect of change in the luminance noise limits on color discrimination. Eighteen trichromats and ten congenital dichromats (eight protans, two deutans) had their color vision evaluated by the Cambridge Colour Test, and were genetically tested for diagnostic confirmation. The stimuli were composed of a mosaic of circles in a 5° circular field. A subset of the circles differed in chromaticity from the remaining field, forming a letter C. Color discrimination was estimated in stimulus conditions differing in luminance noise range: (i) 6–20 cd/m2; (ii) 8–18 cd/m2; (iii) 10–16 cd/m2; and (iv) 12–14 cd/m2. Six equidistant luminance values were used within the luminance noise limits with the mean stimulus luminance maintained constant under all conditions. A four-alternative, forced-choice method was applied to feed a staircase procedure to estimate color discrimination thresholds along eight chromatic axes. An ellipse model was adjusted to the eight color discrimination thresholds. The parameters of performance were threshold vector lengths and the ellipse area. Results were compared using the Kruskal-Wallis test with a significance level of 5%. The linear function model was applied to analyze the dependence of the discrimination parameters on the noise luminance limits. The first derivative of linear function was used as an indicator of the rate of change in color discrimination as a function of luminance noise changes. The rate of change of the ellipse area as a function of the luminance range in dichromats was higher than in trichromats (p < 0.05). Significant difference was also found for individual thresholds in half of the axes we tested. Luminance noise had a greater effect on color discrimination ability of dichromats than the trichromats, especially when the chromaticities were close to their protan and deutan color confusion lines.
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Affiliation(s)
| | - Ketan Brodeur
- University of Michigan, Ann Arbor, MI, United States
| | | | | | | | - Leticia Miquilini
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | | | | | - Einat Hauzman
- Instituto de Psicologia, Universidade de São Paulo, São Paulo, Brazil
| | | | | | - Dora Fix Ventura
- Instituto de Psicologia, Universidade de São Paulo, São Paulo, Brazil
| | - Malinda E C Fitzgerald
- Southern College of Optometry, Memphis, TN, United States.,Biology, Didactic Faculty and Anatomy and Neurobiology, Christian Brothers University, Memphis, TN, United States.,University of Tennessee Health Science Center, Memphis, TN, United States
| | - Givago Silva Souza
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil.,Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Brazil
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Color vision testing versus pattern visual evoked potentials and optical coherence tomography parameters in subclinical optic nerve involvement in multiple sclerosis. J Clin Neurosci 2018; 61:48-53. [PMID: 30455132 DOI: 10.1016/j.jocn.2018.11.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 08/25/2018] [Accepted: 11/04/2018] [Indexed: 11/24/2022]
Abstract
Acute idiopathic demyelinating optic neuritis is frequently the initial manifestation of multiple sclerosis (MS). We aimed to discuss the value of color vision testing to detect possible optic nerve involvement in patients with MS who had no history of optic neuritis. We evaluated color vision with Farnsworth-Munsell 100 (FM-100) hue test. Total error scores (TES), partial error scores for the red-green axis (RGS) and blue-yellow axis (BYS) were calculated. Topographic optic disc parameters (RNFL, RA, DA, CV, RV, and vertical C/D ratio), total macular volume (TMV), central macular thickness (CMT), and retinal ganglion cell layer (RGCL) were determined using spectral domain optical coherence tomography (SD-OCT). Choroidal thickness (CT) was measured using enhanced depth imaging optical coherence tomography (EDI-OCT). Pattern visual evoked potentials (PVEP) were also performed. Twenty-eight patients with RRMS (56 eyes) and 25 healthy controls (50 eyes) were included. P100 latencies were significantly delayed and P100 amplitudes were significantly reduced in the patient group compared with the controls (p ≤ 0.05). Statistically significant thinning was found in temporal quadrant in the patient group compared with the controls (p = 0.002). TES RGS, and BYS were all increased in the patient group but this was not statistically significant. We found no correlation between TES, RGS, BYS, and P100 latencies or OCT parameters. In our investigation as to whether color vision testing could be a simple biomarker for showing neurodegeneration of the anterior visual pathway regardless of optic neuritis, PVEP and OCT-assessed RNFL thickness seemed to be a more valuable biomarker than color vision testing.
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Psychophysical Measurements of Luminance Contrast Sensitivity and Color Discrimination with Transparent and Blue-Light Filter Intraocular Lenses. Ophthalmol Ther 2017; 6:301-312. [PMID: 28795358 PMCID: PMC5693818 DOI: 10.1007/s40123-017-0101-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Indexed: 12/03/2022] Open
Abstract
Introduction The purpose of this study was to measure luminance contrast sensitivity and color vision thresholdfs in normal subjects using a blue light filter lens and transparent intraocular lens material. Methods Monocular luminance grating contrast sensitivity was measured with Psycho for Windows (version 2.36; Cambridge Research Systems) at 3.0, 6.0, 12.0, 20.0, and 30.0 cycles per degree of visual angle (cpd) in 15 normal subjects (eight female), with a mean age of 21.6 years (SD = 3.8 years). Chromatic discrimination was assessed with the Cambridge colour test (CCT) along the protan, deutan, and tritan color confusion axes. Both tests were performed in a darkened room under two situations: with a transparent lens and with blue light filter lens. Subjective impressions were taken by subjects regarding their visual experience under both conditions. Results No difference was found between the luminance contrast sensitivity measured with transparent and blue light filter. However, 13/15 (87%) of the subjects reported more comfortable vision with the blue filter. In the color vision test, tritan thresholds were significantly higher for the blue filter compared with the transparent filter (p = 0.003). For protan and deutan thresholds no differences were found. Conclusion Blue-yellow color vision is impaired with the blue light filter, and no impairment occurs with the transparent filter. No significant differences in thresholds were found in the luminance contrast sensitivity comparing the blue light and transparent filters. The impact of short wavelength light filtering on intrinsically photosensitive retinal ganglion cells is also discussed.
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Zachi EC, Costa TL, Barboni MTS, Costa MF, Bonci DMO, Ventura DF. Color Vision Losses in Autism Spectrum Disorders. Front Psychol 2017; 8:1127. [PMID: 28713324 PMCID: PMC5492848 DOI: 10.3389/fpsyg.2017.01127] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 06/19/2017] [Indexed: 02/04/2023] Open
Abstract
Autism spectrum disorders (ASDs) are neurodevelopmental conditions characterized by impairments in social/communication abilities and restricted behaviors. The present study aims to examine color vision discrimination in ASD children and adolescents without intellectual disability. The participants were also subdivided in order to compare color vision thresholds of autistic participants and those who achieved diagnostic criteria for Asperger Syndrome (AS). Nine subjects with autism, 11 participants with AS and 36 typically developing children and adolescents participated in the study. Color vision was assessed by the Cambridge Color Test (CCT). The Trivector protocol was administered to determine color discrimination thresholds along the protan, deutan, and tritan color confusion lines. Data from ASD participants were compared to tolerance limits for 90% of the population with 90% probability obtained from controls thresholds. Of the 20 ASD individuals examined, 6 (30%) showed color vision losses. Elevated color discrimination thresholds were found in 3/9 participants with autism and in 3/11 AS participants. Diffuse and tritan deficits were found. Mechanisms for chromatic losses may be either at the retinal level and/or reflect reduced cortical integration.
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Affiliation(s)
- Elaine C. Zachi
- Department of Experimental Psychology, Nucleus for Neuroscience and Behavior, Institute of Psychology, University of São PauloSão Paulo, Brazil
| | - Thiago L. Costa
- Department of Experimental Psychology, Nucleus for Neuroscience and Behavior, Institute of Psychology, University of São PauloSão Paulo, Brazil
- Cognitive Neuroscience Laboratory and Developmental Disorders Program, Center for Health and Biological Sciences, Mackenzie Presbyterian UniversitySão Paulo, Brazil
| | - Mirella T. S. Barboni
- Department of Experimental Psychology, Nucleus for Neuroscience and Behavior, Institute of Psychology, University of São PauloSão Paulo, Brazil
| | - Marcelo F. Costa
- Department of Experimental Psychology, Nucleus for Neuroscience and Behavior, Institute of Psychology, University of São PauloSão Paulo, Brazil
| | - Daniela M. O. Bonci
- Department of Experimental Psychology, Nucleus for Neuroscience and Behavior, Institute of Psychology, University of São PauloSão Paulo, Brazil
| | - Dora F. Ventura
- Department of Experimental Psychology, Nucleus for Neuroscience and Behavior, Institute of Psychology, University of São PauloSão Paulo, Brazil
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Nguyen CTO, Hui F, Charng J, Velaedan S, van Koeverden AK, Lim JKH, He Z, Wong VHY, Vingrys AJ, Bui BV, Ivarsson M. Retinal biomarkers provide "insight" into cortical pharmacology and disease. Pharmacol Ther 2017; 175:151-177. [PMID: 28174096 DOI: 10.1016/j.pharmthera.2017.02.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The retina is an easily accessible out-pouching of the central nervous system (CNS) and thus lends itself to being a biomarker of the brain. More specifically, the presence of neuronal, vascular and blood-neural barrier parallels in the eye and brain coupled with fast and inexpensive methods to quantify retinal changes make ocular biomarkers an attractive option. This includes its utility as a biomarker for a number of cerebrovascular diseases as well as a drug pharmacology and safety biomarker for the CNS. It is a rapidly emerging field, with some areas well established, such as stroke risk and multiple sclerosis, whereas others are still in development (Alzheimer's, Parkinson's, psychological disease and cortical diabetic dysfunction). The current applications and future potential of retinal biomarkers, including potential ways to improve their sensitivity and specificity are discussed. This review summarises the existing literature and provides a perspective on the strength of current retinal biomarkers and their future potential.
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Affiliation(s)
- Christine T O Nguyen
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia.
| | - Flora Hui
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Jason Charng
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Shajan Velaedan
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Anna K van Koeverden
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Jeremiah K H Lim
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Zheng He
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Vickie H Y Wong
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Algis J Vingrys
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Bang V Bui
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Magnus Ivarsson
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
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Longbrake EE, Lancia S, Tutlam N, Trinkaus K, Naismith RT. Quantitative visual tests after poorly recovered optic neuritis due to multiple sclerosis. Mult Scler Relat Disord 2016; 10:198-203. [PMID: 27919490 DOI: 10.1016/j.msard.2016.10.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 08/11/2016] [Accepted: 10/24/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Visual dysfunction in MS can be quantified using a variety of tests. Many vision tests have not been formally evaluated among MS patients with existing visual dysfunction. OBJECTIVE Evaluate several versions of visual acuity and contrast sensitivity tests, measures of central and peripheral vision, retina structure, electrophysiologic function, and quality of life among MS patients with moderate/severe visual dysfunction. METHODS Cross-sectional study of 46 patients with stable, incompletely recovered optic neuritis. Testing included Snellen eye charts, several Sloan low contrast charts, Pelli Robson (PR) contrast sensitivity charts, optical coherence tomography, visual fields, Farnsworth Munsell 100-hue test, visual evoked potentials (VEP), and visual function quality of life (VFQ-25) testing. RESULTS 98% of eyes could read two lines of the PR chart, while only 43% read the 2.5% contrast chart. Low contrast tests correlated strongly with each other and with retinal nerve fiber layer (RNFL) thickness, visual fields, and color vision but not with VEPs. For patients with RNFL <75µm, VFQ-25 scores dropped by approximately 2 points for every 1µm decrease in RNFL. CONCLUSION Among MS patients with visual impairment due to optic neuritis, PR contrast sensitivity could be utilized as a single chart. Visual quality of life was associated with RNFL thinning below 75µm.
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Affiliation(s)
- Erin E Longbrake
- Department of Neurology, Washington University in St. Louis, St Louis, MO, United States.
| | - Samantha Lancia
- Department of Neurology, Washington University in St. Louis, St Louis, MO, United States
| | - Nhial Tutlam
- Department of Neurology, Washington University in St. Louis, St Louis, MO, United States
| | - Kathryn Trinkaus
- Division of Biostatistics, Washington University in St. Louis, St Louis, MO, United States
| | - Robert T Naismith
- Department of Neurology, Washington University in St. Louis, St Louis, MO, United States
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Cormenzana Méndez I, Martín A, Charmichael TL, Jacob MM, Lacerda EMCB, Gomes BD, Fitzgerald MEC, Ventura DF, Silveira LCL, O'Donell BM, Souza GS. Color Discrimination Is Affected by Modulation of Luminance Noise in Pseudoisochromatic Stimuli. Front Psychol 2016; 7:1006. [PMID: 27458404 PMCID: PMC4934133 DOI: 10.3389/fpsyg.2016.01006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 06/20/2016] [Indexed: 11/13/2022] Open
Abstract
Pseudoisochromatic stimuli have been widely used to evaluate color discrimination and to identify color vision deficits. Luminance noise is one of the stimulus parameters used to ensure that subject's response is due to their ability to discriminate target stimulus from the background based solely on the hue between the colors that compose such stimuli. We studied the influence of contrast modulation of the stimulus luminance noise on threshold and reaction time color discrimination. We evaluated color discrimination thresholds using the Cambridge Color Test (CCT) at six different stimulus mean luminances. Each mean luminance condition was tested using two protocols: constant absolute difference between maximum and minimum luminance of the luminance noise (constant delta protocol, CDP), and constant contrast modulation of the luminance noise (constant contrast protocol, CCP). MacAdam ellipses were fitted to the color discrimination thresholds in the CIE 1976 color space to quantify the color discrimination ellipses at threshold level. The same CDP and CCP protocols were applied in the experiment measuring RTs at three levels of stimulus mean luminance. The color threshold measurements show that for the CDP, ellipse areas decreased as a function of the mean luminance and they were significantly larger at the two lowest mean luminances, 10 cd/m2 and 13 cd/m2, compared to the highest one, 25 cd/m2. For the CCP, the ellipses areas also decreased as a function of the mean luminance, but there was no significant difference between ellipses areas estimated at six stimulus mean luminances. The exponent of the decrease of ellipse areas as a function of stimulus mean luminance was steeper in the CDP than CCP. Further, reaction time increased linearly with the reciprocal of the length of the chromatic vectors varying along the four chromatic half-axes. It decreased as a function of stimulus mean luminance in the CDP but not in the CCP. The findings indicated that visual performance using pseudoisochromatic stimuli was dependent on the Weber's contrast of the luminance noise. Low Weber's contrast in the luminance noise is suggested to have a reduced effect on chromatic information and, hence, facilitate desegregation of the hue-defined target from the background.
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Affiliation(s)
- Iñaki Cormenzana Méndez
- Departamento de Luminotecnia, Luz y Visión "Ing. Herberto C. Bühler", Facultad de Ciencias Exactas y Tecnología, Universidad Nacional de Tucumán Tucumán, Argentina
| | - Andrés Martín
- Departamento de Luminotecnia, Luz y Visión "Ing. Herberto C. Bühler", Facultad de Ciencias Exactas y Tecnología, Universidad Nacional de Tucumán Tucumán, Argentina
| | | | - Mellina M Jacob
- Instituto de Ciências Biológicas, Universidade Federal do Pará Belém, Brazil
| | | | - Bruno D Gomes
- Instituto de Ciências Biológicas, Universidade Federal do Pará Belém, Brazil
| | - Malinda E C Fitzgerald
- Department of Biology, Christian Brothers UniversityMemphis, TN, USA; Department of Anatomy and Neurobiology, University of Tennessee Health Science CenterMemphis, TN, USA
| | - Dora F Ventura
- Department of Experimental Psychology, Instituto de Psicologia, Universidade de São Paulo São Paulo, Brazil
| | - Luiz C L Silveira
- Instituto de Ciências Biológicas, Universidade Federal do ParáBelém, Brazil; Núcleo de Medicina Tropical, Universidade Federal do ParáBelém, Brazil; Universidade do CeumaSão Luís, Brazil
| | - Beatriz M O'Donell
- Departamento de Luminotecnia, Luz y Visión "Ing. Herberto C. Bühler", Facultad de Ciencias Exactas y Tecnología, Universidad Nacional de Tucumán Tucumán, Argentina
| | - Givago S Souza
- Instituto de Ciências Biológicas, Universidade Federal do ParáBelém, Brazil; Núcleo de Medicina Tropical, Universidade Federal do ParáBelém, Brazil
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Bento-Torres NVO, Rodrigues AR, Côrtes MIT, Bonci DMDO, Ventura DF, Silveira LCDL. Psychophysical Evaluation of Congenital Colour Vision Deficiency: Discrimination between Protans and Deutans Using Mollon-Reffin's Ellipses and the Farnsworth-Munsell 100-Hue Test. PLoS One 2016; 11:e0152214. [PMID: 27101124 PMCID: PMC4839569 DOI: 10.1371/journal.pone.0152214] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 03/10/2016] [Indexed: 11/18/2022] Open
Abstract
We have used the Farnsworth-Munsell 100-hue (FM 100) test and Mollon-Reffin (MR) test to evaluate the colour vision of 93 subjects, 30.4 ± 9.7 years old, who had red-green congenital colour vision deficiencies. All subjects lived in Belém (State of Pará, Brazil) and were selected by the State of Pará Traffic Department. Selection criteria comprised the absence of visual dysfunctions other than Daltonism and no history of systemic diseases that could impair the visual system performance. Results from colour vision deficient were compared with those from 127 normal trichromats, 29.3 ± 10.3 years old. For the MR test, measurements were taken around five points of the CIE 1976 colour space, along 20 directions irradiating from each point, in order to determine with high-resolution the corresponding colour discrimination ellipses (MacAdam ellipses). Three parameters were used to compare results obtained from different subjects: diameter of circle with same ellipse area, ratio between ellipse’s long and short axes, and ellipse long axis angle. For the FM 100 test, the parameters were: logarithm of the total number of mistakes and positions of mistakes in the FM diagram. Data were also simultaneously analysed in two or three dimensions as well as by using multidimensional cluster analysis. For the MR test, Mollon-Reffin Ellipse #3 (u’ = 0.225, v’ = 0.415) discriminated more efficiently than the other four ellipses between protans and deutans once it provided larger angular difference in the colour space between protan and deutan confusion lines. The MR test was more sensitive than the FM 100 test. It separated individuals by dysfunctional groups with greater precision, provided a more sophisticated quantitative analysis, and its use is appropriate for a more refined evaluation of different phenotypes of red-green colour vision deficiencies.
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Affiliation(s)
- Natáli Valim Oliver Bento-Torres
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
- Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém, Pará, Brazil
| | - Anderson Raiol Rodrigues
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará, Brazil
| | | | | | - Dora Fix Ventura
- Departamento de Psicologia Experimental, Instituto de Psicologia, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Luiz Carlos de Lima Silveira
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará, Brazil
- Universidade Ceuma, São Luís, Maranhão, Brazil
- * E-mail:
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Color vision impairment in multiple sclerosis points to retinal ganglion cell damage. J Neurol 2015; 262:2491-7. [PMID: 26259563 DOI: 10.1007/s00415-015-7876-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 07/31/2015] [Accepted: 08/01/2015] [Indexed: 10/23/2022]
Abstract
Multiple Sclerosis (MS) results in color vision impairment regardless of optic neuritis (ON). The exact location of injury remains undefined. The objective of this study is to identify the region leading to dyschromatopsia in MS patients' NON-eyes. We evaluated Spearman correlations between color vision and measures of different regions in the afferent visual pathway in 106 MS patients. Regions with significant correlations were included in logistic regression models to assess their independent role in dyschromatopsia. We evaluated color vision with Hardy-Rand-Rittler plates and retinal damage using Optical Coherence Tomography. We ran SIENAX to measure Normalized Brain Parenchymal Volume (NBPV), FIRST for thalamus volume and Freesurfer for visual cortex areas. We found moderate, significant correlations between color vision and macular retinal nerve fiber layer (rho = 0.289, p = 0.003), ganglion cell complex (GCC = GCIP) (rho = 0.353, p < 0.001), thalamus (rho = 0.361, p < 0.001), and lesion volume within the optic radiations (rho = -0.230, p = 0.030). Only GCC thickness remained significant (p = 0.023) in the logistic regression model. In the final model including lesion load and NBPV as markers of diffuse neuroaxonal damage, GCC remained associated with dyschromatopsia [OR = 0.88 95 % CI (0.80-0.97) p = 0.016]. This association remained significant when we also added sex, age, and disease duration as covariates in the regression model. Dyschromatopsia in NON-eyes is due to damage of retinal ganglion cells (RGC) in MS. Color vision can serve as a marker of RGC damage in MS.
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Kuchenbecker J, Blum M, Paul F. [Investigation of color vision in acute unilateral optic neuritis using a web-based color vision test]. Ophthalmologe 2015. [PMID: 26224172 DOI: 10.1007/s00347-015-0108-5] [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] [Indexed: 11/27/2022]
Abstract
BACKGROUND In acute unilateral optic neuritis (ON) color vision defects combined with a decrease in visual acuity and contrast sensitivity frequently occur. This study investigated whether a web-based color vision test is a reliable detector of acquired color vision defects in ON and, if so, which charts are particularly suitable. METHODS In 12 patients with acute unilateral ON, a web-based color vision test ( www.farbsehtest.de ) with 25 color plates (16 Velhagen/Broschmann and 9 Ishihara color plates) was performed. For each patient the affected eye was tested first and then the unaffected eye. RESULTS The mean best-corrected distance visual acuity (BCDVA) in the ON eye was 0.36 ± 0.20 and 1.0 ± 0.1 in the contralateral eye. The number of incorrectly read plates correlated with the visual acuity. For the ON eye a total of 134 plates were correctly identified and 166 plates were incorrectly identified, while for the disease-free fellow eye, 276 plates were correctly identified and 24 plates were incorrectly identified. Both of the blue/yellow plates were identified correctly 14 times and incorrectly 10 times using the ON eye and exclusively correctly (24 times) using the fellow eye. The Velhagen/Broschmann plates were incorrectly identified significantly more frequently in comparison with the Ishihara plates. In 4 out of 16 Velhagen/Broschmann plates and 5 out of 9 Ishihara plates, no statistically significant differences between the ON eye and the fellow eye could be detected. CONCLUSION The number of incorrectly identified plates correlated with a decrease in visual acuity. Red/green and blue/yellow plates were incorrectly identified significantly more frequently with the ON eye, while the Velhagen/Broschmann color plates were incorrectly identified significantly more frequently than the Ishihara color plates. Thus, under defined test conditions the web-based color vision test can also be used to detect acquired color vision defects, such as those caused by ON. Optimization of the test by altering the combination of plates may be a useful next step.
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Affiliation(s)
- J Kuchenbecker
- Augenklinik des Helios Klinikum Berlin Buch, Schwanebecker Chaussee 50, 13125, Berlin, Deutschland.
| | - M Blum
- Augenklinik des Helios Klinikum Erfurt, Erfurt, Deutschland
| | - F Paul
- NeuroCure Clinical Research Center und Klinisches und Experimentelles Forschungszentrum für Multiple Sklerose, Klinik für Neurologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
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Hasrod N, Rubin A. Colour vision: A review of the Cambridge Colour Test and other colour testing methods. AFRICAN VISION AND EYE HEALTH 2015. [DOI: 10.4102/aveh.v74i1.23] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
The evaluation of colour vision and discrimination of an individual forms an integral part of a routine eye and vision examination. With the increasing prevalence of inherited colour vision deficiencies, defects of colour vision can be detected in an optometric practice by means of a variety of tests available. The present article comprises an overview of the design and function of a selection of colour vision tests that are administered manually and, in some cases, have been modified to form a computerised version.
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Paramei GV, Oakley B. Variation of color discrimination across the life span. JOURNAL OF THE OPTICAL SOCIETY OF AMERICA. A, OPTICS, IMAGE SCIENCE, AND VISION 2014; 31:A375-A384. [PMID: 24695196 DOI: 10.1364/josaa.31.00a375] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The present study, an extension of Paramei [J. Opt. Soc. Am. A, 29, A290, 2012], provides normative data on chromatic discrimination, using the Cambridge Colour Test, for normal trichromats aged 10-88 years. Findings are in accord with a two-phase variation across the life span: chromatic sensitivity improves in adolescence, reaches a maximum around 30 years, and then undergoes a gradual decrease. Indicative parameters are Protan (P), Deutan (D), and Tritan (T) vector lengths and major axes and axis ratios of Ellipses. Trivector data are modeled as non-monotonic combinations of power functions, with goodness-of-fits R(P)2=0.23, R(D)2=0.23, and R(T)2=0.45. For advancing age, sensitivity decline in all chromatic systems was confirmed, though with a marked acceleration after 60 years (reflected by the power function exponent >1) and more pronounced for the tritan system.
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Abstract
Acute optic neuritis is the most common optic neuropathy affecting young adults. Exciting developments have occurred over the past decade in understanding of optic neuritis pathophysiology, and these developments have been translated into treatment trials. In its typical form, optic neuritis presents as an inflammatory demyelinating disorder of the optic nerve, which can be associated with multiple sclerosis. Atypical forms of optic neuritis can occur, either in association with other inflammatory disorders or in isolation. Differential diagnosis includes various optic nerve and retinal disorders. Diagnostic investigations include MRI, visual evoked potentials, and CSF examination. Optical coherence tomography can show retinal axonal loss, which correlates with measures of persistent visual dysfunction. Treatment of typical forms with high-dose corticosteroids shortens the period of acute visual dysfunction but does not affect the final visual outcome. Atypical forms can necessitate prolonged immunosuppressive regimens. Optical coherence tomography and visual evoked potential measures are suitable for detection of neuroaxonal loss and myelin repair after optic neuritis. Clinical trials are underway to identify potential neuroprotective or remyelinating treatments for acutely symptomatic inflammatory demyelinating CNS lesions.
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Affiliation(s)
- Ahmed T Toosy
- Queen Square Multiple Sclerosis Centre, UCL Institute of Neurology, University College London, London, UK; Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, University College London, London, UK.
| | - Deborah F Mason
- Department of Neurology, Christchurch Hospital, Christchurch, New Zealand
| | - David H Miller
- Queen Square Multiple Sclerosis Centre, UCL Institute of Neurology, University College London, London, UK; Department of Neuroinflammation, UCL Institute of Neurology, University College London, London, UK; New Zealand Brain Research Institute, University of Otago, Christchurch, New Zealand
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Martínez-Lapiscina EH, Ortiz-Pérez S, Fraga-Pumar E, Martínez-Heras E, Gabilondo I, Llufriu S, Bullich S, Figueras M, Saiz A, Sánchez-Dalmau B, Villoslada P. Colour vision impairment is associated with disease severity in multiple sclerosis. Mult Scler 2014; 20:1207-16. [DOI: 10.1177/1352458513517591] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Accepted: 11/29/2013] [Indexed: 01/21/2023]
Abstract
Background: Colour vision assessment correlates with damage of the visual pathway and might be informative of overall brain damage in multiple sclerosis (MS). Objective: The objective of this paper is to investigate the association between impaired colour vision and disease severity. Methods: We performed neurological and ophthalmic examinations, as well as magnetic resonance imaging (MRI) and optical coherence tomography (OCT) analyses, on 108 MS patients, both at baseline and after a follow-up of one year. Colour vision was evaluated by Hardy, Rand and Rittler plates. Dyschromatopsia was defined if colour vision was impaired in either eye, except for participants with optic neuritis (ON), for whom only the unaffected eye was considered. We used general linear models adjusted for sex, age, disease duration and MS treatment for comparing presence of dyschromatopsia and disease severity. Results: Impaired colour vision in non-ON eyes was detected in 21 out of 108 patients at baseline. At baseline, patients with dyschromatopsia had lower Multiple Sclerosis Functional Composite (MSFC) scores and Brief Repeatable Battery-Neuropsychology executive function scores than those participants with normal colour vision. In addition, these patients had thinner retinal nerve fiber layer (RNFL), and smaller macular volume, normalized brain volume and normalized gray matter volume (NGMV) at baseline. Moreover, participants with incident dyschromatopsia after one-year follow-up had a greater disability measured by the Expanded Disability Status Scale and MSFC-20 and a greater decrease in NGMV than participants with normal colour vision. Conclusions: Colour vision impairment is associated with greater MS severity.
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Affiliation(s)
| | - Santiago Ortiz-Pérez
- Department of Ophthalmology, Institut D’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clinic of Barcelona, Spain
| | - Elena Fraga-Pumar
- Center of Neuroimmunology and Department of Neurology, Hospital Clinic of Barcelona, Spain
| | - Eloy Martínez-Heras
- Center of Neuroimmunology and Department of Neurology, Hospital Clinic of Barcelona, Spain
| | - Iñigo Gabilondo
- Center of Neuroimmunology and Department of Neurology, Hospital Clinic of Barcelona, Spain
| | - Sara Llufriu
- Center of Neuroimmunology and Department of Neurology, Hospital Clinic of Barcelona, Spain
| | - Santiago Bullich
- Center of Neuroimmunology and Department of Neurology, Hospital Clinic of Barcelona, Spain
| | - Marc Figueras
- Department of Ophthalmology, Institut D’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clinic of Barcelona, Spain
| | - Albert Saiz
- Center of Neuroimmunology and Department of Neurology, Hospital Clinic of Barcelona, Spain
| | - Bernardo Sánchez-Dalmau
- Center of Neuroimmunology and Department of Neurology, Hospital Clinic of Barcelona, Spain
- Department of Ophthalmology, Institut D’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clinic of Barcelona, Spain
| | - Pablo Villoslada
- Center of Neuroimmunology and Department of Neurology, Hospital Clinic of Barcelona, Spain
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Hickman SJ, Raoof N, McLean RJ, Gottlob I. Vision and multiple sclerosis. Mult Scler Relat Disord 2014; 3:3-16. [DOI: 10.1016/j.msard.2013.04.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 04/29/2013] [Indexed: 10/26/2022]
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Costello F. The afferent visual pathway: designing a structural-functional paradigm of multiple sclerosis. ISRN NEUROLOGY 2013; 2013:134858. [PMID: 24288622 PMCID: PMC3830872 DOI: 10.1155/2013/134858] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 07/11/2013] [Indexed: 01/19/2023]
Abstract
Multiple sclerosis (MS) is a disease of the central nervous system (CNS) believed to arise from a dysfunctional immune-mediated response in a genetically susceptible host. The actual cause of MS is not known, and there is ongoing debate about whether this CNS disorder is predominantly an inflammatory versus a degenerative condition. The afferent visual pathway (AVP) is frequently involved in MS, such that one in every five individuals affected presents with acute optic neuritis (ON). As a functionally eloquent system, the AVP is amenable to interrogation with highly reliable and reproducible tests that can be used to define a structural-functional paradigm of CNS injury. The AVP has numerous unique advantages as a clinical model of MS. In this review, the parameters and merits of the AVP model are highlighted. Moreover, the roles the AVP model may play in elucidating mechanisms of brain injury and repair in MS are described.
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Affiliation(s)
- Fiona Costello
- Departments of Clinical Neurosciences and Surgery (Ophthalmology), Hotchkiss Brain Institute, University of Calgary, Canada
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Goulart PRK, Bonci DMO, Galvão ODF, Silveira LCDL, Ventura DF. Color discrimination in the tufted capuchin monkey, Sapajus spp. PLoS One 2013; 8:e62255. [PMID: 23620819 PMCID: PMC3631197 DOI: 10.1371/journal.pone.0062255] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 03/19/2013] [Indexed: 11/18/2022] Open
Abstract
The present study evaluated the efficacy of an adapted version of the Mollon-Reffin test for the behavioral investigation of color vision in capuchin monkeys. Ten tufted capuchin monkeys (Sapajus spp., formerly referred to as Cebus apella) had their DNA analyzed and were characterized as the following: one trichromat female, seven deuteranope dichromats (six males and one female), and two protanope males, one of which was identified as an “ML protanope.” For their behavioral characterization, all of the subjects were tested at three regions of the Commission International de l'Eclairage (CIE) 1976 u′v′ diagram, with each test consisting of 20 chromatic variation vectors that were radially distributed around the chromaticity point set as the test background. The phenotypes inferred from the behavioral data were in complete agreement with those predicted from the genetic analysis, with the threshold distribution clearly differentiating between trichromats and dichromats and the estimated confusion lines characteristically converging for deuteranopes and the “classic” protanope. The discrimination pattern of the ML protanope was intermediate between protan and deutan, with confusion lines horizontally oriented and parallel to each other. The observed phenotypic differentiation confirmed the efficacy of the Mollon-Reffin test paradigm as a useful tool for evaluating color discrimination in nonhuman primates. Especially noteworthy was the demonstration of behavioral segregation between the “classic” and “ML” protanopes, suggesting identifiable behavioral consequences of even slight variations in the spectral sensitivity of M/L photopigments in dichromats.
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Güler M, Türkçüoğlu P, Yılmaz T, Yoldaş TK, Channa R. Comparison of Visual Field Parameters in Early and Advanced Stages of Multiple Sclerosis Patients Without a History of Optic Neuritis. Neuroophthalmology 2013; 37:58-62. [DOI: 10.3109/01658107.2013.767356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Revised: 12/03/2012] [Accepted: 12/03/2012] [Indexed: 11/13/2022] Open
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Jalilian B, Einarsson HB, Vorup-Jensen T. Glatiramer acetate in treatment of multiple sclerosis: a toolbox of random co-polymers for targeting inflammatory mechanisms of both the innate and adaptive immune system? Int J Mol Sci 2012; 13:14579-605. [PMID: 23203082 PMCID: PMC3509598 DOI: 10.3390/ijms131114579] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2012] [Revised: 10/23/2012] [Accepted: 11/05/2012] [Indexed: 01/17/2023] Open
Abstract
Multiple sclerosis is a disease of the central nervous system, resulting in the demyelination of neurons, causing mild to severe symptoms. Several anti-inflammatory treatments now play a significant role in ameliorating the disease. Glatiramer acetate (GA) is a formulation of random polypeptide copolymers for the treatment of relapsing-remitting MS by limiting the frequency of attacks. While evidence suggests the influence of GA on inflammatory responses, the targeted molecular mechanisms remain poorly understood. Here, we review the multiple pharmacological modes-of-actions of glatiramer acetate in treatment of multiple sclerosis. We discuss in particular a newly discovered interaction between the leukocyte-expressed integrin α(M)β(2) (also called Mac-1, complement receptor 3, or CD11b/CD18) and perspectives on the GA co-polymers as an influence on the function of the innate immune system.
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Affiliation(s)
- Babak Jalilian
- Department of Biomedicine, Aarhus University, Wilhelm Meyers Allé 4, Building 1242, DK-8000, Aarhus C, Denmark; E-Mails: (B.J.); (H.B.E.)
| | - Halldór Bjarki Einarsson
- Department of Biomedicine, Aarhus University, Wilhelm Meyers Allé 4, Building 1242, DK-8000, Aarhus C, Denmark; E-Mails: (B.J.); (H.B.E.)
| | - Thomas Vorup-Jensen
- Department of Biomedicine, Aarhus University, Wilhelm Meyers Allé 4, Building 1242, DK-8000, Aarhus C, Denmark; E-Mails: (B.J.); (H.B.E.)
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Sühs KW, Hein K, Sättler MB, Görlitz A, Ciupka C, Scholz K, Käsmann-Kellner B, Papanagiotou P, Schäffler N, Restemeyer C, Bittersohl D, Hassenstein A, Seitz B, Reith W, Fassbender K, Hilgers R, Heesen C, Bähr M, Diem R. A randomized, double-blind, phase 2 study of erythropoietin in optic neuritis. Ann Neurol 2012; 72:199-210. [PMID: 22926853 DOI: 10.1002/ana.23573] [Citation(s) in RCA: 116] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Based on findings in animal models of autoimmune optic nerve inflammation, we have assessed the safety and efficacy of erythropoietin in patients presenting with a first episode of optic neuritis. METHODS Patients with optic neuritis who attended the University Hospitals of Homburg/Saar, Göttingen, or Hamburg (Germany) were included in this double-blind, placebo-controlled, phase 2 study (ClinicalTrials.gov, NCT00355095). They were randomly assigned to groups receiving either 33,000IU recombinant human erythropoietin intravenously daily for 3 days or placebo as an add-on therapy to methylprednisolone. The primary outcome parameter was change in retinal nerve fiber layer (RNFL) thickness after 16 weeks. Secondary outcome parameters included optic nerve atrophy as assessed by magnetic resonance imaging, and changes in visual acuity, visual field, and visual evoked potentials (VEPs). RESULTS Forty patients were assigned to the treatment groups (21/19 erythropoietin/placebo). Safety monitoring revealed no relevant issues. Thirty-seven patients (20/17 erythropoietin/placebo) were analyzed for the primary endpoint according to the intention-to-treat protocol. RNFL thinning was less apparent after erythropoietin treatment. Thickness of the RNFL decreased by a median of 7.5μm by week 16 (mean ± standard deviation, 10.55 ± 17.54μm) compared to a median of 16.0μm (22.65 ± 29.18μm) in the placebo group (p = 0.0357). Decrease in retrobulbar diameter of the optic nerve was smaller in the erythropoietin group (p = 0.0112). VEP latencies at week 16 were shorter in erythropoietin-treated patients than in the placebo group (p = 0.0011). Testing of visual functions revealed trends toward an improved outcome after erythropoietin treatment. INTERPRETATION These results give the first indications that erythropoietin might be neuroprotective in optic neuritis.
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Costa TL, Barboni MTS, Moura ALDA, Bonci DMO, Gualtieri M, de Lima Silveira LC, Ventura DF. Long-term occupational exposure to organic solvents affects color vision, contrast sensitivity and visual fields. PLoS One 2012; 7:e42961. [PMID: 22916187 PMCID: PMC3419737 DOI: 10.1371/journal.pone.0042961] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Accepted: 07/16/2012] [Indexed: 11/24/2022] Open
Abstract
The purpose of this study was to evaluate the visual outcome of chronic occupational exposure to a mixture of organic solvents by measuring color discrimination, achromatic contrast sensitivity and visual fields in a group of gas station workers. We tested 25 workers (20 males) and 25 controls with no history of chronic exposure to solvents (10 males). All participants had normal ophthalmologic exams. Subjects had worked in gas stations on an average of 9.6±6.2 years. Color vision was evaluated with the Lanthony D15d and Cambridge Colour Test (CCT). Visual field assessment consisted of white-on-white 24–2 automatic perimetry (Humphrey II-750i). Contrast sensitivity was measured for sinusoidal gratings of 0.2, 0.5, 1.0, 2.0, 5.0, 10.0 and 20.0 cycles per degree (cpd). Results from both groups were compared using the Mann–Whitney U test. The number of errors in the D15d was higher for workers relative to controls (p<0.01). Their CCT color discrimination thresholds were elevated compared to the control group along the protan, deutan and tritan confusion axes (p<0.01), and their ellipse area and ellipticity were higher (p<0.01). Genetic analysis of subjects with very elevated color discrimination thresholds excluded congenital causes for the visual losses. Automated perimetry thresholds showed elevation in the 9°, 15° and 21° of eccentricity (p<0.01) and in MD and PSD indexes (p<0.01). Contrast sensitivity losses were found for all spatial frequencies measured (p<0.01) except for 0.5 cpd. Significant correlation was found between previous working years and deutan axis thresholds (rho = 0.59; p<0.05), indexes of the Lanthony D15d (rho = 0.52; p<0.05), perimetry results in the fovea (rho = −0.51; p<0.05) and at 3, 9 and 15 degrees of eccentricity (rho = −0.46; p<0.05). Extensive and diffuse visual changes were found, suggesting that specific occupational limits should be created.
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Costa TL, Nagy BV, Barboni MTS, Boggio PS, Ventura DF. Transcranial direct current stimulation modulates human color discrimination in a pathway-specific manner. Front Psychiatry 2012; 3:78. [PMID: 22988446 PMCID: PMC3439847 DOI: 10.3389/fpsyt.2012.00078] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Accepted: 08/15/2012] [Indexed: 11/13/2022] Open
Abstract
Previous research showed that transcranial direct current stimulation (tDCS) can modulate visual cortex excitability. However, there is no experiment on the effects of tDCS on color perception to date. The present study aimed to investigate the effects of tDCS on color discrimination tasks. Fifteen healthy subjects (mean age of 25.6 ± 4.4 years) were tested with Cambridge Color Test 2.0 (Trivector and ellipses protocols) and a Forced-choice Spatial Color Contrast Sensitivity task (vertical red-green sinusoidal grating) while receiving tDCS. Anodal, cathodal, and sham tDCS were delivered at Oz for 22 min using two square electrodes (25 cm(2) with a current of 1.5 mA) in sessions separated by 7 days. Anodal tDCS significantly increased tritan sensitivity (p < 0.01) and had no significant effect on protan, deutan, or red-green grating discrimination. The effects on the tritan discrimination returned to baseline after 15 min (p < 0.01). Cathodal tDCS reduced the sensitivity in the deutan axis and increased sensitivity in the tritan axis (p < 0.05). The lack of anodal tDCS effects in the protan, deutan, and red-green grating sensitivities could be explained by a "ceiling effect" since adults in this age range tend to have optimal color discrimination performance for these hues. The differential effects of cathodal tDCS on tritan and deutan sensitivities and the absence of the proposed ceiling effects for the tritan axes might be explained by Parvocellular (P) and Koniocellular (K) systems with regard to their functional, physiological, and anatomical differences. The results also support the existence of a systematic segregation of P and K color-coding cells in V1. Future research and possible clinical implications are discussed.
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Affiliation(s)
- Thiago L Costa
- Laboratório da Visão, Experimental Psychology Department, University of São Paulo São Paulo, Brazil
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Cao D, Zele AJ, Pokorny J, Lee DY, Messner LV, Diehl C, Ksiazek S. Functional loss in the magnocellular and parvocellular pathways in patients with optic neuritis. Invest Ophthalmol Vis Sci 2011; 52:8900-7. [PMID: 22016061 DOI: 10.1167/iovs.11-7644] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To evaluate contrast threshold and contrast gain in patients with optic neuritis under conditions designed to favor mediation by either the inferred magnocellular (MC) or parvocellular (PC) pathway. METHODS Achromatic and chromatic contrast discrimination was measured in 11 patients with unilateral or bilateral optic neuritis and in 18 age-matched controls with normal vision, using achromatic steady- and pulsed-pedestal paradigms to bias performance toward the MC or PC pathway, respectively. In addition, L-M chromatic discrimination at equiluminance was evaluated using the steady-pedestal paradigm. A physiologically plausible model could describe the data with parameters accounting for contrast gain and contrast sensitivity in the inferred MC or PC pathway. The fitted parameters from the eye affected by optic neuritis were compared with those from the normal eye using generalized estimation equation (GEE) models that can account for within-subject correlations. RESULTS Compared with normal eyes, the affected eyes had significantly higher saturation parameters when measured with both the achromatic pulsed-pedestal paradigm (GEE: β [SE] = 0.35 [0.06]; P < 0.001) and the chromatic discrimination paradigm (β [SE] = 0.18 [0.08]; P = 0.015), suggesting that contrast gain in the inferred PC pathway is reduced; the affected eyes also had reduced absolute sensitivity in the inferred MC pathway measured with the achromatic steady-pedestal paradigm (β [SE] = 0.12 [0.04]; P = 0.005). CONCLUSIONS Optic neuritis produced large sensitivity losses mediated by the MC pathway and contrast gain losses in the inferred PC pathway. A clinical framework is presented for interpreting contrast sensitivity and gain loss to chromatic and achromatic stimuli in terms of retinal and postretinogeniculate loci contributions to detection and discrimination.
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Affiliation(s)
- Dingcai Cao
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, 1905 W.Taylor Street, Room 149, Chicago, IL 60615, USA.
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Independent patterns of damage to retinocortical pathways in multiple sclerosis without a previous episode of optic neuritis. J Neurol 2011; 258:1695-704. [DOI: 10.1007/s00415-011-6008-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2010] [Revised: 03/05/2011] [Accepted: 03/08/2011] [Indexed: 10/18/2022]
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Lima MG, Gomes BD, Ventura DF, Silveira LCDL. Métodos utilizados na avaliação psicofísica da visão de cores humana. PSICOLOGIA USP 2011. [DOI: 10.1590/s0103-65642011005000002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A cor é um atributo perceptual que nos permite identificar e localizar padrões ambientais de mesmo brilho e constitui uma dimensão adicional na identificação de objetos, além da detecção de inúmeros outros atributos dos objetos em sua relação com a cena visual, como luminância, contraste, forma, movimento, textura, profundidade. Decorre daí a sua importância fundamental nas atividades desempenhadas pelos animais e pelos seres humanos em sua interação com o ambiente. A psicofísica visual preocupa-se com o estudo quantitativo da relação entre eventos físicos de estimulação sensorial e a resposta comportamental resultante desta estimulação, fornecendo dessa maneira meios de avaliar aspectos da visão humana, como a visão de cores. Este artigo tem o objetivo de mostrar diversas técnicas eficientes na avaliação da visão cromática humana através de métodos psicofísicos adaptativos.
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Feitosa-Santana C, Paramei GV, Nishi M, Gualtieri M, Costa MF, Ventura DF. Color vision impairment in type 2 diabetes assessed by the D-15d test and the Cambridge Colour Test. Ophthalmic Physiol Opt 2011; 30:717-23. [PMID: 20883359 DOI: 10.1111/j.1475-1313.2010.00776.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Color vision impairment emerges at early stages of diabetes mellitus type 2 (DM2) and may precede diabetic retinopathy or the appearance of vascular alterations in the retina. The aim of the present study was to compare the evaluation of the color vision with two different tests - the Lanthony desaturated D-15d test (a traditional color arrangement test), and the Cambridge Colour Test (CCT) (a computerized color discrimination test) - in patients diagnosed with DM2 without clinical signs of diabetic retinopathy (DR), and in sex- and age-matched control groups. Both color tests revealed statistically significant differences between the controls and the worst eyes of the DM2 patients. In addition, the degree of color vision impairment diagnosed by both tests correlated with the disease duration. The D-15d outcomes indicated solely tritan losses. In comparison, CCT outcomes revealed diffuse losses in color discrimination: 13.3% for best eyes and 29% for worst eyes. In addition, elevation of tritan thresholds in the DM2 patients, as detected by the Trivector subtest of the CCT, was found to correlate with the level of glycated hemoglobin. Outcomes of both tests confirm that subclinical losses of color vision are present in DM2 patients at an early stage of the disease, prior to signs of retinopathy. Considering the advantages of the CCT test compared to the D-15d test, further studies should attempt to verify and/or improve the efficiency of the CCT test.
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Gregori B, Papazachariadis O, Farruggia A, Accornero N. A differential color flicker test for detecting acquired color vision impairment in multiple sclerosis and diabetic retinopathy. J Neurol Sci 2011; 300:130-4. [DOI: 10.1016/j.jns.2010.09.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2010] [Revised: 08/10/2010] [Accepted: 09/01/2010] [Indexed: 11/15/2022]
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