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Zhu M, Liu Y, Fang D, Li M, Fu T, Yao K, Wang P, Sun X, Xiang Y. Safety of repeated low-level red-light therapy for children with myopia. Photodiagnosis Photodyn Ther 2024; 47:104198. [PMID: 38729232 DOI: 10.1016/j.pdpdt.2024.104198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 05/05/2024] [Accepted: 05/06/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUD To investigate the safety of repetitive low-level red-light therapy (RLRLT) in children with myopia. METHODS Children with myopia were assigned to the RLRL and control groups. Axial length (AL) and spherical equivalent refraction (SER) were followed up at 3-, 6-, and 12-month. To evaluate the safety of RLRLT, at 6 and 12 months in the RLRL group, multifocal electroretinography (mfERG) and contrast sensitivity were recorded. Furthermore, optical coherence tomography was used to measure the relative reflectance of the ellipsoid zone (rEZR), photoreceptor outer segment (rPOSR), and retinal pigment epithelium (rRPER). RESULTS A total of 108 children completed the trial (55 in the RLRL group and 53 in the control group). After 3, 6, and 12 months, AL was shorter and SER less myopic in the RLRL group than in the control group. Regarding the safety of the RLRLT, the response density and amplitude of the P1 wave of the first ring of the mfERG increased significantly at 6 months (P = 0.001 and P = 0.017, respectively). At 6 and 12 months, contrast sensitivity at the high spatial frequency increased. Moreover, the rEZR increased significantly at 6 months (P = 0.029), the rPOSR increased significantly at 6 and 12 months (both P < 0.001), and the increase in rPOSR was greater with greater AL regression. CONCLUSIONS Based on retinal function and structure follow-up, RLRLT was safe within 12 months. However, rEZR and rPOSR increased, the effects of this phenomenon requires further observation.
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Affiliation(s)
- Mengxia Zhu
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong, University of Science and Technology, Wuhan, 430030, China
| | - Ying Liu
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong, University of Science and Technology, Wuhan, 430030, China
| | - Dengqin Fang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong, University of Science and Technology, Wuhan, 430030, China
| | - Mu Li
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong, University of Science and Technology, Wuhan, 430030, China
| | - Ting Fu
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong, University of Science and Technology, Wuhan, 430030, China
| | - KeJun Yao
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong, University of Science and Technology, Wuhan, 430030, China
| | - Ping Wang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong, University of Science and Technology, Wuhan, 430030, China
| | - Xufang Sun
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong, University of Science and Technology, Wuhan, 430030, China
| | - Yan Xiang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong, University of Science and Technology, Wuhan, 430030, China.
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Sabeti F, van Kleef JP, Iyer RM, Carle CF, Nolan CJ, Chia RH, Maddess T. Discriminating early-stage diabetic retinopathy with subjective and objective perimetry. Front Endocrinol (Lausanne) 2024; 14:1333826. [PMID: 38264290 PMCID: PMC10804944 DOI: 10.3389/fendo.2023.1333826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 12/13/2023] [Indexed: 01/25/2024] Open
Abstract
Introduction To prevent progression of early-stage diabetic retinopathy, we need functional tests that can distinguish multiple levels of neural damage before classical vasculopathy. To that end, we compared multifocal pupillographic objective perimetry (mfPOP), and two types of subjective automated perimetry (SAP), in persons with type 2 diabetes (PwT2D) with either no retinopathy (noDR) or mild to-moderate non-proliferative retinopathy (mmDR). Methods Both eyes were assessed by two mfPOP test methods that present stimuli within either the central ±15° (OFA15) or ±30° (OFA30), each producing per-region sensitivities and response delays. The SAP tests were 24-2 Short Wavelength Automated Perimetry and 24-2 Matrix perimetry. Results Five of eight mfPOP global indices were significantly different between noDR and mmDR eyes, but none of the equivalent measures differed for SAP. Per-region mfPOP identified significant hypersensitivity and longer delays in the peripheral visual field, verifying earlier findings. Diagnostic power for discrimination of noDR vs. mmDR, and normal controls vs. PwT2D, was much higher for mfPOP than SAP. The mfPOP per-region delays provided the best discrimination. The presence of localized rather than global changes in delay ruled out iris neuropathy as a major factor. Discussion mfPOP response delays may provide new surrogate endpoints for studies of interventions for early-stage diabetic eye damage.
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Affiliation(s)
- Faran Sabeti
- Eccles Institute for Neuroscience, The John Curtin School of Medical Research, The Australian National University, Canberra, ACT, Australia
- Discipline of Optometry, Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - Joshua P. van Kleef
- Eccles Institute for Neuroscience, The John Curtin School of Medical Research, The Australian National University, Canberra, ACT, Australia
| | - Rakesh M. Iyer
- Department of Endocrinology, The Canberra Hospital, Garran, ACT, Australia
| | - Corinne F. Carle
- Eccles Institute for Neuroscience, The John Curtin School of Medical Research, The Australian National University, Canberra, ACT, Australia
| | - Christopher J. Nolan
- Department of Endocrinology, The Canberra Hospital, Garran, ACT, Australia
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Rong Hui Chia
- School of Medicine, University of Western Australia, Crawley, WA, Australia
| | - Ted Maddess
- Eccles Institute for Neuroscience, The John Curtin School of Medical Research, The Australian National University, Canberra, ACT, Australia
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Zhang P, Vafaeva O, Dolf C, Ma Y, Wang G, Cho J, Chan HHL, Marsh-Armstrong N, Zawadzki RJ. Evaluating the performance of OCT in assessing static and potential dynamic properties of the retinal ganglion cells and nerve fiber bundles in the living mouse eye. BIOMEDICAL OPTICS EXPRESS 2023; 14:6422-6441. [PMID: 38420317 PMCID: PMC10898556 DOI: 10.1364/boe.504637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/08/2023] [Accepted: 11/11/2023] [Indexed: 03/02/2024]
Abstract
Glaucoma is a group of eye diseases characterized by the thinning of the retinal nerve fiber layer (RNFL), which is primarily caused by the progressive death of retinal ganglion cells (RGCs). Precise monitoring of these changes at a cellular resolution in living eyes is significant for glaucoma research. In this study, we aimed to assess the effectiveness of temporal speckle averaging optical coherence tomography (TSA-OCT) and dynamic OCT (dOCT) in examining the static and potential dynamic properties of RGCs and RNFL in living mouse eyes. We evaluated parameters such as RNFL thickness and possible dynamics, as well as compared the ganglion cell layer (GCL) soma density obtained from in vivo OCT, fluorescence scanning laser ophthalmoscopy (SLO), and ex vivo histology.
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Affiliation(s)
- Pengfei Zhang
- School of Optoelectronic Engineering and Instrumentation Science, Dalian University of Technology, Dalian, 116024, China
- UC Davis EyePod Small Animals Ocular Imaging Laboratory, University of California Davis, Davis, CA 95616, USA
| | - Olga Vafaeva
- Department of Ophthalmology & Vision Science, University of California Davis Eye Center, 4860 Y Street, Suite 2400, Sacramento, CA 95817, USA
| | - Christian Dolf
- Department of Ophthalmology & Vision Science, University of California Davis Eye Center, 4860 Y Street, Suite 2400, Sacramento, CA 95817, USA
| | - Yanhong Ma
- School of Optoelectronic Engineering and Instrumentation Science, Dalian University of Technology, Dalian, 116024, China
| | - Guozhen Wang
- School of Optoelectronic Engineering and Instrumentation Science, Dalian University of Technology, Dalian, 116024, China
| | - Jessicca Cho
- UC Davis EyePod Small Animals Ocular Imaging Laboratory, University of California Davis, Davis, CA 95616, USA
| | - Henry Ho-Lung Chan
- Laboratory of Experimental Optometry (Neuroscience), School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Hong Kong, China
| | - Nicholas Marsh-Armstrong
- Department of Ophthalmology & Vision Science, University of California Davis Eye Center, 4860 Y Street, Suite 2400, Sacramento, CA 95817, USA
| | - Robert J Zawadzki
- UC Davis EyePod Small Animals Ocular Imaging Laboratory, University of California Davis, Davis, CA 95616, USA
- Center for Human Ocular Imaging Research (CHOIR), Dept. of Ophthalmology & Vision Science, University of California Davis, 4860 Y Street, Suite 2400, Sacramento, CA 95817, USA
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Jeon GS, Chang IB, Ma DJ, Cho IH, Hong IH. Multifocal Electroretinography Changes over 12 Months after Resolution of Central Serous Chorioretinopathy: Prospective Observational Study. Ophthalmic Res 2023; 66:816-823. [PMID: 36966538 DOI: 10.1159/000530276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION This prospective observational study aimed to evaluate the changes in retinal function after the anatomical resolution of central serous chorioretinopathy by multifocal electroretinography. METHODS Thirty-two eyes of 32 patients with unilaterally resolved central serous chorioretinopathy were prospectively studied. Serial multifocal electroretinography examinations were performed at the initial visit for active central serous chorioretinopathy, the time of anatomical resolution (resolved central serous chorioretinopathy), and 3, 6, and 12 months after resolution. The peak amplitudes of the first kernel responses were analysed and compared with those in 27 age-matched normal controls. RESULTS Compared with controls, the N1 amplitudes of rings 1-4 and P1 amplitudes of rings 1-3 showed statistically significant reductions at 12 months after the resolution of central serous chorioretinopathy (p < 0.05). The multifocal electroretinography amplitude substantially increased at the time of resolution and gradually improved until 3 months after the resolution of central serous chorioretinopathy. CONCLUSION Serial examinations with multifocal electroretinography showed that retinal responses increased mostly after the resolution of central serous chorioretinopathy, and this improvement slowly progressed until 3 months; however, the multifocal electroretinography amplitudes remained statistically reduced 12 months after the anatomical resolution of central serous chorioretinopathy, indicating the residual functional deficits detected by multifocal electroretinography.
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Affiliation(s)
- Gang Seok Jeon
- Dasan Samsung Bright Eye Clinic, Gyeonggi-do, Republic of Korea
| | | | - Dae Joong Ma
- Department of Ophthalmology, Gangnam Sacred Heart Hospital, Hallym University Medical Center, Seoul, Republic of Korea
| | - In Hwan Cho
- Department of Ophthalmology, College of Medicine, Soonchunhyang University, Cheonan-si, Republic of Korea
| | - In Hwan Hong
- Department of Ophthalmology, Dongtan Sacred Heart Hospital, Hallym University Medical Center, Hwaseong-si, Republic of Korea
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Liu S, Yuan F, Xiang M. Comparative analysis of electroretinogram with subdermal and invasive recording methods in mice. Biochem Biophys Res Commun 2023; 655:118-126. [PMID: 36934587 DOI: 10.1016/j.bbrc.2023.03.029] [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: 02/24/2023] [Accepted: 03/10/2023] [Indexed: 03/12/2023]
Abstract
Electroretinogram (ERG) is the most common clinical and basic visual electrodiagnostic test, which has long been used to evaluate the retinal function through photic stimulation. Despite its wide application, there are still some pitfalls often neglected in ERG recording, such as the recording time point, active electrode location, and the animal strain. In this study, we systematically analyzed and compared the effects of multiple factors on ERG, which would provide an important reference for ERG detection by other investigators. ERG was recorded using the Celeris D430 rodent ERG testing system. The amplitudes and latencies of a wave, b wave and oscillatory potentials (OPs) recorded from different electrode locations (subdermal and invasive), different times of day (day time 8:00 to 13:00 and night time 18:00 to 23:00), bilateral eyes (left and right), and different mouse strains (C57 and CD1) were analyzed and compared. Our results revealed that ERG was affected by active electrode locations and difference between day and night, while OPs seemed not to be influenced. There was no significant difference in the amplitudes or latencies of ERG and OPs between left and right eyes, irrespective of measurements at day or night, or which method was used. Compared to C57 mice, both ERG and OP responses were significantly decreased in Brn3bAP/AP mice, a model for retinal ganglion cell (RGC) loss. In addition, there were some non-negligible differences in visual responses between C57 and CD1 mouse strains. Our results suggest that the invasive procedure is a reliable method for evaluating the visual function including VEP, ERG and OP responses in mice. Moreover, these comparative analyses provide valuable references for future studies of mammalian visual electrophysiology.
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Affiliation(s)
- Shuting Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
| | - Fa Yuan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
| | - Mengqing Xiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China; Guangdong Provincial Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080, China.
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Kong AW, Della Santina L, Ou Y. Probing ON and OFF Retinal Pathways in Glaucoma Using Electroretinography. Transl Vis Sci Technol 2020; 9:14. [PMID: 33117606 PMCID: PMC7571283 DOI: 10.1167/tvst.9.11.14] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/14/2020] [Indexed: 12/31/2022] Open
Abstract
Glaucoma is a progressive neurodegenerative disease involving damage and eventually death of retinal ganglion cells (RGCs) that comprise the optic nerve. This review summarizes current understanding of specific RGC type vulnerability in glaucoma and how electroretinography (ERG) may provide an objective measure of these functional perturbations. There is building evidence to suggest that ON RGCs, which respond to light increments, may be more resilient to elevated intraocular pressure and glaucoma, whereas OFF RGCs, which respond to light decrements, may be more susceptible. ERG experiments in nonhuman primates and mice have also shown that the ON- and OFF-pathways can be separated using a variety of techniques such as pattern ERG and the photopic negative response. Another ERG paradigm of interest to separate the ON and OFF responses is a flicker stimulus at varying temporal frequencies. Response to lower temporal frequencies is associated with the ON-pathway, and ERG response to higher frequencies is associated with the OFF-pathway. In mice, experimental glaucoma models have shown greater decreases in ERG response at higher frequencies, suggesting that the OFF-pathway is more susceptible. We also summarize current clinical ERG protocols used for glaucoma and discuss innovations for developing new types of stimuli that can further separate the ON- and OFF-pathways. Applying these novel paradigms that distinguish ON- and OFF-pathways may ultimately improve glaucoma diagnostics and monitoring of glaucoma progression.
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Affiliation(s)
- Alan W Kong
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, USA
| | - Luca Della Santina
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, USA
| | - Yvonne Ou
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, USA
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Lypka KR, Rodman J, Starman K, Woods AD, Bi H. Case Report: Optical Coherence Tomography Angiography of Idiopathic Foveal Hypoplasia and Its Correlation With Visual Acuity. Optom Vis Sci 2020; 97:110-120. [PMID: 32011584 DOI: 10.1097/opx.0000000000001471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
SIGNIFICANCE Foveal hypoplasia is described clinically by the absence of a foveal pit and subsequent reduction in visual acuity. Optical coherence tomography angiography provides precise segmentation of the retinal vascular supply demonstrating the vascular perfusion in affected patients. Preservation of perfusion is linked to visual acuity and function. PURPOSE This case report describes a patient with foveal hypoplasia and preservation of visual acuity with preserved retinal capillary density of the superficial and deep capillary plexuses on optical coherence tomography angiography. In addition, the diagnostic findings of foveal hypoplasia as seen on optical coherence tomography angiography will be described. CASE REPORT A 25-year-old Caucasian female with history of foveal hypoplasia presented to the clinic for evaluation. She had no other visual, ocular, or systemic complaints. Her ocular history included Duane syndrome, accommodative insufficiency, and traumatic brain injury. Her medical history included cardiac ablation secondary to supraventricular tachycardia, gall bladder removal, maxillary sinus cyst, and a history of migraines. Best-corrected visual acuity was 20/15 in the right and left eyes. Funduscopic examination was unremarkable. Spectral domain optical coherence tomography revealed absence of the anatomical foveal pit with normal inner retinal morphology. Optical coherence tomography angiography confirmed a decreased foveal avascular zone; however, a vascular density analysis showed normal perfusion to the inner retinal plexuses. CONCLUSIONS Optical coherence tomography angiography is a rapid, noninvasive imaging modality that provides excellent insight into the microvasculature supply to the retina and choroid. As such, it allows for an in-depth analysis into the pathophysiology behind certain conditions such as foveal hypoplasia.
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Affiliation(s)
| | - Julie Rodman
- College of Optometry, Nova Southeastern University, Ft. Lauderdale, Florida
| | - Kelsey Starman
- College of Optometry, Nova Southeastern University, Ft. Lauderdale, Florida
| | - Albert David Woods
- College of Optometry, Nova Southeastern University, Ft. Lauderdale, Florida
| | - Hua Bi
- College of Optometry, Nova Southeastern University, Ft. Lauderdale, Florida
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Boquete L, López-Guillén E, Vilades E, Miguel-Jiménez JM, Pablo LE, De Santiago L, Ortiz del Castillo M, Alonso-Rodríguez MC, Morla EMS, López-Dorado A, Garcia-Martin E. Diagnostic ability of multifocal electroretinogram in early multiple sclerosis using a new signal analysis method. PLoS One 2019; 14:e0224500. [PMID: 31703082 PMCID: PMC6839873 DOI: 10.1371/journal.pone.0224500] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 10/15/2019] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To determine if a novel analysis method will increase the diagnostic value of the multifocal electroretinogram (mfERG) in diagnosing early-stage multiple sclerosis (MS). METHODS We studied the mfERG signals of OD (Oculus Dexter) eyes of fifteen patients diagnosed with early-stage MS (in all cases < 12 months) and without a history of optic neuritis (ON) (F:M = 11:4), and those of six controls (F:M = 3:3). We obtained values of amplitude and latency of N1 and P1 waves, and a method to assess normalized root-mean-square error (FNRMSE) between model signals and mfERG recordings was used. Responses of each eye were analysed at a global level, and by rings, quadrants and hemispheres. AUC (area under the ROC curve) is used as discriminant factor. RESULTS The standard method of analysis obtains further discrimination between controls and MS in ring R3 (AUC = 0.82), analysing N1 waves amplitudes. In all of the retina analysis regions, FNRMSE value shows a greater discriminating power than the standard method. The highest AUC value (AUC = 0.91) was in the superior temporal quadrant. CONCLUSION By analysing mfERG recordings and contrasting them with those of healthy controls it is possible to detect early-stage MS in patients without a previous history of ON.
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Affiliation(s)
- L. Boquete
- Biomedical Engineering Group, Electronics Department, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
- RETICS: Thematic Networks for Co-operative Research in Health for Ocular Diseases, Madrid, Spain
| | - E. López-Guillén
- Biomedical Engineering Group, Electronics Department, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - E. Vilades
- RETICS: Thematic Networks for Co-operative Research in Health for Ocular Diseases, Madrid, Spain
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Institute for Health Research (IIS Aragon), Innovative and Research Group Miguel Servet Ophthalmology (GIMSO), University of Zaragoza, Zaragoza, Spain
| | - J. M. Miguel-Jiménez
- Biomedical Engineering Group, Electronics Department, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - L. E. Pablo
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Institute for Health Research (IIS Aragon), Innovative and Research Group Miguel Servet Ophthalmology (GIMSO), University of Zaragoza, Zaragoza, Spain
| | - L. De Santiago
- Biomedical Engineering Group, Electronics Department, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - M. Ortiz del Castillo
- Biomedical Engineering Group, Electronics Department, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - M. C. Alonso-Rodríguez
- Physics and Mathematics Department, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | | | - A. López-Dorado
- Biomedical Engineering Group, Electronics Department, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - E. Garcia-Martin
- RETICS: Thematic Networks for Co-operative Research in Health for Ocular Diseases, Madrid, Spain
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Institute for Health Research (IIS Aragon), Innovative and Research Group Miguel Servet Ophthalmology (GIMSO), University of Zaragoza, Zaragoza, Spain
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Mahalingam K, Chaurasia AK, Gowtham L, Gupta S, Somarajan BI, Velpandian T, Sihota R, Gupta V. Therapeutic potential of valproic acid in advanced glaucoma: A pilot study. Indian J Ophthalmol 2018; 66:1104-1108. [PMID: 30038151 PMCID: PMC6080453 DOI: 10.4103/ijo.ijo_108_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 04/23/2018] [Indexed: 11/12/2022] Open
Abstract
Purpose Oral valproic acid (VPA) used as an anticonvulsant has been shown to improve contrast threshold sensitivities in patients receiving it on long-term. This study aimed to evaluate the efficacy of oral VPA in improving visual function in eyes with advanced stage glaucoma. Methods In this prospective randomized study, 31 patients (n = 31 eyes) with advanced stage glaucoma (with an intraocular pressure <16 mmHg) in at least one eye received oral VPA 500 mg once a day for 3 months and 33 patients (n = 33 eyes) continued on glaucoma therapy. Patients were followed up at 3 and 12 months (to evaluate the legacy effect of the drug). Blood VPA concentrations were measured at 3 months. Following parameters were assessed at baseline, 3 months and 12 months: log of the minimum angle of resolution (LogMAR) visual acuity, mean deviation on visual fields, and multifocal electroretinogram (ERG). Results Median LogMar visual acuity in the VPA group improved from 0.3 at baseline to 0.18 and 0.18 at 3 and 12 months, respectively (P < 0.01). In comparison, the median visual acuity in control group at baseline was 0.18 and showed neither worsening nor improvement over 3 and 12 months (P = 0.56). The improvement in VPA group was significant compared to the control group (P < 0.01; Wilcoxon Signed-rank test). An improvement in one line was experienced in 11 out of 31 eyes in the VPA group compared to 1 out of 33 eyes among controls (P = 0.003). No significant improvement was noted in the mean deviation, and the multifocal ERG (Latency and amplitudes) in the VPA-treated patients. The average blood VPA concentration measured at 3 months of therapy was 26 ± 8.9 μg/ml (range 8-55 μg/ml) which is much lower than that achieved during anticonvulsant therapy. None of the patients complained of any adverse effects that required stopping VPA therapy. Conclusion A 3 months oral VPA therapy results in some improvement in visual acuity in a subgroup of eyes with advanced glaucoma and the effect was seen to persist 9 months after the drug was stopped.
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Affiliation(s)
- Karthikeyan Mahalingam
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Abadh Kumar Chaurasia
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | | | - Shikha Gupta
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Bindu I Somarajan
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Thirumurthy Velpandian
- Department of Ocular Pharmacology, All India Institute of Medical Sciences, New Delhi, India
| | - Ramanjit Sihota
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Viney Gupta
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Cascavilla ML, Parisi V, Triolo G, Ziccardi L, Borrelli E, Di Renzo A, Balducci N, Lamperti C, Bianchi Marzoli S, Darvizeh F, Sadun AA, Carelli V, Bandello F, Barboni P. Retinal dysfunction characterizes subtypes of dominant optic atrophy. Acta Ophthalmol 2018; 96:e156-e163. [PMID: 28926202 DOI: 10.1111/aos.13557] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 07/06/2017] [Indexed: 01/27/2023]
Abstract
PURPOSE To assess preganglionic retinal function using multifocal electroretinogram (mfERG) in patients affected by dominant optic atrophy (DOA) stratified by OPA1 gene mutation. METHODS Multifocal electroretinogram (mfERG) was recorded in 18 DOA patients (DOA group, 35 eyes) and 25 age-matched healthy subjects (control group, 25 eyes). Patients were stratified in two groups based on gene mutation: missense mutation (DOA-M group, 11 eyes) and mutation causing haploinsufficiency (DOA-H group, 24 eyes). The mfERG N1-P1 response amplitude density (RAD) has been evaluated in five annular retinal areas with different eccentricity from the fovea (ring 1: 0-5 degrees, R1; ring 2: 5-10 degrees, R2; ring 3: 10-15 degrees, R3; ring 4: 15-20 degrees, R4; and ring 5: 20-25 degrees, R5) and in eight sectors on the basis of the retinal topography: temporal-superior (TS), temporal-inferior (TI), nasal-superior (NS) and nasal-inferior (NI), temporal (T), superior (S), nasal (N) and inferior (I). RESULTS Compared to controls, DOA group revealed a significant reduction in N1-P1 RADs values in R1-R4 rings and in TI, NS and N sectors [analysis of variance (ANOVA), p < 0.01). DOA-M group showed a significant reduction in N1-P1 RADs values in R1-R5 rings and in TI, NS, NI, T, N and I sectors (p < 0.01). Dominant optic atrophy-H (DOA-H) group displayed only a significant (p < 0.01) reduction in N1-P1 RADs values, exclusively in R1 and in the NS sector. CONCLUSION Preganglionic retinal impairment occurs in DOA with a clear genotype to retinal dysfunction association. Missense mutations are characterized by a far more severe functional impairment.
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Affiliation(s)
| | | | - Giacinto Triolo
- Scientific Institute San Raffaele Via Olgettina; Milan Italy
| | | | - Enrico Borrelli
- Scientific Institute San Raffaele Via Olgettina; Milan Italy
| | | | | | - Costanza Lamperti
- Unit of Molecular Neurogenetics; Foundation “C. Besta” Neurological Institute-IRCCS; Milan Italy
| | - Stefania Bianchi Marzoli
- Neuro-ophthalmology Unit, Department of Ophthalmology; IRCCS Istituto Auxologico Italiano; Milano Italy
| | - Fatima Darvizeh
- Scientific Institute San Raffaele Via Olgettina; Milan Italy
| | - Alfredo A. Sadun
- Department of Ophthalmology; Dohene Eye Institute, UCLA; Pasadena CA USA
| | - Valerio Carelli
- IRCCS; Istituto delle Scienze Neurologiche di Bologna; Bologna Italy
- Neurology Unit; Department of Biomedical and Neuromotor Sciences (DIBINEM); University of Bologna; Bologna Italy
| | | | - Piero Barboni
- Scientific Institute San Raffaele Via Olgettina; Milan Italy
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Variability of the multifocal electroretinogram based on the type and position of the electrode. Doc Ophthalmol 2016; 133:99-108. [PMID: 27665467 DOI: 10.1007/s10633-016-9560-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 08/24/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE To evaluate and compare the wave amplitude of multifocal electroretinogram (mfERG) measurements and discomfort from Dawson-Trick-Litzkow (DTL) electrode located on the cornea (cDTL) and on the conjunctival fornix (fDTL) and ERG-jet contact lens electrode (CL). METHODS Thirty-six patients and 18 healthy volunteers were evaluated with three different methods (cDTL, fDTL and CL). Wave amplitude, number of artifacts, number of electrode dislocations and level of discomfort obtained with each electrode were compared. These variables were also compared between patients and healthy volunteers (control group). Comparisons between wave amplitudes were made using intraclass correlation coefficient (ICC). RESULTS Responses by the three tested electrode were better correlated (ICC) in patient (0.616-0.756) than in control groups (0.342-0.679). CL provided the highest wave amplitude in both groups (p < 0.005), but it was associated with higher discomfort (p < 0.001) and the highest rate of dislocations (72 and 100 % in control and patients, respectively). Looking at the differences obtained by each electrode between both groups, CL seems to be able to differentiate patient from control in the ring 1 of the mfERG. By contrast, fDTL gave the lowest wave amplitude in both groups, but it had the advantage to, apparently, discriminate between patients and control group in rings 1 and 2. cDTL produced more artifacts than the other electrodes in both groups (p < 0.001). CONCLUSIONS Although wave amplitude measurements with different electrodes were correlated, they cannot be directly compared, so it is mandatory to create an appropriate normative database with each electrode. Despite providing the lowest amplitudes, fDTL seems to offer the best features to perform mfERG regarding discomfort, number of artifacts and diagnostic capability.
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12
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Local Relationship between Global-Flash Multifocal Electroretinogram Optic Nerve Head Components and Visual Field Defects in Patients with Glaucoma. J Ophthalmol 2015; 2015:397495. [PMID: 26697210 PMCID: PMC4677220 DOI: 10.1155/2015/397495] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 11/05/2015] [Accepted: 11/17/2015] [Indexed: 12/02/2022] Open
Abstract
Purpose. To investigate the local relationship between quantified global-flash multifocal electroretinogram (mfERG) optic nerve head component (ONHC) and visual field defects in patients with glaucoma. Methods. Thirty-nine patients with glaucoma and 30 normal controls were enrolled. The ONHC amplitude was measured from the baseline to the peak of the second positive deflection of the induced component. The ONHC amplitude was normalized by dividing ONHC amplitude by the average of seven largest ONHC amplitudes. The ONHC amplitude ratio map and ONHC deficiency map were constructed. The local relationship between the ONHC measurements and visual field defects was evaluated by calculating the overlap between the ONHC deficiency maps and visual field defect plots. Results. The mean ONHC amplitude measurements of patients with glaucoma (6.01 ± 1.91 nV/deg2) were significantly lower than those of the normal controls (10.29 ± 0.94 nV/deg2) (P < 0.001). The average overlap between the ONHC deficiency map and visual field defect plot was 71.4%. The highest overlap (75.0%) was between the ONHC ratios less than 0.5 and the total deviations less than 5%. Conclusions. The ONHC amplitude was reduced in patients with glaucoma compared to that in normal controls. Loss of the ONHC amplitude from the global-flash mfERG showed a high local agreement with visual field defects in patients with glaucoma.
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Effect of lycium barbarum (wolfberry) polysaccharides on preserving retinal function after partial optic nerve transection. PLoS One 2013; 8:e81339. [PMID: 24339917 PMCID: PMC3858224 DOI: 10.1371/journal.pone.0081339] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 10/20/2013] [Indexed: 11/28/2022] Open
Abstract
Lycium Barbarum Polysaccharides (LBP) are the active components of Wolfberry (a traditional Chinese medicine) which has long been used for improving visual function. This study aims to investigate localized changes of retinal function in a partial optic nerve transection (PONT) model, and effects of LBP on visual function. The multifocal electroretinograms (mfERG) were obtained from 30 eyes of 30 Sprague-Dawley rats. The rats were divided into 6 groups (five treatment groups and one control group). Starting from the first day of the experiment, the rats in the (PONT+LBP) group and the (LBP) group were dosed with LBP; rats in the (PONT+PBS (phosphate buffered saline)) group and the (PBS) group were dosed with PBS via nasogastric tube every day until euthanized. The dorsal part of the optic nerve was transected in the (PONT), (PONT+LBP) and (PONT+PBS) groups at the end of week 1 (day 7 after LBP or PBS feeding began). The mfERG was measured at three time points: week 2, week 3 and week 5. Significant reduction of P1 and PhNR amplitudes of the mfERG were observed in all retinal regions a week after PONT. Feeding with LBP prior to PONT preserved retinal function. All mfERG responses returned to the normal range in the superior retina, which corresponds to the transected dorsal region of the optic nerve, while most of the inferior retinal responses were significantly increased at week 4 after PONT. The ventral part of the retina had secondary degeneration which was not only limited to the ganglion cell layer, but is a widespread effect affecting the outer retina. LBP altered the functional reduction caused by PONT by regulating the signal from the outer retina.
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Petrović M, Jovanović P, Trenkić Božinović M, Bojović L, Jolić M. POTENCIJALNA ULOGA VIZUELNO EVOCIRANIH POTENCIJALA I "PATTERN" ELEKTRORETINOGRAFIJE U DIJAGNOZI PRIMARNOG GLAUKOMA OTVORENOG UGLA. ACTA MEDICA MEDIANAE 2012. [DOI: 10.5633/amm.2012.0403s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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15
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Correlation between multifocal pattern electroretinography and Fourier-domain OCT in eyes with temporal hemianopia from chiasmal compression. Graefes Arch Clin Exp Ophthalmol 2012; 251:903-15. [PMID: 23052713 DOI: 10.1007/s00417-012-2156-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Revised: 08/25/2012] [Accepted: 09/03/2012] [Indexed: 10/27/2022] Open
Abstract
PURPOSE To evaluate the correlation between multifocal pattern electroretinography (mfPERG) and Fourier-domain optical coherence tomography (FD-OCT) with regard to macular and retinal nerve fiber layer (RNFL) thickness in eyes with temporal hemianopia from chiasmal compression. METHODS Twenty-five eyes from 25 patients with permanent temporal visual field defects from chiasmal compression and 25 healthy eyes were submitted to mfPERG using a stimulus pattern of 19 rectangles, standard automated perimetry and FD-OCT measurements. The mfPERG response was determined for groups of three rectangles for the nasal and temporal hemifields and for each quadrant. Macular thickness measurements were registered according to an overlaid OCT-generated checkerboard with 36 checks and averaged for the central area, and for each scanned quadrant and hemifield. RNFL thickness was determined for all twelve 30-degree segments around the disc, and averaged for the segments corresponding to the 6, 7, 8, 9, 10, 11 and 12 o'clock position. Correlations were verified with Pearson's correlation coefficients and linear regression analysis. RESULTS Both mfPERG amplitudes and OCT measurements were significantly smaller in eyes with temporal visual field defects than in normals. A significant and strong correlation was found between most mfPERG and macular or RNFL thickness OCT parameters. CONCLUSIONS mfPERG amplitudes and OCT measurements are significantly correlated in patients with chiasmal compression. Both technologies can quantify neuronal loss and, if used in combination, may help clarify structure-function relationships in this patient population.
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Lung JCY, Swann PG, Chan HHL. Early local functional changes in the human diabetic retina: a global flash multifocal electroretinogram study. Graefes Arch Clin Exp Ophthalmol 2012; 250:1745-54. [PMID: 22527315 DOI: 10.1007/s00417-012-2010-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Revised: 02/15/2012] [Accepted: 03/19/2012] [Indexed: 01/04/2023] Open
Abstract
PURPOSE To investigate early functional changes of local retinal defects in type II diabetic patients using the global flash multifocal electroretinogram (MOFO mfERG). METHODS Thirty-eight diabetic patients and 14 age-matched controls were recruited. Nine of the diabetics were free from diabetic retinopathy (DR), while the remainder had mild to moderate non-proliferative diabetic retinopathy. The MOFO mfERG was performed at high (98 %) and low (46 %) contrast levels. MfERG responses were grouped into 35 regions for comparison with DR classification at those locations. Z-scores of the regional mfERG responses were compared across different types of DR defects. RESULTS The mfERG waveform consisted of the direct component (DC) and the induced component (IC). Local reduction in DC and IC amplitudes were found in diabetic patients with and without DR. With increasing severity of retinopathy, there was a further deterioration in amplitude of both components. Under MOFO mfERG paradigm, amplitude was a useful screening parameter. CONCLUSION The MOFO mfERG can help in detecting early functional anomalies before the appearance of visible signs, and may assist in monitoring further functional deterioration in diabetic patients.
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Affiliation(s)
- Jenny C Y Lung
- Laboratory of Experimental Optometry (Neuroscience), School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
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Malik R, Swanson WH, Garway-Heath DF. 'Structure-function relationship' in glaucoma: past thinking and current concepts. Clin Exp Ophthalmol 2012; 40:369-80. [PMID: 22339936 DOI: 10.1111/j.1442-9071.2012.02770.x] [Citation(s) in RCA: 158] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
An understanding of the relationship between functional and structural measures in primary open-angle glaucoma is necessary for both grading the severity of disease and for understanding the natural history of the condition. This article outlines the current evidence for the nature of this relationship and highlights the current mathematical models linking structure and function. Large clinical trials demonstrate that both structural and functional change are apparent in advanced stages of disease, and at an individual level, detectable structural abnormality may precede functional abnormality in some patients, whereas the converse is true in other patients. Although the exact nature of the 'structure-function' relationship in primary open-angle glaucoma is still the topic of scientific debate and the subject of continuing research, this article aims to provide the clinician with an understanding of the past concepts and contemporary thinking in relation to the structure-function relationship in primary open-angle glaucoma.
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Affiliation(s)
- Rizwan Malik
- NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, UK
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