Time-specific intraocular pressure curves in Rhesus macaques (Macaca mulatta) with laser-induced ocular hypertension

OBJECTIVE

To detect and categorize time-specific variations in daytime intraocular pressure (IOP) found in Rhesus monkeys with laser-induced ocular hypertension.

PROCEDURES

Ten male monkeys with argon laser-induced ocular hypertension in one eye were anesthetized with ketamine hydrochloride, and the IOP measured in both eyes at 7 a.m., 7.30 a.m., and then hourly until 1 p.m. with a Tonopen trade mark XL applanation tonometer. Intraocular pressure time profiles for both eyes in each animal were developed. The means +/- SD of the IOPs for both eyes were calculated for the whole 6-h study period, and the values compared statistically. The difference between the lasered eye mean IOP standard deviation and the normal eye mean IOP standard deviation for each animal during the 6-h follow-up was also calculated and compared.

RESULTS

Mean IOP (+/- SD) in the glaucoma and normal eyes for the 10 animals during the 6-h study was 32.6 +/- 2.5 and 14.9 +/- 2.5 mmHg, respectively. The IOP was significantly higher in the experimental eye than in the normal eye (P = 0.0008). The mean IOP in the lasered eye did not significantly change during the study period, whereas a slight but significant increase in IOP of the normal eye over the study period was recorded (P = 0.003). The variance in IOP in the hypertensive eyes was considerably greater than that in the untreated control eyes. From 7 a.m. to 1 p.m. the IOP declined in five eyes and increased in the other five eyes with laser-induced ocular hypertension.

CONCLUSIONS

The time-specific IOP variation pattern in the daytime in the laser treated eyes is significantly greater than the variation in the normotensive eyes. This shows that in order to detect statistical differences between IOP variations induced by an IOP-reducing drug, and the exaggerated spontaneous IOP variations present in the laser-induced hypertensive eye, sufficient animals should be included in any study. Understanding the time-specific IOP variation present in a group of monkeys with laser-induced ocular hypertension is essential prior to using the model for the evaluation of IOP-reducing drugs.

Corneal thickness and endothelial cell density measured by non-contact specular microscopy and pachymetry in Rhesus macaques (Macaca mulatta) with laser-induced ocular hypertension

PURPOSE

Sustained increase in intraocular pressure (IOP) in humans results in a loss of corneal endothelial cells and an increase of corneal thickness. The effects of chronically elevated IOP on the corneal endothelium of monkeys with laser-induced ocular hypertension, a commonly used animal model of human glaucoma have not been documented. This study examined the central corneal thickness (CCT), the corneal endothelial cell density (ECD), and the corneal endothelial cell size (ACS) in Rhesus monkeys with experimental ocular hypertension. Materials and methods. Ten male monkeys with argon laser-induced ocular hypertension in one eye for an average duration of 2.4+/-0.7 years, were sedated with ketamine hydrochloride, and the CCT, ECD, and ACS measured at the center of the cornea of both eyes with a Topcon SP-2000P non-contact specular microscope (Topcon America Corporation((R)), Paramus, NJ, USA). CCT was also measured using a DHG-500 Pachette ultrasonic pachymeter (DHG Technology Inc., Exton, PA, USA). Mean and standard deviation (S.D.) of CCT, ECD and ACS for each eye was calculated and statistically compared.Results. Mean CCT in the hypertensive and normal eyes measured by specular microscopy was 0.477+/-0.023mm and 0.468+/-0.020 mm, respectively. Mean ECD in the hypertensive and normal eyes was 2601.7+/-631.8 and 3990.2+/-402.9 cells mm(-2), respectively. The mean size of the endothelial cells was 252.4+/-23.9 micro m(2) in the normal eye and 408.7+/-115.0 microm m(2) in the hypertensive eye. No significant difference in the measurement of CCT was observed between the specular microscope and the pachymeter (p=0.46). No significant difference in the mean CCT was observed between the two eyes (p=0.4820), whereas the mean ECD was significantly lower in the hypertensive eye than in the normal eye (p<0.001). The ECD was inversely related to the length of IOP elevation (p<0.001).

CONCLUSIONS

No difference in the corneal thickness measurement was observed between the specular microscopy and the pachymetry techniques. Chronic ocular hypertension did not significantly affect the CCT, but caused a significant loss of endothelial cells in the center of the cornea of the laser treated eyes compared to the normotensive eyes. The duration of elevated IOP was the most important factor affecting the ECD.

[Retinal hazard from blue light emitting diode]

PURPOSE

To compare the effect of exposure time from a blue(460 nm) light emitting diode(LED) on the morphology of the outer retina and determine conditions where damage occurs.

MATERIALS AND METHODS

Young adult rhesus monkeys were anesthetized, and received blue LED exposure from a modified slit-lamp. A 3 mm beam of 0.85 mW was imaged onto the retina through a lens positioned before the cornea and exposure damage was determined at time intervals for 12 to 90 min. Fundus photography, fluorescein angiography(FAG), retinal tomography(HRT), and s-cone electororetinogram(S-ERG) were recorded at baseline, 2, and 30 days.

RESULTS

Two days after 40 min exposure, there was a grey, discolored region, which was over-fluorescent in FAG, and an incresse in HRT and S-ERG corresponding to the site which was exposed to LED light. In histological examination at 30 days, the LED had caused produced a marked disruption of the disks of photoreceptor cells, damaged retinal pigment epithelium(RPE) apical villi, and a loss of RPE melanin after 90 min exposure.

CONCLUSION

A threshold level was found around 40 min. This morphological damage may impair function and continuous exposure to blue light is potentially dangerous to vision.

Distant cancer effects on standardised testing of peripheral vision

BACKGROUND

Profound central-retinal visual losses have been a major presenting factor reported in cancer and melanoma associated retinopathies (CAR, MAR). However, it is well established that standardised tests of peripheral retinal function are often the most sensitive detectors of early eye disease. This is a preliminary investigation of the responsiveness of the peripheral retina to "distant" (non-eye or CNS) cancers using easily obtained standardised tests.

METHODS

The design is a single blind study where test results are compared with published norms and a small age matched control group. Of 120 ambulatory cancer outpatients who were interviewed at routine follow up examinations, 111 volunteered and admitted a range of mild visual changes. 25 cancer patients completed all tests of peripheral vision function and a clinical screening. There were seven control subjects of the same age range.

RESULTS

98% (49 of 50) of eyes from the patient cohort were judged clinically normal following examinations which emphasised the central retina, fundus appearance, and static fields. On testing which emphasised the visual periphery, 46 (92%) eyes showed one or more quantitative abnormalities >2 SD from the age adjusted norm means. These abnormalities clustered mainly about dark adaptation (rod cell) sensitivity (31, 62% of measured sites), the blue sensitive retinal cells (17, 34% of measured eyes), and the oscillatory component (OP) of the electroretinogram (23, 46% of measured eyes). One control eye (7%) showed a significant dark adaptation abnormality and ERG reduction. There was no identifiable interaction between chemotherapy mode and the cancer associated retinal deficits (CARD). Antiretinal antibodies were found in sera from most patients and controls.

CONCLUSION

CARD is common in the retinal periphery of many cancer patients, and is distinct from rare CAR, MAR central-retinal responses. CARD has numerous potential clinical uses which justify expanded research with more defined large samples.

Human photopic response to circulating glucose

Circulating glucose was manipulated in young human volunteers with clinically normal vision. Fasting achieved a concentration range of 45-91 mg/dl. And sugar loading produced a range of 79-108 mg/dl. Glucose increased in all subjects. A nonparametric ANOVA provided a p=0.0005 for the significance of the concentration differences between group glucose concentrations under the two conditions in the sample. Each volunteer participated in each condition of the repeated-measures design. Clinical tests were completed before electroretinograms were recorded under photopic and scotopic adaptation conditions. Measures were made from 12 eyes. Only photopic adaptation conditions with maximal stimuli produced significant results. Inter-individual differences were robust and constrained to reduced implicit times for b-wave peaks and 30 Hz flicker implicit times. Under the elevated glucose conditions. Other variables showed very strong trends. These results confirm and extend other human indications of photopic retinal sensitivity to variations within the normal range of circulating glucose concentrations.

Mid-peripheral pattern electrical retinal responses in normals, glaucoma suspects, and glaucoma patients

AIMS

Reliance on intraocular pressure, optic nerve cupping changes, nerve fibre layer integrity, and visual field changes may delay treatment of glaucoma since irreversible changes may have already occurred at the time of diagnosis. Abnormal pattern electrical retinal responses (PERR or PERG) have been demonstrated in patients with ocular hypertension (no visual field changes) and glaucoma when visual stimulation was presented to the central field. Since glaucomatous visual field changes tend to occur first in the mid-periphery, the use of PERR outside of the central field may offer an earlier indication of glaucomatous involvement.

METHODS

Glaucoma suspects and glaucoma patients were derived from a university practice. Normal subjects were recruited from non-patient volunteers. Alternating bar gratings were presented in the supranasal, supratemporal, infratemporal, and infranasal visual field. Six spatial frequencies, from 0.25 to 6.0 cycles per degree, were used for normal volunteers; three spatial frequencies, from 0.38 to 1.5 cycles per degree, were presented to suspects and glaucoma patients. Time of onset of the first negative (N35) and first positive peak (P50) and the amplitude consisting of the absolute difference between the first negative peak and first positive peak (P50 amplitude) are reported. Age corrected values were determined for normals, suspects, and glaucoma patients for each spatial frequency and for each quadrant in the visual field.

RESULTS

Mean P50 amplitudes from normal subjects showed spatial tuning in all quadrants with reduced low frequency attenuation. Normals demonstrated a small decline in amplitude with age. Glaucoma patients demonstrated an age corrected reduction in amplitude and early implicit times. Glaucoma suspects had values between those of normal and glaucoma subjects. P50 amplitudes were weakly correlated with increasing cup to disc diameter ratio. A glaucoma patient with asymmetric visual field loss demonstrated significant diminution of the PERR bilaterally.

CONCLUSION

The PERR, using mid-peripheral stimulation, may be a sensitive tool for the early detection of glaucoma. Further refinements can speed clinical data acquisition and enhance signal to noise ratio.

Signs of glaucoma in rhesus monkeys from a restricted gene pool

PURPOSE

To investigate the distribution of intraocular pressure (IOP) and cup properties in a colony of rhesus monkeys that has had no outside genetic input since 1938 (approximately 12 generations). This sample of sequestered monkeys is significantly larger than any previously reported. Comparisons are made with a sample of random-source monkeys to develop population estimates defining the limits of normalcy.

METHODS

The IOP and cup/disc ratio estimates were collected from 701 eyes of 354 adult rhesus monkeys from the closed colony on Cayo Santiago, Puerto Rico. Results for IOP were compared with the normal rhesus IOP population distribution function calculated from an earlier sample of genetically heterogeneous rhesus.

RESULTS

The mean +/- standard deviation IOP in the Cayo Santiago monkeys (15.8+/-3 mmHg) related well to the calculated "normal" rhesus distribution (14.5+/-2 mmHg) below and around the mean IOP only. Above the mean rhesus IOP, the samples from the Cayo monkeys were strongly skewed: 129 eyes had IOP more than two standard deviations above the normal mean IOP, and 54 eyes had IOP more than three standard deviations above the normal mean IOP. Cup/disc ratio estimations tended to cluster as higher values in the higher IOP quartiles. Some eyes with IOP below the mean had cup/disc ratios > 0.5. Values for IOP that were more than two standard deviations above the mean and cup/disc ratios > 0.4 were not uniformly distributed across social groupings, although incidence of high IOP was more than 25% in one group.

CONCLUSION

After 12 generations with the same genetic pool, expression of ocular hypertension and large optic disc cups is high but not uniform.

Diurnal intraocular pressure curves in healthy rhesus macaques (Macaca mulatta) and rhesus macaques with normotensive and hypertensive primary open-angle glaucoma

PURPOSE

The authors identify any diurnal intraocular pressure (IOP) variation in healthy Cayo Santiago macaques, as well as Cayo Santiago macaques with normotensive and hypertensive primary open-angle glaucoma (POAG), to further evaluate their potential value as a model for human POAG.

METHODS

Twenty-four monkeys (eight animals each of the healthy control, normotensive glaucoma, and hypertensive glaucoma groups) were sedated with ketamine hydrochloride and the IOP measured hourly from 8:00 AM until 3:00 PM with a Tonopen XL applanation tonometer (Mentor, Norwell, MA, U.S.A.). Mean IOP time profiles, mean IOPs at each observation time, and linear trends in mean IOP over time were compared among groups. Intraocular pressure rate-of-change over time and residual variation about the regression line for each individual eye were analyzed. Cup/disc ratio (C/D) was compared with baseline IOP, IOP profile mean and slope, and IOP residual variation.

RESULTS

A significant group and time effect on mean IOP (p = 0.0001 and 0.011, respectively), with highest values at 2:00 PM or 3:00 PM, and a significant increasing linear trend in mean IOP over time in the hypertensive group were observed (p = 0.012). Intermediate readings between control and hypertensive mean IOPs were identified for the normotensive glaucoma group. The biggest range of IOP variation was found in the hypertensive glaucoma monkeys. Higher variations in IOP did not lead to an increase in C/D.

CONCLUSIONS

This study provides evidence that the Cayo Santiago macaques are a valuable model for human normotensive and hypertensive POAG.

Impaired retinal function in young labrador retriever dogs heterozygous for late onset rod-cone degeneration

Xenon-flash d.c.-electroretinograms were recorded from dark adapted, rod-cone degenerate homozygote affected (n = 6), heterozygote carrier (n = 3) and control retinas (n = 4) at 3 and 4 months of age, starting at 0.6 log units below control PII threshold. One log unit higher stimuli were necessary to evoke PII in heterozygote and affected retinas compared to controls. Unique to the heterozygotes, double peaked PII responses that were evoked by -2 log relative units intensity stimulation were significantly (P = 0.028) lower in amplitude than those of controls. PII amplitudes of homozygotes were significantly (P = 0.005) lower in amplitude than those of controls at both ages examined in response to -2 and 0 log relative intensity stimulation. No differences were found in scotopic threshold response amplitudes or times to peak between the three groups. Homozygote affected PII times to peak were significantly (P = 0.005) shorter in relation to controls at -2 log units. Findings suggest that heterozygotes exhibit an impaired retinal function which can be demonstrated at 3 and 4 months in this mutant.

The late positive retinal potential in dogs

The late positive potential of the mammalian electroretinogram has been called the 'PI' or the 'c-wave' potential. It is unusual among retinal potentials because its peak implicit time increases in response to increasing stimulus intensity and because it cannot be demonstrated consistently in small samples of normal humans or normal dogs. We recorded wideband (DC-1 kHz) responses from 34 normal Beagles or dogs of similar size. Of the 34, 11 produced a late positive potential set that satisfied the criteria for c-waves. Multiple aspartate injections always increased c-wave amplitude and stimulus-response linearity in all 'producers'. Non-producers were never converted to producer status by aspartate blocking of the inner retina. Interaction of late positive and negative potentials and the possible influence of normal individual variations in the trans-epithelial potential are discussed. Individual mammal c-wave production is controlled by outer retinal phenomena which vary between individuals.

Early morphometry of a retinal dystrophy in Labrador retrievers

Retinal morphometry was assessed in 7 dogs from a colony of Labrador Retrievers with dystrophic retinas at 1,2,3,4 and 18 months of age. Rod outer segment length and outer nuclear layer width were measured in the central, midperipheral and peripheral retina at six locations along the vertical meridian. Early striking regional differences in onset and rate of progression were characteristic for this inherited retinal degeneration. Notably, some areas of the retina developed fully and normally before degenerating. The central parts of the vertical meridians showed slightly disorganized rod outer segments already at 1 month of age and they were significantly shorter than those of control animals at 3 and 4 months (p < 0.01 and p < 0.001, respectively). The rod outer segments of the midperipheral and peripheral regions were, however, comparable to control animals as late as at 4 months of age. At 18 months the rod outer segments of dystrophic animals were significantly shorter in all retinal regions (p < 0.0005). At the age the outer nuclear layer of the dystrophic animals had become significantly thinner than that of control animals in all retinal regions (p < 0.001), indicating a clear visual cell loss. It is reasonable to characterize this as a retinal degeneration having a relatively slow progression, which enhances its relevance to conditions of clinical significance.

Chronic ocular hypertension alters local retinal responsiveness

Electrophysiological responses of the retina and visual cortex to a series of grating stimuli (6-768 minutes of arc) were recorded in seven sessions using normal beagles, 21 sessions using beagles afflicted with inherited ocular hypertension, and 12 sessions using rhesus monkeys. A 15 degrees field centred around the animal's area centralis or fovea was used to stimulate the central retina. A 30 degrees field, centred on the same spot, was then used to stimulate the larger area. Two recording series were completed on each animal, with both field sizes presented in each recording session. The first recording took place 30 minutes after and the second 2 hours after the injection of thiamylal sodium. Only the signals from the toroidal 15 degrees of the retina of the hypertensive dogs were remarkably larger during the second recording (p = 0.001). No significant differences were found between the two recordings from the retinas of normal dogs or monkeys, nor were there any significant differences between the two recordings from above the cortex in any group. Several hypotheses are proposed to explain the basis for the interaction of thiamylal with the more peripheral retinal function in clinically glaucomatous dogs.

Primary open angle glaucomas in the rhesus monkey

Rhesus monkeys from the closed Cayo Santiago colony of the University of Puerto Rico demonstrate elevated (> or = 22 mm Hg) intraocular pressure in a pattern which significantly favours certain maternal lineage groupings. The colony had remained genetically pure since 1938. Of nine matriarchal lineages (matrilines) examined, two had an incidence of ocular hypertension of more than 40% and six of more than 10%. Information on 18 matrilines is currently located in the colony data base which identifies each individual and its vital statistics. In 1990, six animals were moved to the laboratory in Florida. Among those from a low incidence matriline, we found abnormal optic nerve cups, pallor, reduced function of (mainly peripheral) fields, progression and loss of optic nerve axons in the presence of ocular hypertension. In another individual where the cup/disc ratio for the right eye was 0.7 and left eye 0.4 and outflow facility was normal, we excluded all other causes of optic nerve atrophy, and low tension glaucoma was diagnosed. This female was from a matriline with a low incidence of ocular hypertension. Relatively rapid aging (3-4 years/human year) monkeys with ocular hypertension and familial clustering produce a near ideal glaucoma research model.

Primary open-angle glaucoma alters retinal recovery from a thiobarbiturate: spatial frequency dependence

Electrophysiological responses of the retina to a series of grating stimuli (6-768 min of arc/phase) were recorded in seven sessions using normal Beagles and in 21 sessions using Beagles afflicted with inherited glaucoma. A 15 degrees and a 30 degrees field, centered around the animal's area centralis, were used to stimulate the central retina. Two recording series were completed on each animal, with both stimulus sizes presented in each recording session. The first recording took place 30 min, and the second 2 hr, after the injection of thiamylal sodium. The signals recorded from the toroidal 15 degrees of the retina of the glaucomatous dogs during the second recording were significantly larger than those of the first recording. This difference was found only for the larger (> 48 min of arc/phase) gratings. No significant differences were found between the first and second recordings from the central 15 degrees of glaucomatous dogs, nor at any site in the normal dogs.

Optic nerve aplasia

Optic nerve aplasia is a rare congenital defect invariably associated with other ocular or systemic disorders. We examined a 3-year-old girl with monocular microphthalmos who had optic nerve aplasia on histopathologic examination of the eye after enucleation. Magnetic resonance imaging verified the presence of unilateral optic nerve aplasia, and demonstrated hemichiasmal hypoplasia on the affected side and bilateral optic tracts. The visually evoked cortical response revealed increased signals over the occipital cortex ipsilateral to the aplastic nerve, suggesting misdirection of axons from the temporal retina of the normal eye. The visual pathway in unilateral optic nerve aplasia may assume a primitive form of neuronal organization characterized by an increase in contralateral retinogeniculostriate projection.

A primate model for age related macular drusen

A closed colony of semi-free-ranging rhesus monkeys maintained in isolation since 1938 by the Caribbean Primate Research Center (CPRC) is being studied as a model for age related macular drusen. Of examined colony animals 57.7% of the monkeys and 47.3% of their eyes have drusen. The prevalence and severity of drusen are linearly related to increasing age and are significantly higher in specific maternal lineages (matrilines). An electrophysiological estimate indicates loss of function associated with drusen. Prevalence of drusen in CPRC females is almost twice that of males, while the prevalence among CPRC animals in general appears to be several times that of monkeys from continental US facilities. Evidence suggests that the frequency of endstage lesions is also similar to that in human populations. The CPRC matriline monkeys appear to provide the best model yet reported for human age related macular drusen.

Pigment epithelial function in canine retina

The lateral distribution and temporal changes in the eye standing potential of 15 dogs with normal eyes (as determined by use of an ophthalmoscope and electroretinography) were measured by use of noninvasive methods. The standing potential was converted to an alternating potential by controlled eye movement. The light peak occurred 6 minutes after a stimulus intensity increase of 4 log units. The ratios of the highest measured voltage after the light step divided by the voltage measured immediately before the light step ranged from 1.27 to 2.07 (mean 1.74 +/- SEM, 0.064). The responses typically decayed slowly after the light peak. The potential after the light peak did not return to prelight step values during the observation period. The field potential of the standing potential decreased nonlinearly in temporal direction from the outer canthus.

The quantity of rhodopsin in human eyes

The content of rhodopsin in the eyes of 15 donors (30 eyes) was determined. Both retinal and pigment epithelial fractions were collected from each globe, extracted using 1% CTAB, and the rhodopsin difference spectrum of each fraction was obtained separately. The total amount of rhodopsin, obtained by summing the amounts recovered from the retinal and PE fractions, ranged from 2.00 to 11.94 (median: 6.40) nmoles/eye. Previously reported mean values of about 3.5 to 4.0 nmoles per retina have been obtained using a variety of methods. The present higher values, perhaps largely dependent on procedural details described herein, appear plausible given the known concentrations of rhodopsin in rod outer segments, rod outer segment volumes, and number of rods in the human retina.

Adult-onset macular degeneration in the Cayo Santiago macaques

Since 1985 a group from the University of Florida has examined 136 rhesus monkeys from the Cayo Santiago colony. From the sample, 97 are older than nine years (approximately 30 human years) and 39 are younger. Drusen were found in 17% of the younger eyes and in 46% of the older eyes. All animals over 25 years of age had drusen in the central fundus. The incidence of drusen varied from 19-77% between five social groups. Incidence reported in random-source colonies in the continental U.S.A. is about six percent. Compared to near-age matched controls without drusen, selected rhesus exhibited visual resolution losses amounting to two Snellen-lines or more. The end-stage disciform changes and ultrastructural similarities are comparable with human macular disease. Future prospective studies may include therapies, surgical intervention, environmental manipulation and genetic research.

Macular disease in related rhesus monkeys

During (January) 1986-(May) 1988, we examined 272 eyes in 136 rhesus monkeys in the closed Cayo Santiago colony of the Caribbean Primate Research Center of the University of Puerto Rico. Seventy-eight eyes were less than 10 years of age. One hundred and ninety-four were aged 10-28 years. The fundi were examined and photographed. Fluorescein angiography was performed in some eyes. Selected cases were evaluated for 'acuity' loss by recording of pattern-evoked retinal and cortical signals. Light and electron microscopy were used to evaluate the pigment epithelium of some animals. Thirty-eight percent of all eyes had posterior pole drusen. Incidence was highly age-related. When late-stage lesions were found, we did not see neovascularization, but late hyperfluorescence was consistent with degenerative scarring and atrophy. Electrophysiology demonstrated moderately reduced acuity in the presence of numerous macular drusen. Electrooculograms were low normal. Histopathology showed changes identical to those reported in human age-related macular degeneration. No eyes less than 10 years of age had confluent drusen or disciform-like lesions. The incidence of drusen in samples of some social groups was much higher than others.

Very large neurons of the inner retina of humans and other mammals

Large ganglion cells, called parasol cells, are known to occur in the Golgi-stained, human retina. This report describes a population of much larger cells that is not stained by Golgi technique. These cells may be located in the human ganglion cell layer using Nomarski differential interference contrast optics and unstained, flatmounted tissue. These cells are regularly distributed in young and old adults in a Gaussian fashion along the radii that extend from the perimacula toward the far periphery. The author did not find the cells in the central retina. The most frequent (J-type) cells have soma diameters between 26 and 40 microns. Rare (S-type) cells measure up to 55 microns in diameter. Many cells have processes that appear to be axons or dendrites. These cell types may be especially sensitive to damage early in diseases of the inner retina.

Electroretinograms in early fungal endophthalmitis

To facilitate the early diagnosis of exogenous fungal endophthalmitis, we developed a rabbit model for Aspergillus fumigatus endophthalmitis. Six eyes of six New Zealand white rabbits were inoculated with forty spores of A. fumigatus. A control group of their six contralateral eyes received a similar but sterile inoculum. The rabbit eyes were evaluated with respect to clinical appearance and the electroretinogram. Clinically evident endophthalmitis developed in all six infected eyes at an average of five days after injection (range 3-7 days). Data samples each 48 hours showed transient b-wave amplitude elevations in three infected eyes. These were greater than two standard deviations above the mean pre-injection values (p less than 0.05). These amplitude increases preceded the onset of ophthalmoscopically recognizable infection and were observed at 2 to 5 days after injection (mean = 4 days). B-wave amplitudes in the infected eyes fell below two standard deviations of pre-injection values (p less than 0.05) at an average of 5 days (range 3-7 days) after injection, a corresponding to the onset of clinically obvious infection. At an average of 7 days after injection, all the infected eyes exhibited unmeasurable electroretinogram waveforms and severe infection. Histopathologic study of infected eyes showed extensive fungal infiltration of retina and vitreous tissues. The electroretinogram may be helpful in the early diagnosis of fungal endophthalmitis.

Division of the pattern-evoked retinal response by respiratory acidosis

Analysis in the frequency domain divided the pattern-evoked retinal response (PERR) of the cat into two analog components. A mild respiratory acidosis was produced by raising the end-tidal CO2 from 4-6% to 12-14%. The onset of the acidosis (without hypoxia) was highly correlated with marked decreases in the low-frequency PERR component and in the b-wave of the flash-elicited ERG. The high-frequency PERR component was unchanged relative to the labile low-frequency component (p less than 0.01). The literature has established a firm link between local pH and Müller cell function. These data tend to confirm the hypothesis that the cat's PERR to some grating stimuli of less than 100% contrast may contain separable components of different cellular origin(s).

Electroretinal changes in the presence of a carbonic anhydrase inhibitor

A specific carbonic anhydrase activity inhibitor (methazolamide) was injected into one vitreous body each of 4 New Zealand White rabbits. Electroretinograms (ERG) were recorded before and several times after the methazolamide injection. The stimulus levels maximized the rod and cone response characteristics of the rabbit ERG. The effects of methazolamide were followed over 5 h. During this time, the electroretinograms showed a decline in amplitude of both a and b waves at both stimulus levels. The data support the involvement of carbonic anhydrase in the excitatory physiological events in the retina. Preliminary evidence indicates a slow recovery of the carbonic-anhydrase-inhibited ERG.

Degenerative changes in maculas of rhesus monkeys

In the hope of identifying an animal model for age-related macular degeneration (AMD) we undertook a pilot investigation of aged rhesus monkeys. Twenty-nine monkeys from a seminatural colony were examined at the Caribbean Primate Research Center. Macular drusen were found in 74% of the monkey eyes. Alterations of the retinal pigment epithelium within the macula were noted in 45% of the eyes. Fluorescein angiography in selected animals revealed window defects consistent with drusen. None of this sample showed the exudative form of AMD or disciform scarring. One typical monkey underwent special studies including measurement of visual resolution by electrophysiological study of the retinal and visual cortex. Application of human criteria to this animal supported the diagnosis of early AMD. Histopathologic study of one eye by transmission electron microscopy confirmed the presence of drusen with nearly identical ultrastructural features to those found in the human pigment epithelium in AMD.

Retinal cyclic light damage threshold for albino rats

This study determined the minimum cyclic [12L:12D] light intensity which produces retinal damage in albino (Sprague-Dawley) rats raised from birth to 15 weeks of age under a cyclic light intensity of 6 lux. Four experimental light intensities were tested, including: 1345, 270, 130 and 65 lux. Control animals remained under 6 lux. For each of the intensities tested, the retinas of groups of six rats were evaluated after various durations of light exposure for physiological and morphological evidence of light damage. The indices of damage were (a) histological and morphometric changes in the retina and (b) changes in the amplitude of the b-wave of the electroretinogram. The data indicated that light intensities of 1345 or 270 lux severely damaged retinas of albino rats within 3-7 days of the initiation of light exposure. Exposure to 130 or 65 lux produced much less dramatic changes in the responsiveness and morphology of the retina which did not appear to be permanent. Based on these results, a reasonable estimate for the threshold cyclic light intensity which produces damage to retinas of albino rats raised under 6 lux lies between 130 and 270 lux, or approximately 1.3 log units above the light intensity under which the animals were raised.

Cyclic light intensity threshold for retinal damage in albino rats raised under 6 lx

This study determined the minimum cyclic (12L:12D) light intensity which produces retinal damage in albino (Sprague-Dawley) rats raised from birth to 15 weeks of age under 6 lx (12L:12D). Four experimental light intensities were tested, viz. 1345, 270, 130 and 65 lx. Control animals remained under 6 lx. After various durations of exposure to one of the intensities tested, the retinas of groups of six rats were evaluated for physiological and morphological evidence of light damage. The indices of damage were: (1) histological and morphometric changes in the retina, and (2) changes in the amplitude and latency of the b-wave of the electroretinogram. Light intensities of 1345- or 270 lx severely damage retinas of albino rats raised from birth under 6 lx within 3-7 days of the initiation of light exposure. Exposure to 130- or 65 lx produced much less dramatic changes in the responsiveness and morphology of the retina that did not appear to be permanent. Based on these results, a reasonable estimate for the threshold cyclic-light intensity which produces damage to retinas of albino rats raised under 6 lx lies between 65- and 130 lx, or slightly more than 1 log unit above the light intensity under which the animals were raised. The effects of an animal's light history on retinal susceptibility to light damage are discussed.

Pattern electroretinogram: effects of reference electrode position

The pattern electroretinogram has assumed greater clinical and experimental significance because of its inner retinal origins. However, clinical tests may be confounded by an artifact. We tested subjects varying reference electrode position and eye stimulated while employing the Dawson-Trick-Litzkow (DTL) fiber electrode as the active electrode. The presence of a statistically significant artifactual response could not be confirmed. However, the variability of responses elicited with the outer canthus was less and the signal-to-noise ratio greater than with other reference positions.

Infrared. An unseen and unnecessary hazard in ophthalmic devices

The concept of instrument-induced light damage to the retina is well established. Many have argued that ultraviolet (UV) energy is overwhelmingly responsible and that longer wavelength infrared (IR) energy causes thermal change and plays a minimal role. We suggest that infrared may play a primary role in instrument-induced damage. We measured the radiometric and photometric outputs from commonly used ophthalmic devices in normal use and in IR-blocked conditions. We found IR output to represent a significant portion of the total irradiation produced by these instruments. Infrared was easily and inexpensively minimized without compromising usable visible light in these instruments using an efficient IR filter. The instruments' incandescent lamps, glass envelopes, and optics are poor UV emitters or transmitters. Manufacturers' data do not indicate UV emission. Evidence for UV blocking and IR transmission by the intraocular media is presented.

Macular degeneration in a community of rhesus monkeys. Ultrastructural observations

The eyes of 29 aged adult, (mean age, 20 years) rhesus monkeys were examined for the presence of age-related macular degeneration (AMD). This sample represented approximately 25% of the aged population in the seminatural colony at the Caribbean Primate Research Center (CPRC) of the University of Puerto Rico. Approximately 75% of the animals examined had drusen in the posterior pole. Ultrastructural analysis was used to determine whether the pathologic alteration of Bruch's membrane and drusen in the colony resembled those noted in aged or AMD-afflicted human retinas. There were abnormalities in all layers of Bruch's membrane. Deposits of heterogeneous material, comprised of membranous, granular, and cellular components, were seen in both the inner collagenous zone (ICZ) and the outer collagenous zone (OCZ). Accumulation of this drusenoid material in the ICZ produced a scalloping of the basal border of the retinal pigment epithelium (RPE). Dense bodies were seen in both Bruch's membrane and RPE cytoplasm near the basal infoldings. Cytoplasmic processes, as well as whole cells, were seen with regularity within the drusenoid material. In one case there was a cell with a basement membrane crossing the middle elastic layer of Bruch's membrane. These changes are consistent with those reported in human aging and AMD. Aged individuals in this colony appear to be predisposed to macular degenerative changes and may prove to be an invaluable animal model for studying AMD in humans.

Tissue responses of the monkey retina: tuning and dependence on inner layer integrity

Recent technical and conceptual advances have made it possible to experiment with models of local human inner retinal disease and changes in very small, tissue-specific signals. Local retrograde degeneration of the ganglion cells was induced in four rhesus monkeys by 160 degrees microdiathermy fiber layer burns at the nasal or temporal edges of the optic disc. There were no abnormalities of the classical electroretinograms (ERGs) during the following 210 days. With nasal lesions, pattern-evoked retinal (PERR) and cortical responses over a range of grating contrasts and spatial frequencies were largely normal. The authors found a cortical spatial tuning peak near 0.5 cycles/deg (cpd) and a retinal peak at 0.25-0.3 cpd. With temporal lesions, the retinal signals to high frequency stimuli (greater than 1.0 cpd) approached zero between 20-60 days. The cortical evoked signal declined with a course similar to the retinal components. Histological evidence was found for extensive loss of ganglion cells and fibers in a central 30-40 degrees temporal area, including the macula, 210 days after the temporal lesions. This is strong evidence that local ganglion cell-dependent electrical potentials, bearing little relation to the ERG, can be measured in response to selected stimuli.

The effects of dim cyclic light on pigment epithelial function in the albino rat

Most pathologies of the outer retina include physiological and morphological changes in the pigment epithelium. The question of pigment epithelial involvement in retinal light damage caused by low intensities of light is still unresolved. In the present study, we investigated the effects of low intensity cyclic light on pigment epithelial function in albino rats. The functioning of the pigment epithelium was assessed electrophysiologically from d.c. recordings of ERG c-waves and sodium azide induced changes in the resting potential. Responses obtained from albino rats raised under low intensity cyclic light (0.63 ft cd. 12:12 L:D) were compared to those obtained from albino rats raised under minimal light exposure conditions (dark-reared) and pigmented rats housed under low intensity cyclic light. We report, for the first time, that albino rats raised from birth under low intensity cyclic light possess c-waves. Their responses were comparable in amplitude and latency to those recorded from pigmented rats housed under similar conditions, but were significantly smaller than those recorded from dark-reared albino rats. The reduction in the amplitudes of the c-waves recorded from cyclic light-reared albino rats was probably not due to retinal light damage. Comparisons of the amplitudes and latencies of ERG b-waves recorded from cyclic light-reared and dark-reared albino rats did not suggest that the retinas of the cyclic light-reared albino rats had been damaged by light. Light microscopic examination of these retinas also provided no evidence for light damage. The transient, positive potential changes recorded from cyclic light-reared albino rats in response to bolus injections of sodium azide were significantly smaller than those recorded from either dark-reared albino rats or pigmented rats housed under low intensity cyclic light. The results of these experiments suggest that the pigment epithelium of albino rats is functionally altered by extremely low intensities of cyclic light.

Disease-specific electrophysiological findings in adult ceroid-lipofuscinosis (Kufs disease)

Two adults with mild dementia and a history of memory loss and disequilibrium were seen in the eye clinic following complaints of acuity loss in the 20/30-20/70 (Snellen) range. Results from the fundus examination of one patient were entirely normal; the other showed minimal vascular attenuation and optic atrophy. Electrophysiology was remarkable: (1) Photopic ERG b-waves were reduced, delayed, and showed pronounced oscillations. (2) EOG 'light-rise' potentials were absent or very small. (3) Binocular pattern-VER signals showed addition of the monocular signal. Scotopic ERG signals were normal. Brain biopsy and microscopy showed intercellular, autofluorescent ceroid deposits which provided a clear diagnosis of Kufs disease. Histology of model animal retinal cells show ceroid deposits in cell classes implicated by the human retinal signals. The cluster of electrophysiological results point toward early changes in the pigment epithelium and inner plexiform layer cells as a means of noninvasive diagnosis.

Culture of retinal pigment epithelium from chorio-retinal biopsies

The recently devised methods for surgical sampling of chorio-retinal tissue permits morphological evaluation of retina in various diseases. In the present report it is demonstrated, that the retinal pigment epithelium in such samples can be isolated as a viable cell population, and that the cell mass can be increased sufficiently in culture to permit biochemical as well as morphological studies. This procedure thereby expands the diagnostic potential of the sample tissue.

Retinal pigment epithelial dysfunction in early ovine ceroid lipofuscinosis: electrophysiologic and pathologic correlates

Retinal degeneration is a major finding in the human and ovine ceroid lipofuscinosis. Sequential electroretinographic (ERG) studies in a young, asymptomatic, affected lamb are presented here, which demonstrate a progressive loss of the scotopic b-wave and unrecordable c-waves under halothane anesthesia. Even at this initial stage of disease, lesions were evident in the form of dystrophic retinal pigment epithelial (RPE) villi, and loss of photoreceptor cells and rod outer segments. Cone inner segments were enlarged and scanning electron microscopy emphasized these abnormalities. All cells in tapetal and nontapetal areas contained fluorescent inclusions with similar emission spectra (maximum = 539 nm). By transmission electron microscopy, storage bodies consisted of 'finger-print' profiles and were most prominent in bipolar cells. The pathological features of the retina correlate well with the observed ERG changes, reaffirming the sheep as a useful model to delineate early events in ceroid lipofuscinosis.

Power spectral analysis of visual evoked potentials in multiple sclerosis

Power spectral analysis (PSA) was performed on the visual evoked potentials (VEPs) to counterphased checkerboard stimuli from 98 eyes in 49 patients with multiple sclerosis (MS) and 54 eyes of 27 normal volunteers. Attenuation of high frequency components of the transient visual evoked potential was found in 53% of MS patients and 4% of controls. Loss of high frequency components was poorly correlated with prolonged latency (r = 0.346). The consideration of both PSA and latency of the VEP increased the percentage of MS patients exhibiting visual pathway conduction abnormalities from 61% to 86%. The use of PSA in the diagnosis of MS is useful in increasing detection especially in cases where deformed waveforms preclude a reliable estimation of latency.

Hereditary retinal degeneration in the Rhode Island Red chicken. I. Histology and ERG

Hereditary blindness in Rhode Island Red chickens was analyzed at various post-hatching stages by light microscopy and electrophysiological recordings. At the time of hatching the retina of affected chicks appeared morphologically normal and identical to that of control, non-affected chicks. Whereas the electroretinographic (ERG) response to light stimulus in normal chicks was near the adult level at the time of hatching, no ERG either under light- or dark-adapted conditions was measurable in affected chicks at any stage examined. Photoreceptor cells of affected animals were seen to undergo degenerative changes after about one week post-hatching. Decrease in number of outer segments, spaces between inner segments and large spaces in the outer nuclear layer were apparent by Day 10. By Day 21, most of the photoreceptor inner segments appeared swollen, and the decrease in number of outer segments and photoreceptor nuclei was noteworthy. By the end of the second month no outer segments were seen and the majority of identifiable inner segments were from cones, a larger proportion than normally present being double cones. By six months, very few photoreceptor inner segments and nuclei remained; most inner segments were deformed and diminutive but usually contained a clearstaining oil droplet characteristic of the principal member of the double cone. In all stages after one week of age, pycnotic nuclei and thinning of inner retinal layers accompanied photoreceptor degeneration. In all specimens examined, degeneration of retinal cells was more pronounced in the superior central retina than in the periphery. Pathological changes were frequently also noted in the pigment epithelium overlying degenerating retina. Because the chick retina is well developed at birth, contains a fovea and a significant cone population and because cones (particularly one specific type) survive rods, we believe that this congenitally-blind chicken may be a useful model for studies on human hereditary retinal degenerations.

Rate-dependent inhibition of pattern-evoked retinal responses in the pigeon

Robust signals of corneal derivation were recorded from the pigeon (a foveate model) in response to alternating gratings. When a rotating windmill-like display was superimposed upon the visual field, there was rate-dependent inhibition of the response to the gratings. Inhibition diminished linearly with grating contrasts (11-40%) and nonlinearly above 50%. The responses to diffuse-light stimuli showed no rate dependence but a predictable, steady reduction at all windmill rates. Rate-dependent inhibition has been reported only in the inner-retinal cells of other animals where intracellular recordings have been made.

Results from a simple laser color perimeter

Stimulus size, chromaticity, adaptation, luminance and local adaptation are more easily controlled when laser light rapidly scans the appropriate portion(s) of the visual field. Adaptation of a Ferree-Rand perimeter to the use of He-Ne laser light gives chromatic and achromatic thresholds of relatively low variance.

Relations between the Human Retinal Cone and Ganglion Cell Distribution

The distribution of human cone cells is well known and is frequently cited. The distribution of human ganglion cells is less well known and was published in a booklet which is less frequently cited in the eye literature. Selected published curves provided by these authors and Snellen acuity data were digitally encoded, transformed to linear vertical axes where necessary, scaled and compared. Comparisons were possible along the temporal hemi-meridian and provided correlations (r = 0.99 for ganglion cells versus cone cells; r = 0.99 for ganglion cells versus acuity, and r = 0.98 for cone cells versus acuity). Integration of densities along the horizontal hemi-meridian out to 50 degrees showed that approximately 50% of the cone cells are within 18 degrees of the foveola and that approximately 50% of the ganglion cells are within 13 degrees of the foveola. Appreciation of the strong interrelations between the cone-ganglion cell distributions may provide for a better understanding of the visual of inner-retinal disease. Presently it accounts for aspects of the production of pattern-elicited retinal signals which are under intense investigation in many centers.

Canine visual acuity: retinal and cortical field potentials evoked by pattern stimulation

The visual acuities (i.e., visual thresholds for pattern detection) of four dogs under neuromuscular block were measured using visually evoked cortical potentials (VECP) and/or pattern-evoked retinal potentials (PERR). Stimuli were phase-reversing square-wave gratings with a mean luminance of 86 cd/m2 and 70% contrast. The mean of the VECP thresholds of two dogs tested was 12.59 cycles per degree (cycles/deg). The mean of the PERR thresholds of four dogs tested was 11.61 cycles/deg. The difference between VECP and PERR thresholds was not statistically significant. VECP acuities appear to be determined at or before the last stage of retinal processing (PERR). Our estimates of canine acuity are 1.3-2 times those reported for cats and 0.2-0.4 times those reported for primates when tested under comparable luminance and contrast conditions.

Retinal and cortical pattern responses: a comparison of infants and adults

Retinal and cortical responses to pattern reversal stimulation were recorded simultaneously in three human infants of average age 3.5 months and two adults of average age 28.5 years. The relative power of retinal signals as a function of spatial frequency for both adults and infants was very similar and extrapolated to a threshold of about 30 c/deg [6/6 (20/20)] as did the relative power of the adult cortical signal. The infant cortical signal was relatively more attenuated at higher spatial frequencies and extrapolated to a threshold of 8.5 c/deg [6/22.2 (20/74)]. A greater relative maturity of retinal as compared with cortical neural function in 3.5-month-olds is inferred.

Human pattern-evoked retinal responses are altered by optic atrophy

Electrical signals in response to both diffuse flashes of light and phase-alternating spatial patterns were recorded from the eyes and from the occipital scalp of a subject with a traumatic unilateral (right) optic nerve section. Clinical examination disclosed a grossly normal right eye with no light perception, a Marcus Gunn pupil, and an atrophic optic disc. The left eye was normal. The electroretinogram responses on the lesioned side (OD) were normal, but there was no pattern-evoked retinal response (PERR) and no recordable visual-evoked response present. The conclusion is that the optic nerve and ganglion cells appear to be selectively responsible for the PERR potential.

Dichoptic interaction of harmonically related spatial and temporal frequencies

Steady-state visual evoked potentials were recorded in response to contrast Reprint requests: Dr. Elmar T. Schmeisser, Division of Ocular Hazards, Letterman Army complex (sum of two spatial frequencies) suprathreshold sinusoidal gratings of two and six cycles/degree in a 5 degrees field. Sine mode counterphasing enhances the second temporal harmonic component of the evoked waveform; square mode counterphasing generates a response with essentially all the power at the fundamental temporal frequency. Digital sums of observed responses to simple gratings presented alone had significantly greater amplitudes than any observed response to presented complex gratings. Response amplitudes ranked significantly by condition: binocular greater than dichoptic greater than monoptic. It is concluded that (a) sinusoidal counterphasing stimuli lead to two stimulus events per shift (an observed grating onset and offset), and (b) spatial frequency channels that are harmonically related in 1:3 ratio do not destructively interfere with each other in either monoptic or dichoptic presentation.

The contribution of the central retina to the laser speckle visual evoked response

Laser speckle stimuli were used to examine the contribution of the central retina to the visual evoked response (VER). The foveally fixated test stimuli were either small circular spots or annular targets with dark centers. The speckle elements were shifted seven times per second. Reliable responses could be recorded for even the smallest (1 degree) target size. In addition, it was clearly evident that for spots up to 5 degree in diameter, VER amplitude increased linearly with stimulus area. However, data from annular targets revealed that this result was not strictly dependent upon stimulus area. In many instances, large annular stimuli evoked responses with smaller amplitude than spot stimuli with less area. This result may be due to a center-surround antagonistic interaction. These experiments suggest a potential value for laser speckle VER techniques in the assessment of discrete lesions of the macula.

Interocular luminance differences and the binocular pattern-reversal visual-evoked response

Although the visual-evoked response (VER) is frequently used to assess binocularity, the contribution of the monocular components to the binocular VER is poorly understood. To more fully elucidate this relationship, we examined checkerboard (14 min arc checks) pattern-reversal (3.75 Hz) VERs evoked from observers with normal binocularity, with conditions in which interocular luminance differences (from 0.3 to 2.0 log units) were established. When compared with monocular VERs obtained with similar luminances, the binocular response was always less than the sum of the component monocular responses. In addition, the amplitude of the binocular signal was dependent on the amount of interocular luminance the difference. For interocular luminance differences of less than 0.6 log units the amplitude of the binocular response was consistently greater than either corresponding monocular VER. When the interocular luminance difference was 1.3 log units or greater the amplitude of the binocular response fell below the level of either corresponding monocular response. Furthermore, it does not appear that these results can be attributed to a passive spread of electrical potentials from monocular cortical cell populations. We therefore suggest that these results indicate the activity of a binocular neural process.