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1.
Doc Ophthalmol ; 143(3): 297-304, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34160736

RESUMEN

PURPOSE: To investigate if a lower luminance monochromatic LED stimulus could be used as an alternative to a high luminance white light for the clinical electrooculogram. METHODS: Clinical electrooculograms were recorded in color normal participants (N = 23) aged 22.6 ± 1.2 years, 7 male and 16 female using the standard 100 cd.m-2 white illuminant and four monochromatic LEDs with peak wavelengths of 448, 534, 596 and 634 nm at 30 cd.m-2. Pupils were dilated and there was a 30 cd.m-2pre-adaptation to white light for 2 min followed by 15 min dark adaptation and 20 min recording in the light stimulus using a Ganzfeld stimulator. RESULTS: The normalized LP:DTratio for the short wavelength LED (448 nm) was equivalent in amplitude and timing to the ISCEV standard EOG (p = .99). The LP:DTratio for the white (100 cd.m-2) and 448 nm (30 cd.m-2) were (median ± SEM): 2.49 ± .11 and 2.47 ± .11. The time to light-rise peak was also equivalent being 9.0 ± .2 and 8.0 ± .4 min (p = .54). CONCLUSIONS: Consideration may be given to using a short wavelength monochromatic stimulus that is more comfortable for the subject than the current 100 cd.m-2 illuminant.


Asunto(s)
Electrorretinografía , Pupila , Adaptación a la Oscuridad , Electrooculografía , Femenino , Humanos , Luz , Masculino , Estimulación Luminosa
2.
Doc Ophthalmol ; 136(2): 155, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-29541898

RESUMEN

The article "ISCEV Standard for clinical electro-oculography (2017 update)", written by Paul A. Constable, Michael Bach, Laura J. Frishman, Brett G. Jeffrey, Anthony G. Robson and for the International Society for Clinical Electrophysiology of Vision, was originally published Online First without open access.

3.
Doc Ophthalmol ; 135(3): 219-232, 2017 12.
Artículo en Inglés | MEDLINE | ID: mdl-29019002

RESUMEN

BACKGROUND: The aim of the meta-analysis was to derive a range of mean normal clinical electrooculogram (EOG) values from a systematic review of published EOG studies that followed the guidelines of the ISCEV standard for clinical electro-oculography. METHODS: A systematic literature review was performed using four relevant databases limited to peer-reviewed articles in English between 1967 and February 2017. Studies reporting clinical EOG or FO normal values were included when the report used a standard 30° horizontal saccade, a retinal luminance of between 100 and 250 cd m-2, and had > 10 subjects in their normative values. The search identified 1145 articles after duplicates were removed with subsequent screening of the abstracts excluding a further 1098, resulting in 47 full-text articles that were then assessed by the author (PC) with a final nine articles meeting the inclusion criteria. An overall effect estimate using inverse variance-weighted meta-analysis was performed to estimate the mean values for the light peak/dark trough ratio (LP:DT ratio) (dilated and undilated), the time to the LP, the amplitude of the LP, dark trough (DT) and the fast oscillation (FO) peak-to-trough ratio from the included studies. RESULTS: The mean dilated LP:DT ratio was 2.35 (95% CI 2.28-2.42); undilated LP:DT ratio was 2.37 (95% CI 2.28-2.45); LP amplitude was 835 (95% CI 631-1039) µV and the mean time to the LP being 8.2 (95% CI 7.7-8.7) min. The mean DT amplitude was 358 (95% CI 292-424) µV, and the mean FO peak-to-trough ratio was 1.13 (95% CI 1.11-1.16). The results of the LP/DT ratio are drawn from studies with a mean ± standard deviation (SD) age of 34.08 ± 12.93 years for dilated and 33.65 ± 12.28 years for undilated LP/DT ratios. CONCLUSIONS: The meta-analysis of EOG studies has generated a reference range of normal mean values for clinicians to refer to when using the ISCEV clinical EOG. It provides a potential method to generate similar data sets from published normal values in related visual electrophysiology tests.


Asunto(s)
Electrooculografía/métodos , Retina/fisiología , Visión Ocular/fisiología , Humanos , Valores de Referencia , Epitelio Pigmentado de la Retina/fisiología , Pruebas de Visión/métodos
4.
Doc Ophthalmol ; 134(1): 1-9, 2017 02.
Artículo en Inglés | MEDLINE | ID: mdl-28110380

RESUMEN

The clinical electro-oculogram (EOG) is an electrophysiological test of the outer retina and retinal pigment epithelium (RPE) in which changes in the electrical potential across the RPE are recorded during successive periods of dark and light adaptation. This document presents the 2017 EOG Standard from the International Society for Clinical Electrophysiology of Vision (ISCEV: www.iscev.org ). This standard has been reorganized and updated to include an explanation of the mechanism of the EOG, but without substantive changes to the testing protocol from the previous version published in 2011. It describes methods for recording the EOG in clinical applications and gives detailed guidance on technical requirements, practical issues and reporting of results with the main clinical measure (the Arden ratio) now termed the light peak:dark trough ratio. The standard is intended to promote consistent quality of testing and reporting within and between clinical centers.


Asunto(s)
Adaptación Ocular/fisiología , Electrooculografía/normas , Electrofisiología , Oftalmopatías/diagnóstico , Epitelio Pigmentado de la Retina/fisiología , Electrooculografía/métodos , Humanos , Luz , Movimientos Sacádicos/fisiología , Visión Ocular
5.
Ophthalmic Physiol Opt ; 37(2): 212-224, 2017 03.
Artículo en Inglés | MEDLINE | ID: mdl-28211175

RESUMEN

PURPOSE: To determine whether there is an association with a congenital visual or hearing impairment (VI or HI) and Autism Spectrum Disorder (ASD) in children. METHODS: A systematic literature review was performed using nine relevant databases limited to peer reviewed articles in English between 1994 and January 2016. The search identified 1248 articles after duplicates were removed with subsequent screening of the abstracts excluding a further 1199, resulting in 49 full-text articles that were then independently assessed by five of the authors with a final 15 articles meeting the inclusion criteria. Bias assessment was determined through consensus of the first five authors. A meta-analysis of the included studies was performed to estimate the relative risk of ASD in the VI and HI groups compared to the general population based on reported prevalence rates in similar geographical regions. Overall prevalence rates for ASD were calculated from the combined studies in the VI and HI populations. RESULTS: The overall prevalence of ASD in VI and HI populations was 19% (95% CI 13-25%) and 9% (95% CI 6-12%) respectively. The overall risk-ratio of ASD was greater in the VI 31.0 times (95% CI 18.62-51.56); z = 13.21, p < 0.001) and HI groups 14.1 times (95% CI 3.41-58.62; z = 3.65, p < 0.001) compared to reported ASD prevalence in the general population. CONCLUSION: There is a high association of ASD in VI or HI children and therefore these populations should be assessed for ASD in the presence of a visual or hearing disability.


Asunto(s)
Trastorno del Espectro Autista/epidemiología , Pérdida Auditiva/epidemiología , Trastornos de la Visión/epidemiología , Trastorno del Espectro Autista/etiología , Niño , Salud Global , Pérdida Auditiva/complicaciones , Humanos , Prevalencia , Trastornos de la Visión/complicaciones
6.
Doc Ophthalmol ; 132(2): 83-99, 2016 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-26868825

RESUMEN

PURPOSE: To explore early findings that individuals with autism spectrum disorder (ASD) have reduced scotopic ERG b-wave amplitudes. METHODS: Light-adapted (LA) and dark-adapted (DA) ERGs were produced by a range of flash strengths that included and extended the ISCEV standard from two subject groups: a high-functioning ASD group N = 11 and a Control group N = 15 for DA and N = 14 for LA ERGs who were matched for mean age and range. Flash strengths ranged from DA -4.0 to 2.3 log phot cd s m(-2) and LA -0.5 to 1.0 log phot cd s m(-2), and Naka-Rushton curves were fitted to DA b-wave amplitude over the first growth limb (-4.0 to -1.0 log phot cd s m(-2)). The derived parameters (V max, K m and n) were compared between groups. Scotopic 15-Hz flicker ERGs (14.93 Hz) were recorded to 10 flash strengths presented in ascending order from -3.0 to 0.5 log Td s to assess the slow and fast rod pathways, respectively. LA 30-Hz flicker ERGs, oscillatory potentials (OPs) and the responses to prolonged 120-ms ON-OFF stimuli were also recorded. RESULTS: The ISCEV LA b-wave amplitude produced by 0.5 log phot cd s m(-2) was lower in the ASD group (p < 0.001). Repeated measures ANOVA for the LA b-wave amplitude series forming the photopic hill was significantly (p = 0.01) different between groups. No group differences were observed for the distributions of the time to peaks of LA a-wave, b-wave or the photopic negative responses (phNR) (p > 0.08) to the single flash stimuli, but there was a significant difference in the distribution for the LA b-wave amplitudes (corrected p = 0.006). The prolonged 120-ms ON responses were smaller in the ASD group (corrected p = 0.003), but the OFF response amplitude (p > 0.6) and ON and OFF times to peaks (p > 0.4) were similar between groups. The LA OPs showed an earlier bifurcation of OP2 in the younger ASD participants; however, no other differences were apparent in the OPs or 30-Hz flicker waveforms. DA b-wave amplitudes fell below the control 5th centile of the controls for some individuals including four ASD participants (36 %) at the 1.5 log phot cd s m(-2) flash strength and two (18%) ASD participants at the lower -2 log phot cd s m(-2) flash strength. However, across the 13 flash strengths, there were no significant group differences for b-wave amplitude's growth (repeated measures ANOVA p = 0.83). Nor were there any significant differences between the groups for the Naka-Rushton parameters (p > 0.09). No group differences were observed in the 15-Hz scotopic flicker phase or amplitude (p > 0.1), DA ERG a-wave amplitude or time to peak (p > 26). The DA b-wave time to peak at 0.5 log phot cd s m(-2) was longer in the ASD group (p = 0.04). CONCLUSION: Under LA conditions, the b-wave is reduced across the ASD group, along with the ON response of the prolonged flash ERG. Some ASD individuals also show subnormal DA ERG b-wave amplitudes. These exploratory findings suggest there is altered cone-ON bipolar signalling in ASD.


Asunto(s)
Trastorno del Espectro Autista/fisiopatología , Retina/fisiopatología , Adolescente , Adulto , Niño , Adaptación a la Oscuridad/fisiología , Electrorretinografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Visión Nocturna/fisiología , Estimulación Luminosa , Receptores Ionotrópicos de Glutamato/fisiología , Receptores de Glutamato Metabotrópico/fisiología , Células Bipolares de la Retina/fisiología , Células Fotorreceptoras Retinianas Conos/fisiología , Adulto Joven
7.
Retina ; 36(3): 629-38, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26398689

RESUMEN

PURPOSE: Danon disease is caused by mutations in the lysosome-associated membrane protein-2 gene (LAMP2). In the eye, LAMP2 is expressed only in the retinal pigment epithelium. This study aimed to investigate the previously unreported impact of LAMP2 mutations on the electrooculogram generated by the retinal pigment epithelium. METHODS: Four members of a family with Danon disease were examined. All have mutations in c294G > A, of the LAMP2 gene on Xq24, by which no, or aberrant, protein will be formed. Electrooculograms to International Society for the Clinical Electrophysiology of Vision (ISCEV) standards were recorded with full-field electroretinography, Goldmann kinetic visual fields, and spectral optical coherence tomography with fundus autofluorescence imaging. RESULTS: Electrooculogram amplitude ratios of light rise:dark trough, the Arden index, fell at low-normal limits (range: 1.68-3.94) but misrepresent retinal pigment epithelium health, because the absolute dark trough voltages were abnormally low (median: 140 µV, range: 72-192 µV) as were the light rise amplitudes (median: 297 µV, range: 198-366 µV), and full-field electroretinograms were normal. Hyperfundus autofluorescence and hypofundus autofluorescence changes became more confluent and florid with increasing age of female patients. Goldmann visual field testing showed constriction of the central field. CONCLUSION: Low electrooculogram voltages indicate that the retinal pigment epithelium is unable to maintain its tight junctions in Danon disease.


Asunto(s)
Enfermedad por Depósito de Glucógeno de Tipo IIb/fisiopatología , Enfermedades de la Retina/fisiopatología , Epitelio Pigmentado de la Retina/fisiología , Adolescente , Niño , Electrooculografía , Electrorretinografía , Femenino , Enfermedad por Depósito de Glucógeno de Tipo IIb/genética , Humanos , Proteína 2 de la Membrana Asociada a los Lisosomas/genética , Masculino , Potenciales de la Membrana/fisiología , Persona de Mediana Edad , Linaje , Polimorfismo de Nucleótido Simple , Enfermedades de la Retina/genética , Uniones Estrechas , Tomografía de Coherencia Óptica , Agudeza Visual/fisiología , Campos Visuales/fisiología , Adulto Joven
8.
J Optom ; 17(2): 100495, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-37918059

RESUMEN

PURPOSE: This systematic review evaluates current literature on the impact vision impairment has on reading and literacy levels within education. METHODS: Six databases were searched with inclusion criteria of trials or studies involving children who are blind or vision impaired, and impact on academic or school performance - including reading and literacy. 1262 articles were identified, with 61 papers undergoing full screening. Quality appraisal was performed using Critical Appraisal Skills Program (CASP) and seven articles deemed eligible for inclusion. RESULTS: Included articles achieved a quality score of over 70 % using the CASP checklists. Direct comparison of articles was not possible due to methodological differences in assessing reading and literacy levels. All seven studies investigated aspects of reading speed, with additional measures of reading performance, such as reading reserve, comprehension, and reading accuracy. DISCUSSION: Underlying trends highlighted students with a vision impairment do not perform at same level as their normally sighted peers with respect to reading performance - in terms of speed, but not ability. Additionally, early intervention to enhance literacy skills may help improve educational outcomes. Future direction should be aimed at identifying specific obstacles to learning these students face and providing interventions to improve academic outcomes.


Asunto(s)
Alfabetización , Lectura , Niño , Humanos , Estudiantes , Comprensión
9.
Clin Exp Optom ; : 1-8, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38951809

RESUMEN

CLINICAL RELEVANCE: Children with vision impairment can have difficulty accessing classroom reading material and knowledge of which students are likely to have improved performance reading performance with reverse polarity would be of value to educators. BACKGROUND: Printed material is typically presented as black text on a white background; however, reversing the polarity to white text on a black background may improve the reading speed for children with vision impairment. This study sought to identify the visual function or pathological features of children with vision impairment where reversing the polarity of text would improve their reading performance. METHODS: Forty-eight vision-impaired participants (27 male), aged 5-18 years with binocular visual acuities between 0.18-1.52 logMAR, were included. Reading performance was assessed by changes in Critical Print Size (ΔCPS), Maximum Reading Speed (ΔMRS) in normal and reverse polarity digital print, and numeric reading speed (ΔNRS) with normal and reverse polarity fonts. Correlations were made with 30 Hz flicker electroretinogram amplitude and high/low contrast acuity. Paired nonparametric tests evaluated significance in pathological condition groups. RESULTS: Significant negative correlations were only found between the 30 Hz flicker amplitude and ΔMRS (r = -.42, p = .028) and ΔNRS (r = -.46, p = .027). Follow-up pairwise comparisons based on pathology group only showed a significant effect of the retinal dystrophy group and CPS (n = 12, z = -2.24, p = .025). All other pairwise comparisons based on group were non-significant (p > .05). CONCLUSIONS: This study did not identify a specific pathological group or visual functional measure that could be used as a clinical marker to predict the impact of reversing polarity. However, significant improvements could be made in reading performance for some children and so a reading performance assessment is recommended for all children with vision impairment.

10.
J Ophthalmol ; 2024: 1990419, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39045382

RESUMEN

Visual electrophysiology is often used clinically to determine the functional changes associated with retinal or neurological conditions. The full-field flash electroretinogram (ERG) assesses the global contribution of the outer and inner retinal layers initiated by the rods and cone pathways depending on the state of retinal adaptation. Within clinical centers, reference normative data are used to compare clinical cases that may be rare or underpowered within a specific demographic. To bolster either the reference dataset or the case dataset, the application of synthetic ERG waveforms may offer benefits to disease classification and case-control studies. In this study and as a proof of concept, artificial intelligence (AI) to generate synthetic signals using generative adversarial networks is deployed to upscale male participants within an ISCEV reference dataset containing 68 participants, with waveforms from the right and left eye. Random forest classifiers further improved classification for sex within the group from a balanced accuracy of 0.72-0.83 with the added synthetic male waveforms. This is the first study to demonstrate the generation of synthetic ERG waveforms to improve machine learning classification modelling with electroretinogram waveforms.

11.
J Neurol ; 2024 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-38856724

RESUMEN

This study aimed to examine the existing literature that investigated the effectiveness of optical coherence tomography (OCT) and optical coherence tomography angiography (OCT-A) as a biomarker for idiopathic intracranial hypertension (IIH). Our search was conducted on January 17th, 2024, and included the databases, Medline, Scopus, Embase, Cochrane, Latin American and Caribbean Health Sciences Literature (LILACS), International Standard Randomized Controlled Trial Number (ISRCTN) registry, and the International Clinical Trials Registry Platform (ICTRP). Our final review included 84 articles. In 74 studies, OCT was utilized as the primary ocular imaging method, while OCT-A was employed in two studies including eight studies that utilized both modalities. Overall, the results indicated that IIH patients exhibited significant increases in retinal nerve fiber layer (RNFL) thickness, total retinal and macular thickness, optic nerve head volume, and height, optic disc diameter and area, rim area, and thickness compared to controls. A significant correlation was observed between cerebrospinal fluid (CSF) pressure and OCT parameters including RNFL thickness, total retinal thickness, macular thickness, optic nerve head volume, and optic nerve head height. Interventions aimed at lowering CSF pressure were associated with a substantial improvement in these parameters. Nevertheless, studies comparing peripapillary vessel density using OCT-A between IIH patients and controls yielded conflicting results. Our systematic review supports OCT as a powerful tool to accurately monitor retinal axonal and optic nerve head changes in patients with IIH. Future research is required to determine the utility of OCT-A in IIH.

12.
Sci Data ; 11(1): 365, 2024 Apr 11.
Artículo en Inglés | MEDLINE | ID: mdl-38605088

RESUMEN

Optical coherence tomography (OCT) is a non-invasive imaging technique with extensive clinical applications in ophthalmology. OCT enables the visualization of the retinal layers, playing a vital role in the early detection and monitoring of retinal diseases. OCT uses the principle of light wave interference to create detailed images of the retinal microstructures, making it a valuable tool for diagnosing ocular conditions. This work presents an open-access OCT dataset (OCTDL) comprising over 2000 OCT images labeled according to disease group and retinal pathology. The dataset consists of OCT records of patients with Age-related Macular Degeneration (AMD), Diabetic Macular Edema (DME), Epiretinal Membrane (ERM), Retinal Artery Occlusion (RAO), Retinal Vein Occlusion (RVO), and Vitreomacular Interface Disease (VID). The images were acquired with an Optovue Avanti RTVue XR using raster scanning protocols with dynamic scan length and image resolution. Each retinal b-scan was acquired by centering on the fovea and interpreted and cataloged by an experienced retinal specialist. In this work, we applied Deep Learning classification techniques to this new open-access dataset.


Asunto(s)
Aprendizaje Profundo , Retina , Enfermedades de la Retina , Tomografía de Coherencia Óptica , Humanos , Retinopatía Diabética/diagnóstico por imagen , Edema Macular/diagnóstico por imagen , Retina/diagnóstico por imagen , Enfermedades de la Retina/diagnóstico por imagen
13.
J Autism Dev Disord ; 2024 Feb 23.
Artículo en Inglés | MEDLINE | ID: mdl-38393437

RESUMEN

PURPOSE: Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) are conditions that similarly alter cognitive functioning ability and challenge the social interaction, attention, and communication skills of affected individuals. Yet these are distinct neurological conditions that can exhibit diverse characteristics which require different management strategies. It is desirable to develop tools to assist with early distinction so that appropriate early interventions and support may be tailored to an individual's specific requirements. The current diagnostic procedures for ASD and ADHD require a multidisciplinary approach and can be lengthy. This study investigated the potential of electroretinogram (ERG), an eye test measuring retinal responses to light, for rapid screening of ASD and ADHD. METHODS: Previous studies identified differences in ERG amplitude between ASD and ADHD, but this study explored time-frequency analysis (TFS) to capture dynamic changes in the signal. ERG data from 286 subjects (146 control, 94 ASD, 46 ADHD) was analyzed using two TFS techniques. RESULTS: Key features were selected, and machine learning models were trained to classify individuals based on their ERG response. The best model achieved 70% overall accuracy in distinguishing control, ASD, and ADHD groups. CONCLUSION: The ERG to the stronger flash strength provided better separation and the high frequency dynamics (80-300 Hz) were more informative features than lower frequency components. To further improve classification a greater number of different flash strengths may be required along with a discrimination comparison to participants who meet both ASD and ADHD classifications and carry both diagnoses.

14.
Surv Ophthalmol ; 68(2): 225-240, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36395825

RESUMEN

We review patient-reported outcome measures (PROMs) used to evaluate the quality of life (QoL) in uveitis and provide a quality assessment of the psychometric properties of the PROMs, making it easier to choose the best questionnaire for uveitis. Our review included 158 articles. A total of 98 PROMs were used to measure QoL in uveitis and the National Eye Institute Visual Function Questionnaire 25 (NEI VFQ -25) was the most frequently used PROM in these studies. There were 5 uveitis-specific PROMs, but they were meant for either birdshot choroidopathy or cytomegalovirus retinitis or paediatric uveitis. There are no PROMs developed explicitly for the more common, anterior uveitis, intermediate uveitis, panuveitis, and chronic uveitis. The uveitis-specific PROMs performed better in our quality assessment criteria compared to other PROMs. However, these PROMs were constructed using traditional classical test theory and have not been assessed using the modern family of psychometric assessment methods such as Rasch analysis. As new therapeutic modalities for uveitis such as the new biological agents and steroid implants, continue to evolve, a comprehensive PROM will be increasingly valued in clinical trial settings to compare the effects of treatments from the patient's perspective.


Asunto(s)
Uveítis Intermedia , Uveítis , Humanos , Niño , Calidad de Vida , Uveítis Intermedia/tratamiento farmacológico , Visión Ocular , Encuestas y Cuestionarios , Medición de Resultados Informados por el Paciente
15.
Clin Exp Optom ; : 1-7, 2023 Nov 12.
Artículo en Inglés | MEDLINE | ID: mdl-37952256

RESUMEN

CLINICAL RELEVANCE: The support of students with a vision impairment throughout education could be enhanced by assessing the functional reading ability of the individual. This visual assessment could inform educators of individualised student needs and potentially improve the academic achievement for these students. BACKGROUND: Support for children with a vision impairment within a classroom is typically based on clinical findings of distance visual acuity and visual fields. Therefore, determining optimal print size for reading is essential to ensure best academic outcomes. Secondary aims were to investigate the possible impact of underlying pathology on reading ability. METHODS: Forty-seven participants were recruited from a state-wide support service for children with a vision impairment in South Australia. Three visual acuity groups were formed based on World Health Organisation definitions of mild, moderate, and severe vision impairment. Correlation between clinical measures of distance visual acuity using the Freiburg Visual Acuity Test, were compared with reading acuity and critical print size (smallest font before reading speed reduced) using Minnesota low vision reading chart (MNREAD). RESULTS: No significant correlations were found for mild (0.20-0.49 logMAR) and severe (1.00-1.52 logMAR) vision impairment groups between distance visual acuity and reading acuity read (p = .64, CI [-.585, .395]/p = .82, CI [-.48, .58]) or critical print size (p = .78, CI [-.57, .45]/p = .43, CI [-.34, .68]. A significant correlation was found for the moderate vision impairment group: 0.50-0.99 logMAR for minimum reading acuity (p < .001, CI [.44, .91]) and critical print size (p = .03, CI [.05, .80]). CONCLUSIONS: Standard clinical measures of distance visual acuity are an unpredictable estimate of reading ability in children with mild and severe vision impairment. Additional measures of functional near reading ability could provide a more meaningful indicator of reading ability and help provide optimum support to students through education.

16.
Clin Case Rep ; 11(12): e8362, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38130850

RESUMEN

Key Clinical Message: Inherited retinal dystrophies typically affect vision in early childhood; however, this case highlights a late onset retinal dystrophy presenting in midlife and the need for extended visual electrophysiology testing to determine the etiology. Abstract: A 53-year-old female was referred for visual electrophysiology following a routine optometric eye examination in which yellow flecks were noted in both fundi and the patient had reported a recent near accident whilst driving at night. There was no reported family history of eye disease. Retinal examination identified bilateral yellow punctate and irregularly shaped lesions throughout the posterior poles sparing the macula region. Fundus autofluorescence showed coinciding hyperfluorescence with the lesions and bilateral hypofluorescent crescents superior to the macular with corresponding retinal thinning. Visual fields and color vision were normal. ISCEV standard 20 min and extended 60-min dark adapted electroretinograms were recorded. Recovery to normal b-wave amplitudes was noted in the DA0.01 flash but reduced a-wave amplitudes were noted in the DA3 and DA10 flash following both dark adapted periods. Cone function was reduced but within normal limits. Genetic screening revealed a previously unreported variant of unknown significance in the gene PLA2G5:c.40 + 5del (rs1364254561) which is a member of the phospholipase A2 family and is associated with familial benign flecked retina.

17.
Atten Percept Psychophys ; 85(4): 968-977, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-36823260

RESUMEN

The aim of this report was to analyze reaction times and accuracy in children with a vision impairment performing a feature-based visual search task using a multiverse statistical approach. The search task consisted of set sizes 4, 16, and 24, consisting of distractors (circle) and a target (ellipse) that were presented randomly to school-aged individuals with or without a vision impairment. Interactions and main effects of key variables relating to reaction times and accuracy were analyzed via a novel statistical method blending GAMLSS (generalized additive models for location, scale, and shape) and distributional regression trees. Reaction times for the target-present and target-absent conditions were significantly slower in the vision impairment group with increasing set sizes (p < .001). Female participants were significantly slower than were males for set sizes 16 and 24 in the target-absent condition (p < .001), with male participants being significantly slower than females in the target-present condition (p < .001). Accuracy was only significantly worse (p = .03) for participants less than 14 years of age for the target-absent condition with set sizes 16 and 24. There was a positive association between binocular visual acuity and search time (p < .001). The application of GAMLSS with distributional regression trees to the analysis of visual search data may provide further insights into underlying factors affecting search performance in case-control studies where psychological or physical differences may influence visual search outcomes.


Asunto(s)
Trastornos de la Visión , Visión Ocular , Masculino , Femenino , Humanos , Niño , Agudeza Visual , Tiempo de Reacción , Estudios de Casos y Controles
18.
BMC Res Notes ; 16(1): 238, 2023 Sep 29.
Artículo en Inglés | MEDLINE | ID: mdl-37773138

RESUMEN

OBJECTIVES: The electroretinogram is a clinical test commonly used in the diagnosis of retinal disorders with the peak time and amplitude of the a- and b-waves used as the main indicators of retinal function. However, subtle changes that affect the shape of the electroretinogram waveform may occur in the early stages of disease or in conditions that have a neurodevelopmental or neurodegenerative origin. In such cases, we introduce a statistical approach to mathematically model the shape of the electroretinogram waveform that may aid clinicians and researchers using the electroretinogram or other biological signal recordings to identify morphological features in the waveforms that may not be captured by the time or time-frequency domains of the waveforms. We present a statistical graphics-based analysis of the ascending limb of the b-wave (AL-b) of the electroretinogram in children with and without a diagnosis of autism spectrum disorder (ASD) with a narrative explanation of the statistical approach to illustrate how different features of the waveform based on location and scale derived from raw and registered time series can reveal subtle differences between the groups. RESULTS: Analysis of the raw time trajectories confirmed findings of previous studies with a reduced and delayed b-wave amplitude in ASD. However, when the individual time trajectories were registered then group differences were visible in the mean amplitude at registered time ~ 0.6 suggesting a novel method to differentiate groups using registration of the ERG waveform.


Asunto(s)
Trastorno del Espectro Autista , Niño , Humanos , Factores de Tiempo , Electrorretinografía/métodos , Retina , Proyectos de Investigación , Estimulación Luminosa/métodos
19.
Front Neurosci ; 17: 1215097, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37600004

RESUMEN

The retina and brain share similar neurochemistry and neurodevelopmental origins, with the retina, often viewed as a "window to the brain." With retinal measures of structure and function becoming easier to obtain in clinical populations there is a growing interest in using retinal findings as potential biomarkers for disorders affecting the central nervous system. Functional retinal biomarkers, such as the electroretinogram, show promise in neurological disorders, despite having limitations imposed by the existence of overlapping genetic markers, clinical traits or the effects of medications that may reduce their specificity in some conditions. This narrative review summarizes the principal functional retinal findings in central nervous system disorders and related mouse models and provides a background to the main excitatory and inhibitory retinal neurotransmitters that have been implicated to explain the visual electrophysiological findings. These changes in retinal neurochemistry may contribute to our understanding of these conditions based on the findings of retinal electrophysiological tests such as the flash, pattern, multifocal electroretinograms, and electro-oculogram. It is likely that future applications of signal analysis and machine learning algorithms will offer new insights into the pathophysiology, classification, and progression of these clinical disorders including autism, attention deficit/hyperactivity disorder, bipolar disorder, schizophrenia, depression, Parkinson's, and Alzheimer's disease. New clinical applications of visual electrophysiology to this field may lead to earlier, more accurate diagnoses and better targeted therapeutic interventions benefiting individual patients and clinicians managing these individuals and their families.

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