ABSTRACT
PURPOSE: To evaluate mesopic and photopic contrast sensitivity in patients with congenital red-green color vision deficiency regarding with and without glare conditions and to compare these findings with age- and gender-matched healthy controls with normal color vision. METHODS: Patients with congenital red-green color vision deficiency and age- and gender-matched healthy controls were included in this cross-sectional comparative study. Contrast sensitivity measurements were taken from all subjects in 4 different conditions; binocular mesopic-without glare, mesopic-with glare, photopic-without glare, photopic-with glare, and the results were compared. RESULTS: Twenty one patients with color vision deficiency (13 deuteranopic, 8 protanopic) and 22 age- and gender-matched healthy controls were included in the study. The mean age was 35.2 ± 13.5 years in the protan group, 30.6 ± 7.7 years in the deutan group, 32.0 ± 8.8 years in the control group, and there was no significant difference in age between the groups (P > 0.05). The mean mesopic and photopic contrast sensitivity values of the groups at all spatial frequencies (1.5, 3, 6, 12, 18 cpd) were not statistically significant when evaluated by the multifactor repeated measures test of ANOVA to evaluate the effect of light conditions (with and without glare) (P > .05). CONCLUSION: Mesopic and photopic contrast sensitivity values of patients with congenital red-green color vision deficiency were similar to healthy controls regarding with and without glare conditions.
Subject(s)
Color Vision Defects , Color Vision , Contrast Sensitivity , Humans , Contrast Sensitivity/physiology , Color Vision Defects/physiopathology , Color Vision Defects/diagnosis , Female , Male , Cross-Sectional Studies , Adult , Color Vision/physiology , Young Adult , Middle Aged , Mesopic Vision/physiology , Glare , Visual Acuity , AdolescentABSTRACT
Visual fields under mesopic and scotopic lighting are increasingly being used for macular functional assessment. This review evaluates its statistical significance and clinical relevance, and the optimal testing protocol for early/intermediate age-related macular degeneration (AMD). PubMed and Embase were searched from inception to 14/05/2022. All quality assessments were performed according to GRADE guidelines. The primary outcome was global mean sensitivity (MS), further meta-analysed by: AMD classification scheme, device, test pattern, mesopic/scotopic lighting, stimuli size/chromaticity, pupil dilation, testing radius (area), background luminance, adaptation time, AMD severity, reticular pseudodrusen presence, and follow-up visit. From 1489 studies screened, 42 observational study results contributed to the primary meta-analysis. Supported by moderate GRADE certainty of the evidence, global MS was significantly reduced across all devices under mesopic and scotopic lighting with large effect size (-0.9 [-1.04, -0.75] Hedge's g, P < 0.0001). The device (P < 0.01) and lighting (P < 0.05) used were the only modifiable factors affecting global MS, whereby the mesopic MP-1 and MAIA produced the largest effect sizes and exceeded test-retest variabilities. Global MS was significantly affected by AMD severity (intermediate versus early AMD; -0.58 [-0.88, -0.29] Hedge's g or -2.55 [3.62, -1.47] MAIA-dB) and at follow-up visit (versus baseline; -0.62 [-0.84, -0.41] Hedge's g or -1.61[-2.69, -0.54] MAIA-dB). Magnitudes of retinal sensitivity changes in early/intermediate AMD are clinically relevant for the MP-1 and MAIA devices under mesopic lighting within the central 10° radius. Other factors including pupil dilation and dark adaptation did not significantly affect global MS in early/intermediate AMD.
Subject(s)
Macular Degeneration , Mesopic Vision , Night Vision , Visual Field Tests , Humans , Dark Adaptation/physiology , Lighting , Macular Degeneration/physiopathology , Macular Degeneration/diagnosis , Mesopic Vision/physiology , Night Vision/physiology , Retina/physiopathology , Visual Fields/physiologyABSTRACT
PURPOSE: To explore the influence of preoperative factors, including varying pupil sizes and refractive attributes, on postoperative glare disability in patients undergoing implantable collamer lens (ICL) implantation. SETTING: Second Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China. DESIGN: Prospective observational study. METHODS: The preoperative ocular characteristics and 6-month postoperative glare status in eligible patients who underwent EVO-Visian ICL V4c (VICMO) implantation were analyzed. The glare disability criteria encompassed a glare symptom score >6 and glare sensitivity exceeding 1:2.7. Logistic regression analysis was used to explore the relationship between the preoperative ocular parameters and post-ICL glare. RESULTS: The study included 95 patients (mean age, 26.04 ± 6.29 years), comprising 30 men (58 eyes) and 65 women (129 eyes). Multivariate analysis revealed a significant correlation between postoperative glare disability and increased spherical power in preoperative mesopic pupils (ß = -0.124, P = .039), as well as elevated cylinder power in preoperative mesopic (ß = -0.412, P = .009) and photopic pupils (ß = -0.430, P = .007). Moreover, a larger preoperative mesopic pupil diameter (ß = 0.561, P = .005) demonstrated a significant correlation with glare disability. CONCLUSIONS: Preoperative mesopic pupil dimensions and associated refractive parameters, such as sphere and cylinder, were correlated with glare disability, including the cylinder aspect in photopic pupils, which can assist clinicians in optimizing preoperative selection for ICL implantation, aiding in the anticipation of potential glare disability risks.
Subject(s)
Glare , Lens Implantation, Intraocular , Mesopic Vision , Phakic Intraocular Lenses , Pupil , Visual Acuity , Adult , Female , Humans , Male , Young Adult , Mesopic Vision/physiology , Myopia/surgery , Myopia/physiopathology , Prospective Studies , Pupil/physiology , Refraction, Ocular/physiology , Risk Factors , Vision Disorders/physiopathology , Visual Acuity/physiologyABSTRACT
PURPOSE: To investigate the visual function correlates of self-reported vision-related night driving difficulties among drivers. METHODS: One hundred and seven drivers (age: 46.06 ± 8.24, visual acuity [VA] of 0.2logMAR or better) were included in the study. A standard vision and night driving questionnaire (VND-Q) was administered. VA and contrast sensitivity were measured under photopic and mesopic conditions. Mesopic VA was remeasured after introducing a peripheral glare source into the participants' field of view to enable computation of disability glare index. Regression analyses were used to assess the associations between VND-Q scores, and visual function measures. RESULTS: The mean VND-Q score was -3.96±1.95 logit (interval scale score: 2.46±1.28). Simple linear regression models for photopic contrast sensitivity, mesopic VA, mesopic contrast sensitivity, and disability index significantly predicted VND-Q score (P<0.05), with mesopic VA and disability glare index accounting for the greatest variation (21 %) in VND-Q scores followed by photopic contrast sensitivity (19 %), and mesopic contrast sensitivity (15 %). A multiple regression model to determine the association between the predictors (photopic contrast sensitivity, mesopic VA, mesopic contrast sensitivity, and disability index) and VND-Q score yielded significant results, F (4, 102) = 8.58, P < 0.001, adj. R2 = 0.2224. Seeing dark-colored cars was the most challenging vision task. CONCLUSION: Changes in mesopic visual acuity, photopic and mesopic contrast sensitivity, as well as disability glare index are associated with and explain night driving-related visual difficulties. It is recommended to incorporate measurement of these visual functions into assessments related to driving performance.
Subject(s)
Automobile Driving , Contrast Sensitivity , Glare , Self Report , Visual Acuity , Humans , Male , Female , Visual Acuity/physiology , Middle Aged , Adult , Contrast Sensitivity/physiology , Surveys and Questionnaires , Night Vision/physiology , Vision Disorders/physiopathology , Mesopic Vision/physiology , AgedABSTRACT
Purpose: Subretinal drusenoid deposits (SDD) first appear in the rod-rich perifovea and can extend to the cone-rich fovea. To refine the spatial relationship of visual dysfunction with SDD burden, we determined the topography of mesopic and scotopic light sensitivity in participants with non-neovascular AMD with and without SDD. Methods: Thirty-three subjects were classified into three groups: normal (n = 9), AMD-Drusen (with drusen and without SDD; n = 12), and AMD-SDD (predominantly SDD; n = 12). Mesopic and scotopic microperimetry were performed using 68 targets within the Early Treatment Diabetic Retinopathy Study grid, including points at 1.7° from the foveal center (rod:cone ratio, 0.35). Age-adjusted linear regression was used to compare mesopic and scotopic light sensitivities across groups. Results: Across the entire Early Treatment Diabetic Retinopathy Study grid and within individual subfields, the three groups differed significantly for mesopic and scotopic light sensitivities (all P < 0.05). The AMD-SDD group exhibited significantly decreased mesopic and scotopic sensitivity versus both the normal and the AMD-Drusen groups (all P < 0.05), while AMD-Drusen and normal eyes did not significantly differ (all P > 0.05). The lowest relative sensitivities were recorded for scotopic light levels, especially in the central subfield, in the AMD-SDD group. Conclusions: SDD-associated decrements in rod-mediated vision can be detected close to the foveola, and these deficits are proportionately worse than functional loss in the rod-rich perifovea. This finding suggests that factors other than the previously hypothesized direct cytotoxicity to photoreceptors and local transport barrier limitations may negatively impact vision. Larger prospective studies are required to confirm these observations.
Subject(s)
Macular Degeneration/metabolism , Macular Degeneration/physiopathology , Mesopic Vision/physiology , Night Vision/physiology , Retinal Drusen/metabolism , Vision Disorders/physiopathology , Aged , Aged, 80 and over , Female , Humans , Light , Male , Middle Aged , Multimodal Imaging , Prospective Studies , Tomography, Optical Coherence , Visual Acuity/physiology , Visual Field Tests , Visual Fields/physiologyABSTRACT
The role of the N-Methyl-D-Aspartate Receptor (NMDAR) in the outer retina is unclear despite expression of the NMDAR-complex and its subunits in the outer retina. The flash-electroretinogram (fERG) offers a non-invasive measurement of the retinal field potentials of the outer retina that can serve to clarify NMDAR contribution to early retinal processing. The role of the NMDAR in retinal function was assessed using a genetic mouse model for NMDAR hypofunction (SR-/-), where the absence of the enzyme serine racemase (SR) results in an 85% reduction of retinal D-serine. NMDAR hypo- and hyperfunction in the retina results in alterations in the components of the fERG. The fERG was examined after application of exogenous D-serine to the eye in order to determine whether pre- and post-topical delivery of D-serine would alter the fERG in SR-/- mice and their littermate WT controls. Amplitude and implicit time of the low-frequency components, the a- and b-wave, were conducted. Reduced NMDAR function resulted in a statistically significantly delayed a-wave and reduced b-wave in SR-/- animals. The effect of NMDAR deprivation was more prominent in male SR-/- mice. A hyperfunction of the NMDAR, through exogenous topical delivery of 5 mM D-serine, in WT mice caused a significantly delayed a-wave implicit time and reduced b-wave amplitude. These changes were not observed in female WT mice. There were temporal delays in the a-wave and amplitude and a decrease in the b-wave amplitude and implicit time in both hypo- and NMDAR hyperfunctional male mice. These results suggest that NMDAR and D-serine are involved in the retinal field potentials of the outer retina that interact based on the animal's sex. This implicates the involvement of gonadal hormones and D-serine in retinal functional integrity.
Subject(s)
Electroretinography/drug effects , Retina/physiology , Serine/pharmacology , Animals , Female , Male , Mesopic Vision/physiology , Mice , Mice, Knockout , Photic Stimulation , Racemases and Epimerases , Receptors, N-Methyl-D-Aspartate/metabolismABSTRACT
PURPOSE: To assess the effectiveness of an active learning approach to measuring the contrast sensitivity function (CSF) in patients with various degrees of dry age-related macular degeneration (AMD) under multiple luminance conditions. DESIGN: Cross-sectional study. METHODS: Patients with AMD (26 intermediate AMD, 19 AMD with subretinal drusenoid deposits [SDD], 20 geographic atrophy [GA]) and 23 age-matched controls were tested with the Manifold Contrast Vision Meter (Adaptive Sensory Technology) and the qCSF algorithm, which applies active learning to estimate a model of the CSF's global shape. Testing was performed under conditions of standard and low luminance. For each AMD severity, the area under log CSF (AULCSF) and contrast sensitivities at individual spatial frequencies were calculated for analysis. Low-luminance deficits (LLDs) for visual acuity (VA) and AULCSF were calculated as the difference between standard and low luminance values. RESULTS: Progressive decreases in AULCSF were observed as disease severity increased. For standard luminance, pairwise comparisons revealed significant differences between control/intermediate AMD (P < .0005), control/SDD (P < .0005), control/GA (P < .0005), and intermediate AMD/GA (P < .005). Similarly, for low luminance, pairwise comparisons revealed significant differences between the controls and each disease group (all P < .0005), in addition to significant differences between intermediate AMD/SDD (P < .005), and intermediate AMD/GA (P < .005). No correlations were found between LLD VA and LLD AULCSF in any AMD groups. CONCLUSIONS: Contrast sensitivity measured via qCSF under both standard- and low-luminance conditions correlates with advancing stages of dry AMD. The interaction between luminance and contrast sensitivity appears to reflect a different aspect of visual function than the interaction between luminance and VA.
Subject(s)
Contrast Sensitivity/physiology , Geographic Atrophy/physiopathology , Mesopic Vision/physiology , Night Vision/physiology , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Humans , Light , Male , Middle Aged , Prospective Studies , Visual Acuity/physiology , Visual Field Tests , Visual FieldsABSTRACT
PURPOSE: To study the change in contrast sensitivities in eyes with Fuchs endothelial dystrophy and bullous keratopathy after Descemet membrane endothelial keratoplasty (DMEK). METHODS: In this prospective study, 50 pseudophakic eyes of 50 patients who received DMEK surgery at the Charité-Universitätsmedizin Berlin were included. Visual acuity; contrast sensitivity using OPTEC 6500 at spatial frequencies of 1.5, 3, 6, 12, and 18 cycles/degree in photopic and mesopic light with and without glare; central corneal thickness (CCT); and anterior and posterior corneal aberrations were measured preoperatively and at 3 and 12 months postoperatively. RESULTS: Best-corrected visual acuity (preoperative 0.67 ± 0.46 and after 12 months 0.19 ± 0.16 LogMAR, P < 0.001) and photopic and mesopic contrast sensitivities with and without glare improved significantly, whereas CCT decreased significantly (preoperative 677 ± 114 µm, after 12 months 527 ± 29 µm, P < 0.001). Preoperative CCT correlates significantly with preoperative photopic contrast sensitivity (correlation coefficient -0.462, P = 0.002), and postoperative total anterior aberrations correlates with postoperative photopic contrast sensitivity (correlation coefficient -0.361, P = 0.006). CONCLUSIONS: Photopic and mesopic contrast sensitivities, especially with glare, are impaired in patients with Fuchs endothelial dystrophy and bullous keratopathy. The extent of the corneal thickening seems to mainly influence the contrast sensitivity preoperatively. DMEK surgery improves the contrast sensitivity significantly. However, higher postoperative anterior corneal aberrations limit the postoperative contrast sensitivities.
Subject(s)
Blister/surgery , Contrast Sensitivity/physiology , Corneal Diseases/surgery , Descemet Stripping Endothelial Keratoplasty , Fuchs' Endothelial Dystrophy/surgery , Aged , Aged, 80 and over , Blister/physiopathology , Cell Count , Color Vision/physiology , Corneal Diseases/physiopathology , Corneal Endothelial Cell Loss/physiopathology , Corneal Wavefront Aberration/physiopathology , Endothelium, Corneal/pathology , Female , Fuchs' Endothelial Dystrophy/physiopathology , Humans , Male , Mesopic Vision/physiology , Postoperative Complications , Postoperative Period , Prospective Studies , Recovery of Function/physiologyABSTRACT
PURPOSE: To assess the effect of EVO+ (V5) Visian implantable collamer lens implantation on mesopic visual performance, quality of vision (QoV), and quality of life (QoL). DESIGN: Prospective interventional case series. METHODS: Thirty-six eyes of 36 participants who underwent EVO+ implantation for myopia were evaluated preoperatively and at postoperative visits at 1 week and 1, 3, and 6 months. Visual acuity (VA) and mesopic contrast sensitivity (CS) with and without halogen- and xenon-type glare sources were evaluated at each visit. Subjective QoV was assessed with the QoV questionnaire and QoL assessed with the Quality of Life Impact of Refractive Correction (QIRC) questionnaire at each visit. Ring-shaped dysphotopsia was also assessed at each postoperative visit. Linear, cumulative link and logit mixed models were fitted to analyze the effect of the EVO+. RESULTS: Following EVO+ implantation, VA significantly (P ≤ .012) improved at the 4 postoperative visits. Mesopic CS progressively improved at 1, 3, and 6 months postoperatively (P ≤ .012). Halogen glare CS decreased at 1 week and halogen and xenon glare CS improved at 6 months (P ≤ .016). Photostress recovery time after halogen glare improved at 3 and 6 months (P ≤ .004). QoV scores improved at 1 week and 3 and 6 months (P ≤ .001). QIRC scores improved postoperatively (P < .001). Ring-shaped dysphotopsia decreased at 3 and 6 months (P ≤ .007). CONCLUSIONS: EVO+ implantation provides good mesopic visual performance, QoV, and QoL during up to 6 months follow-up. Some activities performed under mesopic conditions with glare sources may be affected during the first postoperative week. Ring-shaped dysphotopsia is negligibly bothersome 6 months after surgery.
Subject(s)
Lens Implantation, Intraocular , Myopia/surgery , Phakic Intraocular Lenses , Quality of Life/psychology , Visual Acuity/physiology , Adult , Contrast Sensitivity/physiology , Female , Glare , Humans , Male , Mesopic Vision/physiology , Myopia/physiopathology , Myopia/psychology , Prospective Studies , Surveys and Questionnaires , Vision Disorders/physiopathologyABSTRACT
PURPOSE: To explore the differential effects of age and eccentricity on the perception of motion at photopic and mesopic light levels. METHODS: Thirty-six visually normal participants (18 younger; mean age 25 years, range: 20-31) and (18 older; mean age 70 years, range: 60-79) underwent two testing sessions, one at photopic and one at mesopic light levels. In each session, motion perception was tested binocularly at two eccentricities (centrally, and peripherally at 15° rightwards and 5° superior to the horizontal) for four motion tasks: minimum contrast of a drifting Gabor to identify motion direction (motion contrast); translational global motion coherence; biological motion embedded in noise and the minimum duration of a high-contrast Gabor to determine the direction of motion, using two Gabor sizes to measure spatial surround suppression of motion. RESULTS: There was a significant main effect of light condition (higher thresholds in mesopic) for motion contrast (p < 0.001), translational global motion (p = 0.001) and biological motion (p < 0.001); a significant main effect of age (higher thresholds in older adults) for motion contrast (p < 0.001) and biological motion (p = 0.04) and a significant main effect of eccentricity (higher thresholds peripherally) for motion contrast (p < 0.001) and biological motion (p < 0.001). Additionally, we found a significant three-way interaction between light levels, age and eccentricity for translational global motion (similar increase in mesopic thresholds centrally for both groups, but a much larger deterioration in older adult's peripheral mesopic thresholds, p = 0.02). Finally, we found a two-way interaction between light condition and eccentricity for translational global motion (higher values in central mesopic relative to peripheral photopic, p = 0.001) and for biological motion (higher values in peripheral mesopic relative to central photopic, p < 0.001). CONCLUSIONS: For the majority of tasks assessed, motion perception was reduced in mesopic relative to photopic conditions, to a similar extent in both age groups. However, because some older adults exhibited elevated thresholds even under photopic conditions, particularly in the periphery, the ability to detect mesopic moving stimuli even at high contrast was markedly impaired in some individuals. Our results imply age-related differences in the detection of peripheral moving stimuli at night that might impact hazard avoidance and night driving ability.
Subject(s)
Aging/physiology , Color Vision/physiology , Contrast Sensitivity/physiology , Mesopic Vision/physiology , Motion Perception/physiology , Aged , Automobile Driving , Female , Humans , Male , Middle Aged , Reference ValuesABSTRACT
Purpose: Exposure to high-intensity or outdoor lighting has been shown to decrease the severity of myopia in both human epidemiological studies and animal models. Currently, it is not fully understood how light interacts with visual signaling to impact myopia. Previous work performed in the mouse retina has demonstrated that functional rod photoreceptors are needed to develop experimentally-induced myopia, alluding to an essential role for rod signaling in refractive development. Methods: To determine whether dim rod-dominated illuminance levels influence myopia susceptibility, we housed male C57BL/6J mice under 12:12 light/dark cycles with scotopic (1.6 × 10-3 candela/m2), mesopic (1.6 × 101 cd/m2), or photopic (4.7 × 103 cd/m2) lighting from post-natal day 23 (P23) to P38. Half the mice received monocular exposure to -10 diopter (D) lens defocus from P28-38. Molecular assays to measure expression and content of DA-related genes and protein were conducted to determine how illuminance and lens defocus alter dopamine (DA) synthesis, storage, uptake, and degradation and affect myopia susceptibility in mice. Results: We found that mice exposed to either scotopic or photopic lighting developed significantly less severe myopic refractive shifts (lens treated eye minus contralateral eye; -1.62 ± 0.37D and -1.74 ± 0.44D, respectively) than mice exposed to mesopic lighting (-3.61 ± 0.50D; P < 0.005). The 3,4-dihydroxyphenylacetic acid /DA ratio, indicating DA activity, was highest under photopic light regardless of lens defocus treatment (controls: 0.09 ± 0.011 pg/mg, lens defocus: 0.08 ± 0.008 pg/mg). Conclusions: Lens defocus interacted with ambient conditions to differentially alter myopia susceptibility and DA-related genes and proteins. Collectively, these results show that scotopic and photopic lighting protect against lens-induced myopia, potentially indicating that a broad range of light levels are important in refractive development.
Subject(s)
Color Vision/physiology , Dopamine/metabolism , Light , Mesopic Vision/physiology , Myopia/metabolism , Night Vision/physiology , Retina/metabolism , Animals , Blotting, Western , Chromatography, High Pressure Liquid , Disease Models, Animal , Dopamine Plasma Membrane Transport Proteins/genetics , Gene Expression Regulation/physiology , Male , Mice , Mice, Inbred C57BL , Monoamine Oxidase/genetics , Refraction, Ocular/physiology , Signal Transduction/physiology , Vesicular Monoamine Transport Proteins/genetics , Visual Acuity/physiologyABSTRACT
BACKGROUND/AIMS: To evaluate the applicability of mesopic light sensitivity measurements obtained by fundus-controlled perimetry (FCP, also termed 'microperimetry') as clinical trial endpoint in Stargardt disease (STGD1). METHODS: In this retrospective, monocentre cohort study, 271 eyes of 136 patients (age, 37.1 years) with STGD1 and 87 eyes of 54 healthy controls (age, 41.0 years) underwent mesopic FCP, using a pattern of 50 stimuli (achromatic, 400-800 nm) centred on the fovea. The concurrent validity of mesopic FCP testing using the MAIA device (CenterVue, Italy), the retest variability and its determinants, and the progression of sensitivity loss over time were investigated using mixed-model analyses. The main outcomes were the average pointwise sensitivity loss in dependence of patients' demographic, functional and imaging characteristics, the intrasession 95% coefficient of repeatability, and the pointwise sensitivity loss over time. RESULTS: Pointwise sensitivity loss was on average (estimate (95% CI)) 13.88 dB (12.55 to 15.21) along the horizontal meridian and was significantly associated with the electrophysiological subgroup, presence/absence of foveal sparing, best-corrected visual acuity and disease duration. The 95% coefficient of repeatability was 12.15 dB (10.78 to 13.38) and varied in dependence of the underlying mean sensitivity and local sensitivity slope. The global progression rate for the sensitivity loss was 0.45 dB/year (0.13 to 0.78) and was higher for the central and inner ETDRS subfields compared with more peripheral regions. CONCLUSIONS: Mesopic light sensitivity measured by FCP is reliable and susceptible for functional changes. It constitutes a potential clinical outcome for both natural history studies as well as future interventional studies in patients with STGD1.
Subject(s)
Light , Mesopic Vision/physiology , Retina/radiation effects , Stargardt Disease/physiopathology , Visual Fields/physiology , Adult , Female , Genes, Recessive , Humans , Male , Middle Aged , Retina/physiopathology , Retrospective Studies , Stargardt Disease/genetics , Visual Acuity/physiology , Visual Field Tests , Young AdultABSTRACT
Purpose: To examine longitudinal changes of retinal thickness and retinal sensitivity in patients with intermediate age-related macular degeneration (iAMD) and predominantly reticular pseudodrusen (RPD). Methods: At baseline 30 eyes of 25 iAMD patients underwent optical coherence tomography imaging, mesopic and scotopic fundus-controlled perimetry (FCP) with follow-up examinations at month 12 (20 eyes), 24 (12 eyes), and 36 (11 eyes). Thicknesses of different retinal layers and results of FCP testing (n = 56 stimuli) were spatially and longitudinally analyzed using linear mixed-effects models. Results: At baseline, the thickness of the partial outer retinal layer (pORL, 70.21 vs. 77.47 µm) and both mesopic (16.60 vs. 18.72 dB) and scotopic (12.14 vs. 18.67 dB) retinal sensitivity were decreased in areas with RPD compared with unremarkable areas (P < 0.001). Over three years, mean change of pORL was -0.66 normative standard deviation (SD; i.e., z-score, P < 0.001) for regions with existing RPD, -0.40 SD (P < 0.001) for regions with new occurring RPD, and -0.17 SD (P = 0.041) in unremarkable regions. Decrease of scotopic and mesopic sensitivity over three years was more pronounced in areas with existing (-3.51 and -7.76 dB) and new occurring RPD (-2.06 and -5.97 dB). Structure-function analysis revealed that 1 SD decrease of pORL thickness was associated with a sensitivity reduction of 3.47 dB in scotopic and 0.79 dB in mesopic testing. Conclusions: This study demonstrates progressive outer retinal degeneration and impairment of photoreceptor function in eyes with iAMD and RPD over three years. Preservation of outer retinal thickness and reduction of RPD formation may constitute meaningful surrogate endpoints in interventional trials on eyes with AMD and RPD aiming to slow outer retinal degeneration.
Subject(s)
Macular Degeneration/physiopathology , Retina/physiopathology , Retinal Drusen/physiopathology , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Humans , Longitudinal Studies , Macular Degeneration/diagnostic imaging , Male , Mesopic Vision/physiology , Middle Aged , Night Vision/physiology , Photoreceptor Cells, Vertebrate/pathology , Retina/diagnostic imaging , Retinal Drusen/diagnostic imaging , Slit Lamp Microscopy , Tomography, Optical Coherence , Visual Acuity/physiology , Visual Field Tests , Visual Fields/physiologyABSTRACT
Purpose: Retinitis pigmentosa (RP) is a blinding neurodegenerative disease of the retina that can be affected by many factors. The present study aimed to analyze the effect of different environmental light intensities in rd10 mice retina. Methods: C57BL/6J and rd10 mice were bred and housed under three different environmental light intensities: scotopic (5 lux), mesopic (50 lux), and photopic (300 lux). Visual function was studied using electroretinography and optomotor testing. The structural and morphological integrity of the retinas was evaluated by optical coherence tomography imaging and immunohistochemistry. Additionally, inflammatory processes and oxidative stress markers were analyzed by flow cytometry and western blotting. Results: When the environmental light intensity was higher, retinal function decreased in rd10 mice and was accompanied by light-dependent photoreceptor loss, followed by morphological alterations, and synaptic connectivity loss. Moreover, light-dependent retinal degeneration was accompanied by an increased number of inflammatory cells, which became more activated and phagocytic, and by an exacerbated reactive gliosis. Furthermore, light-dependent increment in oxidative stress markers in rd10 mice retina pointed to a possible mechanism for light-induced photoreceptor degeneration. Conclusions: An increase in rd10 mice housing light intensity accelerates retinal degeneration, activating cell death, oxidative stress pathways, and inflammatory cells. Lighting intensity is a key factor in the progression of retinal degeneration, and standardized lighting conditions are advisable for proper analysis and interpretation of experimental results from RP animal models, and specifically from rd10 mice. Also, it can be hypothesized that light protection could be an option to slow down retinal degeneration in some cases of RP.
Subject(s)
Inflammation/etiology , Lighting/adverse effects , Oxidative Stress/radiation effects , Radiation Injuries, Experimental/etiology , Retina/radiation effects , Retinal Degeneration/etiology , Animals , Blotting, Western , Disease Models, Animal , Electroretinography , Female , Flow Cytometry , Inflammation/physiopathology , Male , Mesopic Vision/physiology , Mice , Mice, Inbred C57BL , Mice, Mutant Strains , Night Vision/physiology , Polymerase Chain Reaction , Radiation Dosage , Radiation Injuries, Experimental/metabolism , Radiation Injuries, Experimental/physiopathology , Retina/physiopathology , Retinal Degeneration/metabolism , Retinal Degeneration/physiopathology , Tomography, Optical Coherence , Visual Acuity/physiology , cis-trans-Isomerases/geneticsABSTRACT
Contrast sensitivity functions (CSFs) characterize the sensitivity of the human visual system at different spatial scales, but little is known as to how contrast sensitivity for achromatic and chromatic stimuli changes from a mesopic to a highly photopic range reflecting outdoor illumination levels. The purpose of our study was to further characterize the CSF by measuring both achromatic and chromatic sensitivities for background luminance levels from 0.02 cd/m2 to 7,000 cd/m2. Stimuli consisted of Gabor patches of different spatial frequencies and angular sizes, varying from 0.125 to 6 cpd, which were displayed on a custom high dynamic range (HDR) display with luminance levels up to 15,000 cd/m2. Contrast sensitivity was measured in three directions in color space, an achromatic direction, an isoluminant "red-green" direction, and an S-cone isolating "yellow-violet" direction, selected to isolate the luminance, L/M-cone opponent, and S-cone opponent pathways, respectively, of the early postreceptoral processing stages. Within each session, observers were fully adapted to the fixed background luminance (0.02, 2, 20, 200, 2,000, or 7,000 cd/m2). Our main finding is that the background luminance has a differential effect on achromatic contrast sensitivity compared to chromatic contrast sensitivity. The achromatic contrast sensitivity increases with higher background luminance up to 200 cd/m2 and then shows a sharp decline when background luminance is increased further. In contrast, the chromatic sensitivity curves do not show a significant sensitivity drop at higher luminance levels. We present a computational luminance-dependent model that predicts the CSF for achromatic and chromatic stimuli of arbitrary size.
Subject(s)
Color Perception/physiology , Color Vision/physiology , Contrast Sensitivity/physiology , Light , Mesopic Vision/physiology , Adult , Female , Humans , Male , Middle Aged , Retinal Cone Photoreceptor Cells , Spatio-Temporal Analysis , Young AdultABSTRACT
Purpose: To assess which visual function measures are most strongly associated with overall retinal drusen volume in age-related macular degeneration (AMD). Methods: A total of 100 eyes (16 eyes with early AMD, 62 eyes with intermediate AMD, and 22 eyes from healthy controls) were recruited in this cross-sectional study. All subjects underwent several functional assessments: best-corrected visual acuity (BCVA), low-luminance visual acuity (LLVA), visual acuity (VA) measured with the Moorfields Acuity Chart (MAC-VA), contrast sensitivity with the Pelli-Robson test, reading speed using the International Reading Speed texts, and mesopic and dark-adapted microperimetry. Drusen volume was automatically determined based on optical coherence tomography using an approach based on convolutional neural networks. The relationship between drusen volume and visual function was assessed with linear regressions controlling for confounders. Results: Mean drusen volume and MAC-VA differed significantly among all AMD stages and controls (P < 0.001). In univariate linear regression, LLVA, MAC-VA, contrast sensitivity, and mesopic and dark-adapted microperimetry were significantly negatively associated with the overall drusen volume (all P < 0.006). After controlling for AMD stage, age, and the presence of subretinal drusenoid deposits, MAC-VA and mesopic and dark-adapted microperimetry were still significantly associated with drusen volume (P = 0.008, P = 0.023, and P = 0.022, respectively). Conclusions: Our results suggest that MAC-VA, as well as mesopic and dark-adapted microperimetry, might indicate structural changes related to drusen volume in early stages of AMD.
Subject(s)
Macular Degeneration/physiopathology , Retinal Drusen/physiopathology , Visual Acuity/physiology , Aged , Contrast Sensitivity , Cross-Sectional Studies , Dark Adaptation/physiology , Female , Humans , Male , Mesopic Vision/physiology , Middle Aged , Visual Field Tests , Visual Fields/physiologyABSTRACT
BACKGROUND: Older drivers have a crash rate nearly equal to that of young drivers whose crash rate is the highest among all age groups. Contrast sensitivity impairment is common in older adults. The purpose of this study is to examine whether parameters from the photopic and mesopic contrast sensitivity functions (CSF) are associated with incident motor vehicle crash involvement by older drivers. METHODS: This study utilized data from older drivers (ages ≥60 years) who participated in the Strategic Highway Research Program Naturalistic Driving Study, a prospective, population-based study. At baseline participants underwent photopic and mesopic contrast sensitivity testing for targets from 1.5-18 cycles per degree. Model fitting generated area under the log CSF (AULCSF) and peak log sensitivity. Participant vehicles were instrumented with sensors that captured continuous driving data when the vehicle was operating (accelerometers, global positioning system, forward radar, 4-channel video). They participated for 1-2 years. Crashes were coded from the video and other data streams by trained analysts. RESULTS: The photopic analysis was based on 844 drivers, and the mesopic on 854 drivers. Photopic AULCSF and peak log contrast sensitivity were not associated with crash rate, whether defined as all crashes or at-fault crashes only (all p > 0.05). Mesopic AULCSF and peak log sensitivity were associated with an increased crash rate when considered for all crashes (rate ratio (RR): 1.36, 95% CI: 1.06-1.72; RR: 1.28, 95% CI: 1.01-1.63, respectively) and at-fault crashes only (RR: 1.50, 95% CI: 1.16-1.93; RR: 1.38, 95% CI: 1.07-1.78, respectively). CONCLUSIONS: Results suggest that photopic contrast sensitivity testing may not help us understand future crash risk at the older-driver population level. Results highlight a previously unappreciated association between older adults' mesopic contrast sensitivity deficits and crash involvement regardless of the time of day. Given the wide variability of light levels encountered in both day and night driving, mesopic vision tests, with their reliance on both cone and rod vision, may be a more comprehensive assessment of the visual system's ability to process the roadway environment.
Subject(s)
Accidents, Traffic/prevention & control , Automobile Driving/statistics & numerical data , Color Vision/physiology , Contrast Sensitivity/physiology , Mesopic Vision/physiology , Visual Acuity , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Prospective Studies , United States , Vision TestsABSTRACT
PURPOSE: To investigate retinal sensitivity in the junctional zone of geographic atrophy (GA) secondary to age-related macular degeneration using patient-tailored perimetry grids for mesopic and dark-adapted two-color fundus-controlled perimetry. METHODS: Twenty-five eyes with GA of 25 patients (prospective, natural-history Directional Spread in Geographic Atrophy study [DSGA; NCT02051998]) and 40 eyes of 40 normal subjects were included. Patient-tailored perimetry grids were generated using annotated fundus autofluorescence data. Customized software positioned test-points along iso-hulls surrounding the GA boundary at distances of 0.43°, 0.86°, 1.29°, 2.15°, and 3.01°. The grids were used for duplicate mesopic and dark-adapted two-color (cyan and red) fundus-controlled perimetry. Age-adjusted reference-data were obtained through regression analysis of normative data followed by spatial interpolation. RESULTS: The mean sensitivity loss for mesopic testing decreased with the distance to GA (-10.3 dB [0.43°], -8.2 dB [0.86°], -7.1 dB [1.29°], -6.8 dB [2.15°], and -6.6 dB [3.01°]; P < 0.01). Dark-adapted cyan sensitivity loss exceeded dark-adapted red sensitivity loss for all iso-hulls (-14.8 vs. -11.7 dB, -13.5 vs. -10.1 dB, -12.8 vs. -9.1 dB, -11.6 vs. -8.2 dB, -10.7 vs. -8.0 dB; P < 0.01). CONCLUSION: Patient-tailored fundus-controlled perimetry grids allowed for testing of retinal function in the junctional zone of GA with high spatial resolution. A distinct decrease in mesopic sensitivity loss between 0.43° (125 µm) and 1.29° (375 µm) was observed that leveled off at more distant test-points. In proximity to the GA boundary, the results indicate that rod exceeded cone dysfunction.
Subject(s)
Dark Adaptation/physiology , Geographic Atrophy/physiopathology , Macular Degeneration/complications , Mesopic Vision/physiology , Retina/physiopathology , Visual Fields/physiology , Aged , Aged, 80 and over , Female , Geographic Atrophy/etiology , Humans , Male , Middle Aged , Prospective Studies , Reproducibility of Results , Tomography, Optical Coherence , Visual Acuity , Visual Field TestsABSTRACT
BACKGROUND: Mesopic conditions elicit both rod and cone responses, and they are more commonly encountered in daily life than are scotopic conditions; yet visual function outcome measures of mesopic visual acuity (VA) or contrast sensitivity (CS) are rarely evaluated. OBJECTIVE: In retinitis pigmentosa (RP), we explored whether visual reductions in mesopic versus photopic conditions were correlated with cone or rod function, as well as the between-visit test-retest variability in mesopic measures. METHODS: At each of two visits, 22 RP subjects completed mesopic and photopic ETDRS VA and Pelli-Robson chart CS tests obtained with and without a U23 NoIR 4% transmission filter; testing of perifoveal scotopic cone or rod sensitivity with the AdaptDx; and the Rabin Cone Contrast Test (CCT). RESULTS: A greater CS reduction in mesopic versus photopic conditions was significantly related to absence of scotopic rod function (p = 0.038) or longer self-reported duration of night vision loss (p = 0.044). VA reductions >0.2 logMAR in mesopic versus photopic conditions were significantly related to reduced cone-mediated scotopic sensitivity (p = 0.038). Significant predictors of the CCT ratio of S-cone to M- and L-cone sensitivity were mesopic VA (p = 0.038) and absence of AdaptDx rod function (p = 0.008). Test-retest 95% coefficients of repeatability were not significantly different when comparing between photopic and mesopic tests of VA (0.16 and 0.12 logMAR, respectively) or CS (0.21 and 0.24 logCS, respectively). CONCLUSIONS: Perifoveal scotopic rod and cone function measured with the AdaptDx was significantly correlated with mesopic CS and VA, respectively, which had good, acceptable test-retest repeatability; thus, they appear to be suitable outcome measures to monitor mesopic visual function in clinical practice or trials. RP subjects with reduced mesopic VA and no perifoveal rod function had a greater loss of sensitivity for S-cones than for L-/M-cones.
Subject(s)
Contrast Sensitivity/physiology , Mesopic Vision/physiology , Retinal Cone Photoreceptor Cells/physiology , Retinal Rod Photoreceptor Cells/physiology , Retinitis Pigmentosa/physiopathology , Visual Acuity , Adult , Female , Follow-Up Studies , Humans , Male , Middle Aged , Reproducibility of Results , Retinitis Pigmentosa/diagnosis , Retrospective Studies , Visual Fields/physiologyABSTRACT
PURPOSE: This study compared visual performance and optical properties of three filters. METHOD: Two groups of twenty adults were recruited: wearers of progressive addition lenses (PAL, 46-73 years) and wearers of single vision lenses (SVL, 26-55 years). Three spectacle filters (Hoya, Japan) were compared: clear control, Standard Drive (STD), and Professional Drive (PRO) lenses. Optical transmittance was measured by a Jasco V-650 spectrophotometer. Best corrected visual acuity (BCVA) was measured in photopic (BCVAphotopic) and mesopic (BCVAmesopic) conditions and under glare (BCVAglare). Photopic contrast sensitivity (CS) was also measured. RESULTS: The three longpass filters show cutoff at 426±2nm (STD/PRO) and 405±2nm (clear lens). BCVAglare improved with Drive filters compared to the clear one (p<0.05) from 0.03 to -0.02 (STD) and to -0.01 (PRO) for PAL and from -0.08 to -0.12 (STD and PRO) for SVL. For PAL, BCVAmesopic improved from 0.15 to 0.12 (STD, p<0.05) and 0.13 (PRO), while no substantial difference was observed for SVL. CS showed some improvements with Drive lenses at some angular frequencies between 6 and 18 cycles/deg, mainly for the PAL group. No BCVAphotopic differences were found. After testing all filters, each for two weeks, 79% (PAL) and 60% (SVL) of participants preferred Drive lenses. CONCLUSIONS: Drive lenses are found to maintain or improve some visual functions compared to the clear lens. The improvement of mesopic visual acuity, visual acuity under glare, and contrast sensitivity is mainly attributed to the reduction of intraocular light scattering as a consequence of the total light attenuation in the spectral range below the cutoff.