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1.
Sci Rep ; 12(1): 12063, 2022 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-35835923

RESUMO

The etiology of open-angle glaucoma (OAG) is yet unclear. This study investigated possible risk factors, such as the morphology of the border tissue that affect the pattern of visual field (VF) progression in eyes with OAG. 166 eyes of 166 OAG patients with an externally oblique border tissue (EOBT) at least in one direction were included. EOBT was obtained by analyzing enhanced depth imaging spectral-domain optical coherence tomography images. A pointwise linear regression was used to determine VF progression by measuring the deterioration rate of each point in the VF. The odds ratio of VF progression for each risk factor was estimated using logistic regression analysis. Seventy (42.2%) eyes showed VF deterioration. In multivariate analysis, longer follow-up period, higher baseline intraocular pressure (IOP), lower mean ocular perfusion pressure (MOPP), and smaller angular location of the longest EOBT were associated with VF progression (all p values were below 0.05). In the multivariate analysis, the location of the longest EOBT was significantly associated with inferior (p = 0.002) and central (p = 0.017) VF progression. In conclusion, VF progression pattern in OAG eyes is associated with the location of the longest EOBT as well as other known risk factors.


Assuntos
Glaucoma de Ângulo Aberto , Campos Visuais , Progressão da Doença , Glaucoma de Ângulo Aberto/diagnóstico por imagem , Glaucoma de Ângulo Aberto/fisiopatologia , Humanos , Tomografia de Coerência Óptica , Campos Visuais/fisiologia
2.
Retina ; 42(3): 569-575, 2022 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-35188495

RESUMO

PURPOSE: To test the hypothesis that Müller cell dysfunction in macular telangiectasia type 2 (MacTel) results in delayed cone adaptation kinetics and to assess absolute cone and rod thresholds in this condition. METHODS: Adaptation after an approximate 63.5% full-field cone photopigment bleach was assessed for Goldmann size V (1.7° diameter) 640 nm (red) and 480 nm (blue) targets presented at a retinal locus corresponding to 2° temporal to fixation. The cone time constant of adaptation and absolute cone and rod thresholds were calculated from exponential functions fitted to the resultant dark adaptation curves. RESULTS: Eighteen eyes with MacTel (from 11 patients) were compared with 19 control eyes (from 16 normal subjects). Cone adaptation kinetics were significantly impaired in MacTel, as was the absolute cone threshold. Final thresholds for blue targets were also significantly elevated in MacTel, consistent with impaired rod absolute threshold. Losses in sensitivity observed in MacTel were consistent with a so-called d1/2 mechanism (i.e., receptoral) site of sensitivity loss. CONCLUSION: In addition to previously documented impairments in rod dark adaptation, MacTel results in a significant elevation in cone thresholds because of pathology at the level of the photoreceptors. The delays in cone adaptation that we found in eyes with MacTel may reflect impairment of the Müller cell-mediated cone-specific visual cycle.


Assuntos
Regeneração/fisiologia , Células Fotorreceptoras Retinianas Cones/fisiologia , Pigmentos da Retina/fisiologia , Telangiectasia Retiniana/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Adaptação à Escuridão/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Acuidade Visual/fisiologia , Campos Visuais/fisiologia
3.
Invest Ophthalmol Vis Sci ; 63(2): 26, 2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-35175279

RESUMO

Purpose: Retinitis pigmentosa (RP) is typified by progressive peripheral visual field (pVF) loss in patterns that can vary between individuals. Greater understanding of pVF preservation may inform research on therapeutic targets. However, characteristics of retained pVF are incompletely understood. We aimed to evaluate the spatial characteristics of retained pVF in RP. Methods: We developed a computational platform to generate a probability map of the spatial distribution of retained pVF loci using the Goldmann V4e isopter. RP subjects were grouped into cross-sectional and longitudinal datasets. Probability maps of retained pVF were generated for categories of symptomatic disease duration (SDD). We applied a mathematical model to determine the anatomical correlate of the retained pVF. Results: A total of 152 subjects were included. The mean age was 46.7 years. SDD was <20 years (47.4%), 20 to 40 years (39.5%), or >40 years (13.2%). Longitudinal data (3.2-5.7 years of follow up) were available for 65 subjects. In the cross-sectional dataset, retained pVF loci were most likely to be located between the 50° and 80° isoeccentric meridians and between the 30° to 50° radial axes. In the longitudinal dataset, inferotemporal pVF loci were the most likely to be preserved over time. The area of pVF retention corresponded anatomically to the pre-equatorial superonasal retina. Conclusions: Semiautomated quantitation of pVF may be a useful tool to analyze spatial characteristics of VF in RP. Retinal cells in the superonasal periphery may be resilient to RP-related functional decline. Understanding the cellular and molecular basis of pVF resilience in the retina may inform efforts to develop treatment modalities for RP.


Assuntos
Retina/fisiopatologia , Retinite Pigmentosa/fisiopatologia , Campos Visuais/fisiologia , Percepção Visual/fisiologia , Adulto , Algoritmos , Estudos Transversais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Probabilidade , Estudos Retrospectivos , Análise Espacial , Testes de Campo Visual , Adulto Jovem
4.
Invest Ophthalmol Vis Sci ; 63(2): 27, 2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-35179554

RESUMO

Purpose: Luminance contrast is the fundamental building block of human spatial vision. Therefore contrast sensitivity, the reciprocal of contrast threshold required for target detection, has been a barometer of human visual function. Although retinal ganglion cells (RGCs) are known to be involved in contrast coding, it still remains unknown whether the retinal layers containing RGCs are linked to a person's contrast sensitivity (e.g., Pelli-Robson contrast sensitivity) and, if so, to what extent the retinal layers are related to behavioral contrast sensitivity. Thus the current study aims to identify the retinal layers and features critical for predicting a person's contrast sensitivity via deep learning. Methods: Data were collected from 225 subjects including individuals with either glaucoma, age-related macular degeneration, or normal vision. A deep convolutional neural network trained to predict a person's Pelli-Robson contrast sensitivity from structural retinal images measured with optical coherence tomography was used. Then, activation maps that represent the critical features learned by the network for the output prediction were computed. Results: The thickness of both ganglion cell and inner plexiform layers, reflecting RGC counts, were found to be significantly correlated with contrast sensitivity (r = 0.26 ∼ 0.58, Ps < 0.001 for different eccentricities). Importantly, the results showed that retinal layers containing RGCs were the critical features the network uses to predict a person's contrast sensitivity (an average R2 = 0.36 ± 0.10). Conclusions: The findings confirmed the structure and function relationship for contrast sensitivity while highlighting the role of RGC density for human contrast sensitivity.


Assuntos
Sensibilidades de Contraste/fisiologia , Aprendizado Profundo , Glaucoma de Ângulo Aberto/fisiopatologia , Degeneração Macular/fisiopatologia , Neurônios Retinianos/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Glaucoma de Ângulo Aberto/diagnóstico por imagem , Humanos , Degeneração Macular/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Redes Neurais de Computação , Tomografia de Coerência Óptica , Acuidade Visual/fisiologia , Testes de Campo Visual , Campos Visuais/fisiologia , Adulto Jovem
5.
Retina ; 42(3): 529-539, 2022 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-35188491

RESUMO

PURPOSE: To evaluate the interrelationship between macular sensitivity and retinal perfusion density (PD) in eyes with myopic macular degeneration (MMD). METHODS: One hundred and thirty-eight highly myopic eyes from 82 adult participants were recruited. Macular sensitivity was evaluated using the Microperimeter MP-3. Retinal PD was measured using the PLEX Elite 9000 swept source optical coherence tomography angiography. Macular sensitivity values between different categories of MMD and its relationship with optical coherence tomography angiography measurements were evaluated using multivariable linear mixed models, adjusting for age and axial length. RESULTS: Macular sensitivity reduced with increasing severity of MMD (ß ≤ -0.95, P < 0.001), whereas the best-corrected visual acuity was not associated with MMD severity (P > 0.04). Persons who were older (ß = -0.08, P < 0.001), with longer axial length (ß = -0.32, P = 0.005), presence of macular diffuse choroidal atrophy (ß = -2.16, P < 0.001) or worse MMD (ß = -5.70, P < 0.001), and presence of macular posterior staphyloma (ß ≤ -2.98, P < 0.001) or Fuchs spot (ß = -1.58, P = 0.04) were associated with reduced macular sensitivity. Macular sensitivity was significantly associated with deep retinal PD in MMD (ß = 0.15, P = 0.004) but not with superficial retinal PD (P = 0.62). CONCLUSION: There was a strong correlation between reduced macular sensitivity and increasing MMD severity, even in mild MMD independent of the best-corrected visual acuity. Furthermore, macular sensitivity was correlated with deep retinal PD, suggesting a vasculature-function relationship in MMD.


Assuntos
Degeneração Macular/fisiopatologia , Miopia Degenerativa/fisiopatologia , Retina/fisiologia , Vasos Retinianos/fisiopatologia , Adulto , Idoso , Comprimento Axial do Olho , Capilares/fisiopatologia , Angiografia por Tomografia Computadorizada , Feminino , Humanos , Degeneração Macular/diagnóstico , Masculino , Pessoa de Meia-Idade , Miopia Degenerativa/diagnóstico , Refração Ocular , Sensibilidade e Especificidade , Tomografia de Coerência Óptica , Acuidade Visual/fisiologia , Testes de Campo Visual , Campos Visuais/fisiologia
6.
Sci Rep ; 12(1): 2063, 2022 02 08.
Artigo em Inglês | MEDLINE | ID: mdl-35136111

RESUMO

Understanding brain function requires repeatable measurements of neural activity across multiple scales and multiple brain areas. In mice, large scale cortical neural activity evokes hemodynamic changes readily observable with intrinsic signal imaging (ISI). Pairing ISI with visual stimulation allows identification of primary visual cortex (V1) and higher visual areas (HVAs), typically through cranial windows that thin or remove the skull. These procedures can diminish long-term mechanical and physiological stability required for delicate electrophysiological measurements made weeks to months after imaging (e.g., in subjects undergoing behavioral training). Here, we optimized and directly validated an intact skull ISI system in mice. We first assessed how imaging quality and duration affect reliability of retinotopic maps in V1 and HVAs. We then verified ISI map retinotopy in V1 and HVAs with targeted, multi-site electrophysiology several weeks after imaging. Reliable ISI maps of V1 and multiple HVAs emerged with ~ 60 trials of imaging (65 ± 6 min), and these showed strong correlation to local field potential (LFP) retinotopy in superficial cortical layers (r2 = 0.74-0.82). This system is thus well-suited for targeted, multi-area electrophysiology weeks to months after imaging. We provide detailed instructions and code for other researchers to implement this system.


Assuntos
Mapeamento Encefálico/métodos , Fenômenos Eletrofisiológicos/fisiologia , Imagem Óptica/métodos , Vias Visuais/fisiologia , Algoritmos , Animais , Potenciais Evocados Visuais/fisiologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Estimulação Luminosa , Crânio/diagnóstico por imagem , Campos Visuais/fisiologia
7.
Invest Ophthalmol Vis Sci ; 63(2): 23, 2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-35147659

RESUMO

Purpose: The purpose of this study was to investigate whether the lamina cribrosa (LC) curve changes in response to intraocular pressure (IOP) reduction following administration of topical ocular hypotensive eye drops in eyes with normal tension glaucoma (NTG). Methods: Ninety-three eyes of 93 patients with treatment naïve NTG at initial examination and with ≥20% reduction from baseline IOP following administration of topical ocular hypotensive eye drops were included. Serial horizontal B-scan images of the optic nerve head (ONH) were obtained from each eye using enhanced depth imaging spectral domain optical coherence tomography (OCT) before and 1 year after IOP-lowering treatment. The LC curvature in each eye was assessed by measuring the LC curvature index (LCCI) in horizontal OCT B-scan images obtained at three (superior, central, and inferior) locations spaced equidistantly across the vertical optic disc diameter before and after IOP-lowering treatment. We evaluated the OCT detectible change in the LC curvature based on the interval change of LCCI to exceed the intersession standard deviation of 1.96 times and factors associated with the magnitude of the LCCI change in the eyes showing significant LC change. Results: IOP decreased from 15.7 ± 2.5 mm Hg at baseline to 11.2 ± 1.7 mm Hg after topical glaucoma medication. Among the 93 subjects, 62 (66.7%) eyes showed the significant reduction of the LCCI (interssetional change over 1.5) after the treatment; greater interssessional change of the LCCI after IOP reduction was associated with younger age (P = 0.020) and larger baseline LCCI (P < 0.001). Conclusions: The OCT detectible changes in LC curvature occurred in response to a modest decrease in the IOP in the naïve NTG eyes. The therapeutic benefit of these changes need to be assessed in longitudinal studies.


Assuntos
Pressão Intraocular/fisiologia , Glaucoma de Baixa Tensão/fisiopatologia , Hipotensão Ocular/fisiopatologia , Disco Óptico/patologia , Administração Oftálmica , Idoso , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/fisiologia , Feminino , Gonioscopia , Humanos , Glaucoma de Baixa Tensão/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Soluções Oftálmicas , Disco Óptico/diagnóstico por imagem , Estudos Prospectivos , Microscopia com Lâmpada de Fenda , Tomografia de Coerência Óptica , Tonometria Ocular , Acuidade Visual/fisiologia , Testes de Campo Visual , Campos Visuais/fisiologia
8.
Invest Ophthalmol Vis Sci ; 63(2): 29, 2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-35201263

RESUMO

Purpose: Glaucoma is a disorder that involves visual field loss caused by retinal ganglion cell damage. Previous diffusion magnetic resonance imaging (dMRI) studies have demonstrated that retinal ganglion cell damage affects tissues in the optic tract (OT) and optic radiation (OR). However, because previous studies have used a simple diffusion tensor model to analyze dMRI data, the microstructural interpretation of white matter tissue changes remains uncertain. In this study, we used a multi-contrast MRI approach to further clarify the type of microstructural damage that occurs in patients with glaucoma. Methods: We collected dMRI data from 17 patients with glaucoma and 30 controls using 3-tesla (3T) MRI. Using the dMRI data, we estimated three types of tissue property metrics: intracellular volume fraction (ICVF), orientation dispersion index (ODI), and isotropic volume fraction (IsoV). Quantitative T1 (qT1) data, which may be relatively specific to myelin, were collected from all subjects. Results: In the OT, all four metrics showed significant differences between the glaucoma and control groups. In the OR, only the ICVF showed significant between-group differences. ICVF was significantly correlated with qT1 in the OR of the glaucoma group, although qT1 did not show any abnormality at the group level. Conclusions: Our results suggest that, at the group level, tissue changes in OR caused by glaucoma might be explained by axonal damage, which is reflected in the intracellular diffusion signals, rather than myelin damage. The significant correlation between ICVF and qT1 suggests that myelin damage might also occur in a smaller number of severe cases.


Assuntos
Glaucoma de Ângulo Aberto/diagnóstico por imagem , Imageamento por Ressonância Magnética Multiparamétrica , Trato Óptico/diagnóstico por imagem , Vias Visuais/diagnóstico por imagem , Substância Branca/diagnóstico por imagem , Adulto , Idoso , Feminino , Glaucoma de Ângulo Aberto/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Trato Óptico/fisiopatologia , Transtornos da Visão/fisiopatologia , Campos Visuais/fisiologia , Vias Visuais/fisiopatologia , Substância Branca/fisiopatologia , Adulto Jovem
9.
Invest Ophthalmol Vis Sci ; 63(2): 32, 2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-35212721

RESUMO

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.


Assuntos
Degeneração Macular/metabolismo , Degeneração Macular/fisiopatologia , Visão Mesópica/fisiologia , Visão Noturna/fisiologia , Drusas Retinianas/metabolismo , Transtornos da Visão/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Luz , Masculino , Pessoa de Meia-Idade , Imagem Multimodal , Estudos Prospectivos , Tomografia de Coerência Óptica , Acuidade Visual/fisiologia , Testes de Campo Visual , Campos Visuais/fisiologia
10.
PLoS Comput Biol ; 18(1): e1009771, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-35007281

RESUMO

Visual performance varies around the visual field. It is best near the fovea compared to the periphery, and at iso-eccentric locations it is best on the horizontal, intermediate on the lower, and poorest on the upper meridian. The fovea-to-periphery performance decline is linked to the decreases in cone density, retinal ganglion cell (RGC) density, and V1 cortical magnification factor (CMF) as eccentricity increases. The origins of polar angle asymmetries are not well understood. Optical quality and cone density vary across the retina, but recent computational modeling has shown that these factors can only account for a small percentage of behavior. Here, we investigate how visual processing beyond the cone photon absorptions contributes to polar angle asymmetries in performance. First, we quantify the extent of asymmetries in cone density, midget RGC density, and V1 CMF. We find that both polar angle asymmetries and eccentricity gradients increase from cones to mRGCs, and from mRGCs to cortex. Second, we extend our previously published computational observer model to quantify the contribution of phototransduction by the cones and spatial filtering by mRGCs to behavioral asymmetries. Starting with photons emitted by a visual display, the model simulates the effect of human optics, cone isomerizations, phototransduction, and mRGC spatial filtering. The model performs a forced choice orientation discrimination task on mRGC responses using a linear support vector machine classifier. The model shows that asymmetries in a decision maker's performance across polar angle are greater when assessing the photocurrents than when assessing isomerizations and are greater still when assessing mRGC signals. Nonetheless, the polar angle asymmetries of the mRGC outputs are still considerably smaller than those observed from human performance. We conclude that cone isomerizations, phototransduction, and the spatial filtering properties of mRGCs contribute to polar angle performance differences, but that a full account of these differences will entail additional contribution from cortical representations.


Assuntos
Retina/fisiologia , Visão Ocular/fisiologia , Córtex Visual/fisiologia , Campos Visuais/fisiologia , Adulto , Biologia Computacional , Humanos , Células Fotorreceptoras Retinianas Cones/fisiologia , Células Ganglionares da Retina/fisiologia , Máquina de Vetores de Suporte , Adulto Jovem
11.
Nat Commun ; 13(1): 328, 2022 01 17.
Artigo em Inglês | MEDLINE | ID: mdl-35039507

RESUMO

Historically, the study of patients with spatial neglect has provided fundamental insights into the neural basis of spatial attention. However, lesion mapping studies have been unsuccessful in establishing the potential role of associative networks spreading on the dorsal-medial axis, mainly because they are uncommonly targeted by vascular injuries. Here we combine machine learning-based lesion-symptom mapping, disconnection analyses and the longitudinal behavioral data of 128 patients with well-delineated surgical resections. The analyses show that surgical resections in a location compatible with both the supplementary and the cingulate eye fields, and disrupting the dorsal-medial fiber network, are specifically associated with severely diminished performance on a visual search task (i.e., visuo-motor exploratory neglect) with intact performance on a task probing the perceptual component of neglect. This general finding provides causal evidence for a role of the frontal-medial network in the voluntary deployment of visuo-spatial attention.


Assuntos
Atenção/fisiologia , Percepção Espacial/fisiologia , Campos Visuais/fisiologia , Percepção Visual/fisiologia , Adulto , Comportamento , Neoplasias Encefálicas/fisiopatologia , Neoplasias Encefálicas/cirurgia , Estudos de Casos e Controles , Feminino , Glioma/fisiopatologia , Glioma/cirurgia , Humanos , Masculino , Máquina de Vetores de Suporte , Substância Branca/cirurgia
12.
Invest Ophthalmol Vis Sci ; 63(1): 18, 2022 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-35024761

RESUMO

Purpose: Growing evidence suggests that dendrite retraction or degeneration in a subpopulation of the retinal ganglion cells (RGCs) may precede detectable soma abnormalities and RGC death in glaucoma. Visualization of the lamellar structure of the inner plexiform layer (IPL) could advance clinical management and fundamental understanding of glaucoma. We investigated whether visible-light optical coherence tomography (vis-OCT) could detect the difference in the IPL sublayer thicknesses between small cohorts of healthy and glaucomatous subjects. Method: We imaged nine healthy and five glaucomatous subjects with vis-OCT. Four of the healthy subjects were scanned three times each in two separate visits, and five healthy and five glaucoma subjects were scanned three times during a single visit. IPL sublayers were manually segmented using averaged A-line profiles. Results: The mean ages of glaucoma and healthy subjects are 59.6 ± 13.4 and 45.4 ± 14.4 years (P = 0.02.) The visual field mean deviations (MDs) are -26.4 to -7.7 dB in glaucoma patients and -1.6 to 1.1 dB in healthy subjects (P = 0.002). Median coefficients of variation (CVs) of intrasession repeatability for the entire IPL and three sublayers are 3.1%, 5.6%, 6.9%, and 5.6% in healthy subjects and 1.8%, 6.0%, 7.7%, and 6.2% in glaucoma patients, respectively. The mean IPL thicknesses are 36.2 ± 1.5 µm in glaucomatous and 40.1 ± 1.7 µm in healthy eyes (P = 0.003). Conclusions: IPL sublayer analysis revealed that the middle sublayer could be responsible for the majority of IPL thinning in glaucoma. Vis-OCT quantified IPL sublayers with good repeatability in both glaucoma and healthy subjects.


Assuntos
Glaucoma/diagnóstico , Pressão Intraocular/fisiologia , Células Ganglionares da Retina/patologia , Tomografia de Coerência Óptica/métodos , Campos Visuais/fisiologia , Adulto , Idoso , Feminino , Glaucoma/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Curva ROC
13.
Invest Ophthalmol Vis Sci ; 63(1): 12, 2022 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-34994768

RESUMO

Purpose: The purpose of this study was to investigate the perimetric features and their associations with structural and functional features in patients with RP1L1-associated occult macular dystrophy (OMD; i.e. Miyake disease). Methods: In this international, multicenter, retrospective cohort study, 76 eyes of 38 patients from an East Asian cohort of patients with RP1L1-associated OMD were recruited. Visual field tests were performed using standard automated perimetry, and the patients were classified into three perimetric groups based on the visual field findings: central scotoma, other scotoma (e.g. paracentral scotoma), and no scotoma. The association of the structural and functional findings with the perimetric findings was evaluated. Results: Fifty-four eyes (71.1%) showed central scotoma, 14 (18.4%) had other scotomata, and 8 (10.5%) had no scotoma. Central scotoma was mostly noted in both eyes (96.3%) and within the central 10 degrees (90.7%). Among the three perimetric groups, there were significant differences in visual symptoms, best-corrected visual acuity (BCVA), and structural phenotypes (i.e. severity of photoreceptor changes). The central scotoma group showed worse BCVA often with severe structural abnormalities (96.3%) and a pathogenic variant of p.R45W (72.2%). The multifocal electroretinogram (mfERG) groups largely corresponded with the perimetric groups; however, 8 (10.5%) of 76 eyes showed mfERG abnormalities preceding typical central scotoma. Conclusions: The patterns of scotoma with different clinical severity were first identified in occult macular dystrophy, and central scotoma, a severe pattern, was most frequently observed. These perimetric patterns were associated with the severity of BCVA, structural phenotypes, genotype, and objective functional characteristics which may precede in some cases.


Assuntos
Degeneração Macular/fisiopatologia , Escotoma/fisiopatologia , Campos Visuais/fisiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Eletrorretinografia , Proteínas do Olho/genética , Extremo Oriente , Feminino , Genótipo , Humanos , Degeneração Macular/diagnóstico por imagem , Degeneração Macular/genética , Masculino , Pessoa de Meia-Idade , Fenótipo , Estudos Retrospectivos , Escotoma/diagnóstico por imagem , Escotoma/genética , Tomografia de Coerência Óptica , Acuidade Visual/fisiologia , Testes de Campo Visual , Adulto Jovem
15.
Ophthalmology ; 129(2): 171-180, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34339778

RESUMO

PURPOSE: To develop and validate a multimodal artificial intelligence algorithm, FusionNet, using the pattern deviation probability plots from visual field (VF) reports and circular peripapillary OCT scans to detect glaucomatous optic neuropathy (GON). DESIGN: Cross-sectional study. SUBJECTS: Two thousand four hundred sixty-three pairs of VF and OCT images from 1083 patients. METHODS: FusionNet based on bimodal input of VF and OCT paired data was developed to detect GON. Visual field data were collected using the Humphrey Field Analyzer (HFA). OCT images were collected from 3 types of devices (DRI-OCT, Cirrus OCT, and Spectralis). Two thousand four hundred sixty-three pairs of VF and OCT images were divided into 4 datasets: 1567 for training (HFA and DRI-OCT), 441 for primary validation (HFA and DRI-OCT), 255 for the internal test (HFA and Cirrus OCT), and 200 for the external test set (HFA and Spectralis). GON was defined as retinal nerve fiber layer thinning with corresponding VF defects. MAIN OUTCOME MEASURES: Diagnostic performance of FusionNet compared with that of VFNet (with VF data as input) and OCTNet (with OCT data as input). RESULTS: FusionNet achieved an area under the receiver operating characteristic curve (AUC) of 0.950 (0.931-0.968) and outperformed VFNet (AUC, 0.868 [95% confidence interval (CI), 0.834-0.902]), OCTNet (AUC, 0.809 [95% CI, 0.768-0.850]), and 2 glaucoma specialists (glaucoma specialist 1: AUC, 0.882 [95% CI, 0.847-0.917]; glaucoma specialist 2: AUC, 0.883 [95% CI, 0.849-0.918]) in the primary validation set. In the internal and external test sets, the performances of FusionNet were also superior to VFNet and OCTNet (FusionNet vs VFNet vs OCTNet: internal test set 0.917 vs 0.854 vs 0.811; external test set 0.873 vs 0.772 vs 0.785). No significant difference was found between the 2 glaucoma specialists and FusionNet in the internal and external test sets, except for glaucoma specialist 2 (AUC, 0.858 [95% CI, 0.805-0.912]) in the internal test set. CONCLUSIONS: FusionNet, developed using paired VF and OCT data, demonstrated superior performance to both VFNet and OCTNet in detecting GON, suggesting that multimodal machine learning models are valuable in detecting GON.


Assuntos
Glaucoma de Ângulo Aberto/diagnóstico por imagem , Aprendizado de Máquina , Doenças do Nervo Óptico/diagnóstico por imagem , Tomografia de Coerência Óptica , Transtornos da Visão/fisiopatologia , Campos Visuais/fisiologia , Adulto , Idoso , Algoritmos , Área Sob a Curva , Estudos Transversais , Feminino , Glaucoma de Ângulo Aberto/fisiopatologia , Humanos , Pressão Intraocular , Masculino , Pessoa de Meia-Idade , Imagem Multimodal , Fibras Nervosas/patologia , Doenças do Nervo Óptico/fisiopatologia , Curva ROC , Células Ganglionares da Retina/patologia , Testes de Campo Visual
16.
Brain Res ; 1776: 147744, 2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-34848173

RESUMO

When a brief flash is quickly presented aligned with a moving target, the flash typically appears to lag behind the moving stimulus. This effect is widely known in the literature as a flash-lag illusion (FLI). The flash-lag is an example of a motion-induced position shift. Since auditory deprivation leads to both enhanced visual skills and impaired temporal abilities, both crucial for the perception of the flash-lag effect, here we hypothesized that lack of audition could influence the FLI. 13 early deaf and 18 hearing individuals were tested in a visual FLI paradigm to investigate this hypothesis. As expected, results demonstrated a reduction of the flash-lag effect following early deafness, both in the central and peripheral visual fields. Moreover, only for deaf individuals, there is a positive correlation between the flash-lag effect in the peripheral and central visual field, suggesting that the mechanisms underlying the effect in the center of the visual field expand to the periphery following deafness. Overall, these findings reveal that lack of audition early in life profoundly impacts early visual processing underlying the flash-lag effect.


Assuntos
Surdez/fisiopatologia , Ilusões/fisiologia , Percepção Visual/fisiologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tempo de Reação/fisiologia , Campos Visuais/fisiologia , Adulto Jovem
17.
Clin Neurol Neurosurg ; 212: 107080, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34883282

RESUMO

BACKGROUND: Mild traumatic brain injury (mTBI)is the most common form of traumatic brain injury accounting for 70-80% of all brain injuries annually. There is increasing evidence that long lasting morphological and functional consequence can be present in visual system following mTBI. Among all the visual manifestation, awareness of Visual field defects is important because it may compromise the social, personal or professional life of any individual. Retinal structural changes such as thinning of Retinal nerve fiber layer (RFNL)captured using optical coherence tomography have emerged as a possible biomarker in many neurological diseases however very little is known in cases with mTBI OBJECTIVE: (I) To demonstrate the structural changes/morphological changes in retina if any following mTBI. (II) Whether the structural changes in retina have any association with the development of Visual field deficits leading to Visual function impairment following mTBI (III) Clinical relevance of structural changes in retina as a possible biomarker for visual function impairment due to visual field deficits. MATERIALS AND METHODS: Our study included 60 patients with mTBI who fulfilled the inclusion criteria. All patients underwent a detailed ophthalmic evaluation with special focus on temporal recording of Retinal nerve layer thickness using SD- Optical Coherence Tomography and Visual field (Visual field Index) by Humphrey Automated Field Analyser. RESULTS: 30% of eyes had significant thinning of RFNL (> 30% of the base line thickness) at 6 months following mTBI. Visual function impairment due to visual field deficits (VFI < 80%) at 6 months was seen in 40% of the eyes. The structural changes and visual function impairment peaked at 6 months' post injury. A strong Association was noted between RFNL thinning and manifestation of Visual field deficits (VFI < 80%) leading to visual function impairment (P < 0.001). The Correlation Co-efficient between thinning of RFNL and Visual field deficits had a positive correlation(p < 0.001). CONCLUSION: This novel study has demonstrated that visual functional impairment due to Visual field deficits is a real possibility following mTBI. Monitoring of retinal parameter such as thinning of Retinal nerve fiber layer, using Optical coherence tomography, can be a biomarker for early detection or development of visual field defects in mTBI.


Assuntos
Concussão Encefálica , Neurônios Retinianos/patologia , Transtornos da Visão , Campos Visuais/fisiologia , Adulto , Concussão Encefálica/complicações , Concussão Encefálica/diagnóstico , Concussão Encefálica/patologia , Concussão Encefálica/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Neurônios Retinianos/ultraestrutura , Tomografia de Coerência Óptica , Transtornos da Visão/diagnóstico , Transtornos da Visão/etiologia , Transtornos da Visão/patologia , Transtornos da Visão/fisiopatologia , Testes de Campo Visual
18.
Retina ; 42(2): 357-368, 2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-34510129

RESUMO

PURPOSE: To assess global, zonal, and local correlations between vessel density changes measured by optical coherence tomography angiography and retinal sensitivity measured by microperimetry across diabetic retinopathy severity. METHODS: Diabetic patients and nondiabetic controls underwent optical coherence tomography angiography imaging and microperimetry testing. Pearson's correlation was used to assess associations between average sensitivity and skeletonized vessel density (SVD) or foveal avascular zone area centrally. Linear mixed effects modeling was used to assess relationships between local SVD measurements and their spatially corresponding retinal sensitivity measurements. RESULTS: Thirty-nine eyes from 39 participants were imaged. In all slabs, there was a statistically significant positive correlation between retinal sensitivities and SVDs on both global and zonal scales. No statistically significant correlation was found between central retinal sensitivities and the foveal avascular zone areas. Assessment of 1,136 spatially paired retinal sensitivity and SVD measurements revealed a statistically significant local relationship; this seemed to be driven by eyes with proliferative diabetic retinopathy that had reduced retinal sensitivities. CONCLUSION: This study supports positive correlations between SVD and retinal sensitivity at global and zonal spatial scales in diabetic eyes. However, our analysis did not find evidence of statistically significant correlations between retinal sensitivity and SVD on a local scale until advanced diabetic retinopathy.


Assuntos
Retinopatia Diabética/fisiopatologia , Retina/fisiologia , Vasos Retinianos/fisiopatologia , Campos Visuais/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Angiografia por Tomografia Computadorizada , Estudos Transversais , Retinopatia Diabética/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fluxo Sanguíneo Regional/fisiologia , Vasos Retinianos/diagnóstico por imagem , Tomografia de Coerência Óptica , Acuidade Visual/fisiologia , Testes de Campo Visual
19.
Ophthalmology ; 129(1): 35-44, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34506846

RESUMO

PURPOSE: To estimate the effect of achieving target intraocular pressure (IOP) values on visual field (VF) worsening in a treated clinical population. DESIGN: Retrospective analysis of longitudinal data. PARTICIPANTS: A total of 2852 eyes of 1688 patients with glaucoma-related diagnoses treated in a tertiary care practice. All included eyes had at least 5 reliable VF tests and 5 IOP measures on separate visits along with at least 1 target IOP defined by a clinician on the first or second visit. METHODS: The primary dependent variable was the slope of the mean deviation (MD) over time (decibels [dB]/year). The primary independent variable was mean target difference (measured IOP - target IOP). We created simple linear regression models and mixed-effects linear models to study the relationship between MD slope and mean target difference for individual eyes. In the mixed-effects models, we included an interaction term to account for disease severity (mild/suspect, moderate, or advanced) and a spline term to account for the differing effects of achieving target IOP (target difference ≤0) and failing to achieve target IOP (target difference >0). MAIN OUTCOME MEASURES: Rate of change in MD slope (changes in dB/year) per 1 mmHg change in target difference at different stages of glaucoma severity. RESULTS: Across all eyes, a simple linear regression model demonstrated that a 1 mmHg increase in target difference had a -0.018 dB/year (confidence interval [CI], -0.026 to -0.011; P < 0.05) effect on MD slope. The mixed-effects model shows that eyes with moderate disease that fail to achieve their target IOP experience the largest effects, with a 1 mmHg increase in target difference resulting in a -0.119 dB/year (CI, -0.168 to -0.070; P < 0.05) worse MD slope. The effects of missing target IOP on VF worsening were more pronounced than the effect of absolute level of IOP on VF worsening, where a 1 mmHg increase in IOP had a -0.004 dB/year (CI, -0.011 to 0.003; P > 0.05) effect on the MD slope. CONCLUSIONS: In treated patients, failing to achieve target IOP was associated with more rapid VF worsening. Eyes with moderate glaucoma experienced the greatest VF worsening from failing to achieve target IOP.


Assuntos
Glaucoma de Ângulo Aberto/fisiopatologia , Pressão Intraocular/fisiologia , Transtornos da Visão/fisiopatologia , Campos Visuais/fisiologia , Idoso , Idoso de 80 Anos ou mais , Paquimetria Corneana , Progressão da Doença , Feminino , Glaucoma de Ângulo Aberto/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Hipertensão Ocular/diagnóstico , Hipertensão Ocular/fisiopatologia , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Tonometria Ocular , Transtornos da Visão/diagnóstico , Testes de Campo Visual
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