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1.
Vestn Oftalmol ; 136(4. Vyp. 2): 183-192, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32880138

RESUMO

PURPOSE: To evaluate the relationship between the morphological and functional parameters of retinal pigment epithelium (RPE) and photoreceptors (PR) in inherited retinal diseases (IRD). MATERIAL AND METHODS: The study included 52 patients (104 eyes), 23 of them with Stargardt Disease (STGD), 19 with cone-rod dystrophy (CRD), 10 with retinitis pigmentosa/pigmentary abiotrophy (RP) of comparable disease durations. All patients underwent standard and additional ophthalmological examination: fundus autofluorescence (AF), spectral optical coherence tomography (OCT), computer perimetry (CP), electro-oculography (EOG), Ganzfeld electroretinography (gERG). RESULTS: Comparison of the groups of IRD patients and groups according to the degree of RPE damage with the control group revealed an increase in differences in the EOG and gERG indicators as the area and depth of damage to the RPE and PR progressed. The patterns of changes in RPE and PR, the frequency of their occurrence with IRD in this patient sample are described. A moderate correlation was found between the amount of RPE loss and EOG light rise, as well as between the defect of the ellipsoid zone and the amplitude of α- and ß-waves, the latency of ß-wave of the gERG. Some patients showed a mismatch between a small defect of the ellipsoid zone and RPE with significant damage to the visual field and reduction of the EOG and gERG indicators. The obtained electrophysiological indicators revealed pathological changes in RPE and PR, more significant and widespread in some cases than it was shown with visualization methods. Weak and moderate correlations between visual acuity, and RPE damage and light sensitivity index with loss of ellipsoid zone were calculated. CONCLUSIONS: Modern methods of retinal examination can help obtain complete and versatile picture of morphological and functional state of the retina in IDR that supplement each other. EOG and gERG have capability to determine the degree of RPE and PR functions impairment including those cases when morphological studies are not sufficiently informative.


Assuntos
Epitélio Pigmentado da Retina , Retinite Pigmentosa , Eletrorretinografia , Angiofluoresceinografia , Humanos , Retina , Tomografia de Coerência Óptica
2.
Vestn Oftalmol ; 136(4. Vyp. 2): 296-299, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32880154

RESUMO

Retinitis pigmentosa (PR) is manifested by decreased vision, night blindness and narrowing of the visual field. In RP, the level of docosahexaenoic acid (DHA) in blood plasma and red blood cells is significantly reduced. The largest amount of DHA is contained in the retina (30-40% of phospholipids). DHA increases membrane permeability, accelerates the release of vital proteins and retinal enzymes, provides differentiation of photoreceptors, and slows down apoptosis. The introduction of DHA in isolation or in combination with other fatty acids into the body increases its concentration and can be used for metabolism. While there is a known correlation between the level of DHA in the blood and certain retinal functions (visual acuity, light sensitivity, the value of bioelectric potential), many years of multicenter studies have not produced reliable data on the direct effect of isolated or combined use of DHA in maintaining retinal functions in PR. Despite inconsistent outcomes, the clinical trials should continue.


Assuntos
Retinite Pigmentosa , Campos Visuais , Ácidos Docosa-Hexaenoicos , Eletrorretinografia , Humanos , Retina , Acuidade Visual
3.
PLoS One ; 15(9): e0238435, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32886670

RESUMO

The endoplasmic reticulum (ER) membrane protein complex (EMC) is a conserved protein complex involved in inserting the transmembrane domain of membrane proteins into membranes in the ER. EMC3 is an essential component of EMC and is important for rhodopsin synthesis in photoreceptor cells. However, the in vivo function of Emc3 in bipolar cells (BCs) has not been determined. To explore the role of Emc3 in BCs, we generated a BC-specific Emc3 knockout mouse model (named Emc3 cKO) using the Purkinje cell protein 2 (Pcp2) Cre line. Although normal electroretinography (ERG) b-waves were observed in Emc3 cKO mice at 6 months of age, Emc3 cKO mice exhibited reduced b-wave amplitudes at 12 months of age, as determined by scotopic and photopic ERG, and progressive death of BCs, whereas the ERG a-wave amplitudes were preserved. PKCa staining of retinal cryosections from Emc3 cKO mice revealed death of rod BCs. Loss of Emc3 led to the presence of the synaptic protein mGLuR6 in the outer nuclear layer (ONL). Immunostaining analysis of presynaptic protein postsynaptic density protein 95 (PSD95) revealed rod terminals retracted to the ONL in Emc3 cKO mice at 12 months of age. In addition, deletion of Emc3 resulted in elevated glial fibrillary acidic protein, indicating reactive gliosis in the retina. Our data demonstrate that loss of Emc3 in BCs leads to decreased ERG response, increased astrogliosis and disruption of the retinal inner nuclear layer in mice of 12 months of age. Taken together, our studies indicate that Emc3 is not required for the development of BCs but is important for long-term survival of BCs.


Assuntos
Proteínas de Membrana/metabolismo , Células Bipolares da Retina/metabolismo , Degeneração Retiniana/metabolismo , Animais , Modelos Animais de Doenças , Eletrorretinografia , Retículo Endoplasmático/metabolismo , Retículo Endoplasmático/patologia , Feminino , Masculino , Camundongos , Camundongos Knockout , Receptores de Glutamato Metabotrópico , Retina/metabolismo , Células Fotorreceptoras Retinianas Bastonetes/metabolismo
4.
Middle East Afr J Ophthalmol ; 27(2): 86-90, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32874040

RESUMO

PURPOSE: An electronegative electroretinogram (ERG), defined as having a b:a wave ratio ≤1 in the scotopic flash ERG response, indicates relative inner retinal dysfunction. Causes vary depending upon the study population. In the Arabian Gulf, where inherited retinal disease is relatively prevalent, common diagnoses associated with electronegative ERGs have not been described. In this study, we report the frequency and causes of electronegative ERGs in a cohort of Emirati patients with inherited retinal disease. METHODS: A retrospective review was performed of all full-field ERGs done for Emirati patients in the Ocular Genetics Service of Cleveland Clinic Abu Dhabi from January 2017 to December 2019. Those who had an electronegative ERG in at least one eye were included in the study. RESULTS: Out of 137 patients, 9 probands (6.6%) had an electronegative ERG. The mean age at presentation was 24 years (range 5-48 years), and five patients (55.6%) were male. The final clinical diagnoses were congenital stationary night blindness (CSNB) (two TRPM1-related and one Oguchi disease), X-linked retinoschisis (XLRS) (one genetically confirmed and two not genetically tested), cone-rod dystrophy (one CRX-related and one not genetically tested), and enhanced S-cone syndrome (ESCS) (one NRL-related). The one patient who did not have bilateral electronegative ERGs was a male with XLRS whose fellow eye had an unrecordable ERG. CONCLUSIONS: In this series of Emirati patients, an electronegative ERG was most commonly associated with the inherited retinal diseases recessive CSNB and XLRS. An electronegative ERG was noted in a case of NRL-related ESCS.


Assuntos
Distrofias de Cones e Bastonetes/fisiopatologia , Eletrorretinografia , Oftalmopatias Hereditárias/fisiopatologia , Doenças Genéticas Ligadas ao Cromossomo X/fisiopatologia , Miopia/fisiopatologia , Cegueira Noturna/fisiopatologia , Retina/fisiopatologia , Degeneração Retiniana/fisiopatologia , Retinosquise/fisiopatologia , Transtornos da Visão/fisiopatologia , Adolescente , Adulto , Criança , Pré-Escolar , Distrofias de Cones e Bastonetes/epidemiologia , Oftalmopatias Hereditárias/epidemiologia , Feminino , Doenças Genéticas Ligadas ao Cromossomo X/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Miopia/epidemiologia , Cegueira Noturna/epidemiologia , Degeneração Retiniana/epidemiologia , Retinosquise/epidemiologia , Estudos Retrospectivos , Emirados Árabes Unidos/epidemiologia , Transtornos da Visão/epidemiologia , Adulto Jovem
5.
Middle East Afr J Ophthalmol ; 27(2): 128-130, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32874047

RESUMO

We report two cases with foveal congenital simple hamartoma of the retinal pigment epithelium (CSHRPE), as both patients presented to our retina services complaining of a unilateral decreased vision. Full ophthalmic examination and multimodal imaging were performed including fundus photography, fundus autofluorescence, optical coherence tomography, fluorescein angiography, and electrophysiological testing. Both patients presented with 20/80 vision in the affected eyes. Foveal CSHRPE was found in both eyes, along with parapapillary hyperpigmented rim, multiple pinpoint macular lesions, and few posterior pole hyperpigmented lesions. Multifocal electroretinogram showed diminished central amplitude in both eyes, with three-dimensional topography map showing blunted foveal peaks in one eye and the absence of a central peak in the other patient. Both patients had a stable vision and clinical examination of the CSHRPE during 5 and 6 years follow up, respectively. Foveal CSHRPE is usually symptomatic and results in a decline in visual acuity. Follow-up of these patients showed stable vision and clinical examination.


Assuntos
Hamartoma/congênito , Doenças Retinianas/congênito , Epitélio Pigmentado da Retina/anormalidades , Adulto , Técnicas de Diagnóstico Oftalmológico , Eletrorretinografia , Angiofluoresceinografia , Fóvea Central/patologia , Fundo de Olho , Hamartoma/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Imagem Multimodal , Doenças Retinianas/diagnóstico , Epitélio Pigmentado da Retina/patologia , Tomografia de Coerência Óptica/métodos , Acuidade Visual/fisiologia
6.
Middle East Afr J Ophthalmol ; 27(2): 139-141, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32874050

RESUMO

Paracentral acute middle maculopathy (PAMM) is an optical coherence tomography (OCT) finding seen in patients with retinal capillary ischemia. In this case report, we present a case of PAMM after a transient central retinal artery occlusion and the multifocal electroretinogram (mfERG) and other multimodal imaging findings. Clinical examination, OCT angiography, OCT en face, fluorescein angiography, and visual fields were performed at the baseline and follow-up examinations. As a result, we identified in this PAMM case evidence of hypoperfusion in both the choriocapillaris as well as the deep capillary plexus. To the best of our knowledge, the involvement of choriocapillaris has not been reported previously in the literature. Moreover, we concluded that mfERG constitutes a useful investigation in PAMM and this is the first mfERG findings to be presented for a PAMM case specifically.


Assuntos
Isquemia/diagnóstico , Oclusão da Artéria Retiniana/diagnóstico , Artéria Retiniana/patologia , Capilares/patologia , Corioide/irrigação sanguínea , Eletrorretinografia , Angiofluoresceinografia , Humanos , Isquemia/fisiopatologia , Masculino , Pessoa de Meia-Idade , Imagem Multimodal , Retina/fisiopatologia , Oclusão da Artéria Retiniana/fisiopatologia , Estudos Retrospectivos , Tomografia de Coerência Óptica
7.
Vestn Oftalmol ; 136(4): 47-56, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32779456

RESUMO

PURPOSE: To evaluate the possibility of using the system "Neuro-ERG" (with a module for multifocal ERG) in the study of focal and diffuse pathology in laboratory animals (rabbits). MATERIAL AND METHODS: Focal retinal damage was modelled in 5 eyes of 5 rabbits by singular laser pulses (532 nm, 100 ms, power 30, 60, 100, 150 and 200 mW) and diffuse retinal damage was modelled in 5 eyes of 5 rabbits by exposure to polychromatic light for 14 days (9500 lm, 6400 K, 230 mW/cm2, 8 h/day). The pair of eyes and areas of intact retina in the eyes with focal retinal damage were used for control. Multifocal electroretinography (mfERG) was recorded using the «Neuro-ERG¼ system (Neurosoft, Russia) before exposure, after 1 hour (in focal damage model), and 1, 7 and 14 days after exposure. In addition, three-time recording of mfERG was made before and after the experiments. Analysis included the amplitude and time characteristics of mfERG components, as well as the level of reproducibility of mfERG at each recording. RESULTS: In the modeling of focal damage of the rabbit retina, significant changes in mfERG (pattern stimulus consisted of 61 hexagons) were detected when the retinal damage area was more than 170 µm in diameter or more than 35% of the hexagon area in the pattern-stimulus. A significant moderate inverse correlation (0.52

Assuntos
Eletrorretinografia , Doenças Retinianas , Animais , Coelhos , Reprodutibilidade dos Testes , Retina , Federação Russa
8.
J Vis Exp ; (161)2020 07 14.
Artigo em Inglês | MEDLINE | ID: mdl-32744516

RESUMO

The retinal pigment epithelium (RPE) is a specialized monolayer of cells strategically located between the retina and the choriocapillaris that maintain the overall health and structural integrity of the photoreceptors. The RPE is polarized, exhibiting apically and basally located receptors or channels, and performs vectoral transport of water, ions, metabolites, and secretes several cytokines. In vivo noninvasive measurements of RPE function can be made using direct-coupled ERGs (DC-ERGs). The methodology behind the DC-ERG was pioneered by Marmorstein, Peachey, and colleagues using a custom-built stimulation recording system and later demonstrated using a commercially available system. The DC-ERG technique uses glass capillaries filled with Hank's buffered salt solution (HBSS) to measure the slower electrical responses of the RPE elicited from light-evoked concentration changes in the subretinal space due to photoreceptor activity. The prolonged light stimulus and length of the DC-ERG recording make it vulnerable to drift and noise resulting in a low yield of useable recordings. Here, we present a fast, reliable method for improving the stability of the recordings while reducing noise by using vacuum pressure to reduce/eliminate bubbles that result from outgassing of the HBSS and electrode holder. Additionally, power line artifacts are attenuated using a voltage regulator/power conditioner. We include the necessary light stimulation protocols for a commercially available ERG system as well as scripts for analysis of the DC-ERG components: c-wave, fast oscillation, light peak, and off response. Due to the improved ease of recordings and rapid analysis workflow, this simplified protocol is particularly useful in measuring age-related changes in RPE function, disease progression, and in the assessment of pharmacological intervention.


Assuntos
Fenômenos Eletrofisiológicos/efeitos da radiação , Eletrorretinografia , Luz , Epitélio Pigmentado da Retina/fisiologia , Epitélio Pigmentado da Retina/efeitos da radiação , Envelhecimento/fisiologia , Animais , Camundongos
9.
Zhonghua Yan Ke Za Zhi ; 56(7): 514-518, 2020 Jul 11.
Artigo em Chinês | MEDLINE | ID: mdl-32842333

RESUMO

Objective: To investigate the features of the full-field electroretinogram (FERG) in patients with ocular surface alkaline injury, and to clarify the clinical significance of FERG examination in alkaline ocular trauma. Methods: Retrospective series of case study. A total of 22 patients with chemical ocular surface injury who were treated in the Department of Ophthalmology of Peking University Third Hospital from May 2018 to January 2020 were selected, including 20 males (25 eyes) and 2 females (2 eyes). The age ranged from 19 to 60 years old (average, 41). There were 17 eyes with alkaline ocular trauma, 7 eyes with thermal burn, and 3 eyes with acid ocular trauma. Seventeen contralateral healthy eyes in patients with unilateral mechanical trauma were used as controls. Fourteen alkaline trauma eyes with visual acuity records were further observed according to the degree of visual impairment. All patients were subjected to different flash intensity stimuli in accordance with a standard of the International Society for Clinical Electrophysiology of Vision for dark-adapted and light-adapted full-field FERG. One-way ANOVA and SNK-q was used for the comparison between groups. The unpaired t test was used for the comparison of patients with different vision. Results: Compared with healthy eyes the injured eyes' amplitude of dark adaption FERG b-wave under the dark stimulation of 0.01 cd·s·m-2 in alkaline ocular trauma, thermal burn, acid ocular trauma was (135±85), (169±55), and (112±43) versus (341±53) µV, respectively; compared with healthy eyes, the differences were statistically significant (F=31.38; q=8.94, 5.70, 5.45;all P<0.01). Compared with healthy eyes the injured eyes' amplitude of dark adaption FERG a-wave under the dark stimulation of 3.00 cd·s·m-2 in alkaline ocular trauma, thermal burn, acid ocular trauma was (178±78), (172±35), and (99±53) versus (334±60) µV, respectively; compared with healthy eyes, the differences were statistically significant (F=24.33; q=7.04, 5.60, 5.80;all P<0.01). Compared with healthy eyes the injured eyes' amplitude of dark adaption FERG b-wave under the dark stimulation of 3.00 cd·s·m-2 in alkaline ocular trauma, thermal burn, acid ocular trauma was (354±79), (342±77), and (352±201) versus (600±78) µV, respectively; compared with healthy eyes, the differences were statistically significant (F=27.68; q=8.11, 6.51, 4.48; all P<0.01). Compared with healthy eyes the injured eyes' amplitude of dark adaption FERG OPs under the dark stimulation of 3.00 cd·s·m-2 in alkaline ocular trauma, thermal burn, acid ocular trauma was (97±54), (107±41), and (45±22) versus (206±32) µV, respectively; compared with healthy eyes, the differences were statistically significant (F=25.03; q=7.36, 5.13, 5.96; all P<0.01).There was no significant difference in FERG between patients with visual acuity≥0.2 and those with visual acuity<0.2 (P>0.05) after alkaline ocular trauma. Conclusions: By detecting the amplitude change of FERG wave form of chemical ocular trauma, in this study, the amplitude of FERG wave form in alkaline ocular trauma was generally decreased. It's suggested that alkaline ocular trauma can cause damage to the rod and cone systems of retinal. (Chin J Ophthalmol, 2020, 56: 514-518).


Assuntos
Eletrorretinografia , Doenças Retinianas , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Retina , Células Fotorreceptoras Retinianas Cones , Estudos Retrospectivos , Adulto Jovem
10.
PLoS One ; 15(8): e0236568, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32790788

RESUMO

PURPOSE: To evaluate the ability of re-test pattern electroretinogram (RE-PERG), a non-invasive and fast steady-state PERG, to detect inner retinal bioelectric function anomalies in patients with early-onset Alzheimer's disease (AD). METHODS: The study population consisted of 17 patients with AD-related mild cognitive impairment (MCI), 16 patients with vascular dementia (VD)-related MCI, both assessed using the neuropsychological Mini-Mental State Examination (MMSE) and by structural magnetic resonance imaging, and 19 healthy, age-matched normal controls (NC). All participants were visually asymptomatic, had normal or near-normal general cognitive functioning and no or minimal impairments in daily life activities. Visual field (VF) test, optical coherence tomography (OCT) and RE-PERG, sampled in five consecutive blocks of 130 events, were performed. RESULTS: There was no statistically significant difference among the three groups with respect to age, VF parameters (mean and pattern standard deviations) and OCT parameters (ganglion cell complex thickness and retinal nerve fiber layer thickness). The mean amplitude in the RE-PERG was significantly lower, but only weakly in the AD group than in NC (p = 0.1) whereas the intrinsic variability of the 2nd harmonic phase was significantly higher in the AD group than in either the VD or NC group (p<0.001). CONCLUSIONS: RE-PERG is altered in early-stage AD, showing a reduced amplitude with high intrinsic phase variability. It also allows the discrimination of AD from VD. A high intrinsic variability in the PERG signal, determined using RE-PERG, may thus be a new promising test for neurodegenerative diseases.


Assuntos
Doença de Alzheimer/diagnóstico , Eletrorretinografia , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/fisiopatologia , Método Duplo-Cego , Diagnóstico Precoce , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Tomografia de Coerência Óptica , Testes de Campo Visual
11.
J Fr Ophtalmol ; 43(7): 586-597, 2020 Sep.
Artigo em Francês | MEDLINE | ID: mdl-32631695

RESUMO

Major depressive disorder, bipolar disorder and schizophrenia are currently among the most common psychiatric disorders, known to constitute a serious public health issue in terms of morbidity, mortality and functional handicap. Their pathophysiology is still unclear, but there is now increasing evidence supporting the existence of abnormalities of neurotransmission. As the retina is an extension of the central nervous system, it may be an interesting site of study which might provide a better understanding of the pathophysiology of psychiatric disorders. Several studies have demonstrated retinal abnormalities, with abnormal cone and rod responses on electroretinography (ERG), suggesting a process of functional neuronal loss, structurally supported by a decrease in the retinal nerve fiber layer thickness (RNFL) on optical coherence tomography (OCT), which suggests involvement of the molecular signal pathways of neurotransmission. These tests could be useful tools for diagnosing and monitoring psychiatric disorders. This article is an overview of the literature on retinal abnormalities observed in patients with major depressive disorder, bipolar disorder or schizophrenia, and discusses how they could be pathophysiologic markers.


Assuntos
Transtorno Bipolar/fisiopatologia , Transtorno Depressivo Maior/fisiopatologia , Retina/diagnóstico por imagem , Retina/fisiologia , Esquizofrenia/fisiopatologia , Acuidade Visual/fisiologia , Transtorno Bipolar/complicações , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/patologia , Transtorno Depressivo Maior/complicações , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/patologia , Eletrorretinografia , Humanos , Fibras Nervosas/patologia , Fibras Nervosas/fisiologia , Retina/patologia , Células Fotorreceptoras Retinianas Cones/patologia , Células Fotorreceptoras Retinianas Cones/fisiologia , Células Ganglionares da Retina/patologia , Células Ganglionares da Retina/fisiologia , Esquizofrenia/complicações , Esquizofrenia/diagnóstico , Esquizofrenia/patologia , Tomografia de Coerência Óptica
12.
Doc Ophthalmol ; 141(3): 279-292, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32506269

RESUMO

PURPOSE: To determine whether normal to supernormal 30-Hz flicker ERGs are associated with visual function and prognosis in patients with central retinal artery occlusion (CRAO). METHODS: A total of 133 patients diagnosed with unilateral acute non-arteritic CRAO by examination with electroretinography (ERG) were examined. Thirty-hertz flicker ERG amplitudes were analyzed according to the severity of CRAO, and their correlation with visual function and prognosis was assessed. All patients were categorized into one of three groups according to the flicker ERG amplitude ratios between affected and fellow eyes: ≥ 110%, supernormal; 90-110%, normal; and < 90%, subnormal. RESULTS: Thirty-hertz flicker ERG parameters differed significantly according to the severity of retinal ischemia, i.e., between incomplete versus complete CRAO: mean amplitude (55.89 ± 24.38 > 45.41 ± 23.47 µV, P = 0.029), amplitude ratio (76.1 ± 23.1% > 58.7 ± 25.7%, P < 0.001), and proportion of normal to supernormal flicker ERGs (30.5% > 12.4%, P < .001). One-month and final follow-up visual function and prognosis were better in the normal to supernormal flicker ERGs: 1 month BCVA (1.55 ± 0.65 > 2.05 ± 0.61 logMAR, P < .001), final BCVA (1.32 ± 0.79 > 1.97 ± 0.68 logMAR, P < .001), 1-month VA improvement (- 0.50 ± 0.47 > - 0.10 ± 0.29 logMAR, P < .001), and final VA improvement (- 0.74 ± 0.61 > - 0.18 ± 0.37 logMAR, P < .001). CONCLUSIONS: Normal to supernormal 30-Hz flicker ERG changes in eyes with CRAO are associated with the milder severity of retinal ischemia and showed better visual function and outcome than the subnormal ERG group.


Assuntos
Eletrorretinografia , Retina/fisiopatologia , Oclusão da Artéria Retiniana/fisiopatologia , Acuidade Visual/fisiologia , Doença Aguda , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Oclusão da Artéria Retiniana/diagnóstico por imagem , Tomografia de Coerência Óptica
13.
Doc Ophthalmol ; 141(3): 259-267, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32506270

RESUMO

PURPOSE: Pre-term infants are at risk of abnormal visual development that can range from subtle to severe. The aim of this study was to compare flash VEPs in clinically stable pre-term and full-term infants at 6 months of age. METHODS: Twenty-five pre-term and 25 full-term infants underwent flash VEP testing at the age of 6 months. Monocular VEPs were recorded using flash goggles on a RETIscan system under normal sleeping conditions. Amplitude and peak time responses of the P2 component in the two eyes were averaged and compared between the two groups. Multiple regression analyses were performed to assess the relationship of the P2 responses with birth weight (BW) and gestational age (GA). RESULTS: At 6 months corrected age, pre-term infants had significantly delayed P2 peak times than full-term infants (mean difference: 10.88 [95% CI 4.00-17.76] ms, p = 0.005). Pre-term infants also showed significantly reduced P2 amplitudes as compared to full-term infants (mean difference: 2.36 [0.83-3.89] µV, p = 0.003). Although the regression model with GA and BW as fixed factors explained 20% of the variance in the P2 peak time (F2,47 = 5.98, p = .0045), only GA showed a significant negative relationship (ß = -2.66, p = .003). Neither GA (ß = 0.21, p = .28) nor BW (ß = 0.001, p = .32) showed any relationship with P2 amplitude. CONCLUSIONS: Our results demonstrate that, compared with full-term infants, clinically stable pre-term infants exhibit abnormal flash VEPs, with a delay in P2 peak time and a reduction in P2 amplitude. These findings support a potential dysfunction of the visual pathway in clinically stable pre-term infants as compared to full-term infants.


Assuntos
Potenciais Evocados Visuais/fisiologia , Recém-Nascido Prematuro/fisiologia , Nascimento a Termo/fisiologia , Peso ao Nascer , Eletrorretinografia , Feminino , Idade Gestacional , Humanos , Lactente , Recém-Nascido , Masculino , Estimulação Luminosa/métodos , Tempo de Reação/fisiologia , Vias Visuais/fisiologia
14.
Doc Ophthalmol ; 141(3): 253-257, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32507902

RESUMO

PURPOSE: The photopic negative response (PhNR) correlates with ganglion cell function and has previously been examined as an indicator of glaucomatous optic nerve damage. However, it is a prolonged response that is measured against baseline, and its clinical utility has been limited by extensive variability, poor repeatability, and baseline instability. We have observed a distinct brief negative wave ("N-wave") commonly present within the slow PhNR trough, which may provide practical and analytic advantages as a clinical measure. METHODS: We reviewed data from an interventional trial of 59 glaucoma patients who had 4 exams over an 8-month period. The PhNR was recorded with standard ISCEV stimuli (1 Hz and in some cases 4 Hz stimulation), and N-waves were measured manually, relative to return to baseline. RESULTS: N-waves, when present, could be measured easily despite shifting baselines and a degree of background noise. The PhNR median amplitude centered around 18 µV, while the N-wave median centered around 7 µV, with a distribution of responses skewed toward low or zero amplitudes. CONCLUSIONS: The N-wave appears to be a component of the longer PhNR, though its exact origin and significance remain unclear. As a rapid waveform that is independent of baseline, the N-wave is in many ways easier to measure accurately than the slower PhNR, which is highly dependent on baseline stability. The N-wave may prove useful clinically if further studies can optimize its stimulation, show its behavior in normal individuals and find correlation with markers of optic nerve disease.


Assuntos
Visão de Cores/fisiologia , Glaucoma/fisiopatologia , Doenças do Nervo Óptico/fisiopatologia , Retina/fisiopatologia , Células Ganglionares da Retina/fisiologia , Administração Oftálmica , Adulto , Idoso , Idoso de 80 Anos ou mais , Método Duplo-Cego , Eletrorretinografia , Feminino , Glaucoma/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Fator de Crescimento Neural/uso terapêutico , Soluções Oftálmicas , Doenças do Nervo Óptico/tratamento farmacológico , Estimulação Luminosa , Estudos Prospectivos , Proteínas Recombinantes , Adulto Jovem
15.
Doc Ophthalmol ; 141(3): 293-305, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32542469

RESUMO

PURPOSE: The electroretinogram (ERG) has proven to be useful in the evaluation and monitoring of patients with posterior uveitis. ERG oscillatory potentials (OPs) are sometimes reduced in many uveitic eyes with otherwise grossly normal ERG responses. This study compares ERG parameters, including OPs, between patients with birdshot chorioretinopathy, other posterior uveitis, and controls. METHODS: This was a retrospective case-control study. Sixty-four patients seen at a clinical practice had a total of 93 visits during which ERG was performed on both eyes. ERG data from 93 age-matched controls were also collected. Root-mean-squared (RMS) energy of the OPs was calculated using Fourier analysis for 88 patients and 88 age-matched controls for whom complete data were available. Photopic flicker amplitudes, photopic flicker latencies, scotopic b-wave amplitudes, and OP RMS values were compared between patients and controls. Diagnostic performance was assessed using receiver operating characteristic (ROC) curves. RESULTS: The mean ages of patients and controls were 55.9 ± 10.8 (SD) years and 55.1 ± 11.5, respectively. 83% of the patients had a diagnosis of BCR. The mean OP RMS value was significantly different in patients (15.6 µV ± 9.7 µV) versus control eyes (33.0 µV ± 12.7 µV), p < 0.001. Area under the ROC curves (AUROC) was 0.75 for photopic flicker amplitudes, 0.77 for photopic flicker latencies, 0.72 for scotopic b-wave amplitudes, and 0.88 for OP RMS. AUROC was significantly different between OP RMS and photopic flicker amplitudes (p < 0.001), between OP RMS and flicker latencies (p = 0.0032), and between OP RMS and scotopic b-wave amplitudes (p < 0.0001). CONCLUSION: Analysis of OPs shows greater sensitivity and specificity in the diagnosis and evaluation of patients with birdshot chorioretinopathy than photopic and scotopic ERG amplitudes and photopic flicker latencies.


Assuntos
Coriorretinopatia de Birdshot/fisiopatologia , Eletrorretinografia , Retina/fisiopatologia , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Oscilometria , Estimulação Luminosa , Curva ROC , Estudos Retrospectivos , Uveíte Posterior/fisiopatologia , Acuidade Visual/fisiologia
16.
Cochrane Database Syst Rev ; 6: CD008428, 2020 06 18.
Artigo em Inglês | MEDLINE | ID: mdl-32573764

RESUMO

BACKGROUND: Retinitis pigmentosa (RP) comprises a group of hereditary eye diseases characterized by progressive degeneration of retinal photoreceptors. It results in severe visual loss that may lead to blindness. Symptoms may become manifest during childhood or adulthood which include poor night vision (nyctalopia) and constriction of peripheral vision (visual field loss). Visual field loss is progressive and affects central vision later in the disease course. The worldwide prevalence of RP is approximately 1 in 4000, with 100,000 individuals affected in the USA. At this time, there is no proven therapy for RP. OBJECTIVES: The objective of this review was to synthesize the best available evidence regarding the effectiveness and safety of vitamin A and fish oils (docosahexaenoic acid (DHA)) in preventing the progression of RP. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), which contains the Cochrane Eyes and Vision Trials Register (2020, Issue 2); Ovid MEDLINE; Embase.com; PubMed; Latin American and Caribbean Health Sciences Literature Database (LILACS); ClinicalTrials.gov; the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP); and OpenGrey. We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 7 February 2020. SELECTION CRITERIA: We included randomized controlled trials that enrolled participants of any age diagnosed with any degree of severity or type of RP, and evaluated the effectiveness of vitamin A, fish oils (DHA), or both compared to placebo, vitamins (other than vitamin A), or no therapy, as a treatment for RP. We excluded cluster-randomized trials and cross-over trials. DATA COLLECTION AND ANALYSIS: We prespecified the following outcomes: mean change from baseline visual field, mean change from baseline electroretinogram (ERG) amplitudes, and anatomic changes as measured by optical coherence tomography (OCT), at one-year follow-up, and mean change in visual acuity, at five-year follow-up. Two review authors independently extracted data and evaluated risk of bias for all included trials. We also contacted study investigators for further information when necessary. MAIN RESULTS: In addition to three trials from the previous version of this review, we included a total of four trials with 944 participants aged 4 to 55 years. Two trials included only participants with X-linked RP and the other two included participants with RP of all forms of genetic predisposition. Two trials evaluated the effect of DHA alone; one trial evaluated vitamin A alone; and one trial evaluated DHA and vitamin A versus vitamin A alone. Two trials recruited participants from the USA, and the other two recruited from the USA and Canada. All trials were at low risk of bias for most domains. We did not perform meta-analysis due to clinical heterogeneity. Four trials assessed visual field sensitivity. Investigators found no evidence of a difference in mean values between the groups. However, one trial found that the annual rate of change of visual field sensitivity over four years favored the DHA group in foveal (-0.02 ± 0.55 (standard error (SE)) dB versus -0.47 ± 0.03 dB, P = 0.039), macular (-0.42 ± 0.05 dB versus -0.85 ± 0.03 dB, P = 0.031), peripheral (-0.39 ± 0.02 versus -0.86 ± 0.02 dB, P < 0.001), and total visual field sensitivity (-0.39 ± 0.02 versus -0.86 ± 0.02 dB, P < 0.001). The certainty of the evidence was very low. The four trials evaluated visual acuity (LogMAR scale) at a follow-up of four to six years. In one trial (208 participants), investigators found no evidence of a difference between the two groups, as both groups lost 0.7 letters of the Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity per year. In another trial (41 participants), DHA showed no evidence of effect on visual acuity (mean difference -0.01 logMAR units (95% confidence interval -0.14 to 0.12; one letter difference between the two groups; very low-certainty evidence). In the third trial (60 participants), annual change in mean number of letters correct was -0.8 (DHA) and 1.4 letters (placebo), with no evidence of between-group difference. In the fourth trial (572 participants), which evaluated (vitamin A + vitamin E trace) compared with (vitamin A trace + vitamin E trace), decline in ETDRS visual acuity was 1.1 versus 0.9 letters per year, respectively. All four trials reported electroretinography (ERG). Investigators of two trials found no evidence of a difference between the DHA and placebo group in yearly rates of change in 31 Hz cone ERG amplitude (mean ± SE) (-0.028 ± 0.001 log µV versus -0.022 ± 0.002 log µV; P = 0.30); rod ERG amplitude (mean ± SE) (-0.010 ± 0.001 log µV versus -0.023 ± 0.001 log µV; P = 0.27); and maximal ERG amplitude (mean ± SE) (-0.042 ± 0.001 log µV versus -0.036 ± 0.001 log µV; P = 0.65). In another trial, a slight difference (6.1% versus 7.1%) in decline of ERG per year favored vitamin A (P = 0.01). The certainty of the evidence was very low. One trial (51 participants) that assessed optical coherence tomography found no evidence of a difference in ellipsoid zone constriction (P = 0.87) over two years, with very low-certainty evidence. The other three trials did not report this outcome. Only one trial reported adverse events, which found that 27/60 participants experienced 42 treatment-related emergent adverse events (22 in DHA group, 20 in placebo group). The certainty of evidence was very low. The rest of the trials reported no adverse events, and no study reported any evidence of benefit of vitamin supplementation on the progression of visual acuity loss. AUTHORS' CONCLUSIONS: Based on the results of four studies, it is uncertain if there is a benefit of treatment with vitamin A or DHA, or both for people with RP. Future trials should also take into account the changes observed in ERG amplitudes and other outcome measures from trials included in this review.


Assuntos
Ácidos Docosa-Hexaenoicos/uso terapêutico , Retinite Pigmentosa/terapia , Vitamina A/uso terapêutico , Vitaminas/uso terapêutico , Adolescente , Adulto , Criança , Pré-Escolar , Terapia Combinada/métodos , Progressão da Doença , Ácidos Docosa-Hexaenoicos/efeitos adversos , Eletrorretinografia , Feminino , Óleos de Peixe/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto , Retinite Pigmentosa/genética , Acuidade Visual , Campos Visuais/fisiologia , Vitamina A/efeitos adversos , Vitaminas/efeitos adversos , Adulto Jovem
17.
Vestn Oftalmol ; 136(3): 18-24, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32504472

RESUMO

PURPOSE: To study the data of monocular and binocular multifocal electroretinogram (mfERG), flash visual evoked potential (f-VEP), spatial contrast sensitivity (SCS) with and without yellow filters in healthy elderly people. MATERIAL AND METHODS: The study included 16 people (8 male and 8 female) with average age of 51.63±4.7 years. Their visual acuity was 0.5±0.35 without correction and 1.0 with correction. For spectral correction, we used Y1 color filters (CF) (analogue of SN60AT) from the «Lornet-M vision spectral correction kit¼ set with 80% light transmission and wave cut-off of 460 nm. Patients had mfERG recordings performed monocularly and binocularly, f-VEP monocularly, and their spatial contrast sensitivity (SCS) was measured (Astroinform SPE, Russia). The data acquired before and after applying CF was compared. RESULTS: The data of SCS with light filter was slightly higher at medium and high spatial frequencies (SF): for the right eye on medium SF of 43.8 and 41.8 dB (p≤0.735), 41.5 and 39.8 dB (p≤0.061) for the left eye. The increase of mfERG P1 latency monocularly after application of CF in the R1 ring area was 3.0 ms (40.8-43.8ms) for the right eye (p≤0.05) and 0.9 ms for the left eye (43.7-44.5ms) (p≤0.326). The trend remained for simultaneous mfERG. CONCLUSION: The influence of yellow filters on spectral vision correction can be manifested in inconsistency of SCS, f-VEP, monocular and binocular mfERG readings. Statistically significant differences in healthy individuals of 5th-6th age decades manifest as elongation of the latency of mfERG peaks.


Assuntos
Eletrorretinografia , Potenciais Evocados Visuais , Visão Ocular , Sensibilidades de Contraste , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Federação Russa , Visão Binocular , Acuidade Visual
18.
Doc Ophthalmol ; 141(3): 237-251, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32405730

RESUMO

PURPOSE: There are several stimulus paradigms used in objective visual acuity assessment based on steady-state visual evoked potentials (SSVEPs). The aim of this study was to explore the difference and performance of common used six stimulus paradigms (reverse vertical sinusoidal gratings, reverse horizontal sinusoidal gratings, reverse vertical square-wave gratings, brief-onset vertical sinusoidal gratings, reversal checkerboards and oscillating expansion-contraction concentric-rings) of SSVEP acuity assessment. METHODS: We tested subjective visual acuity both by tumbling E and Freiburg Visual Acuity and Contrast Test (FrACT) in 11 subjects. SSVEPs were induced by 11 spatial frequencies for each paradigm, and then a threshold determination criterion was used to define the objective SSVEP visual acuity. RESULTS: After SSVEP signal analysis, we found there was difference in SSVEP response of harmonic components and no difference in sensitive electrode placement for the six paradigms. We selected six electrodes (PO3, POz, PO4, O1, Oz and O2) as the sensitive electrodes to use in data processing for each paradigm. The results showed that except for brief-onset vertical sinusoidal gratings, the correlation and agreement between objective SSVEP and subjective FrACT acuity were all quite good, demonstrating good performance in acuity detection for the rest five paradigms. CONCLUSION: Except for brief-onset vertical sinusoidal gratings, all the five stimulus paradigms of reverse vertical sinusoidal gratings, reverse horizontal sinusoidal gratings, reverse vertical square-wave gratings, reversal checkerboards and oscillating expansion-contraction concentric-rings performed quite well in objective SSVEP visual acuity assessment.


Assuntos
Potenciais Evocados Visuais/fisiologia , Estimulação Luminosa/métodos , Acuidade Visual/fisiologia , Adulto , Eletroencefalografia/métodos , Eletrorretinografia , Feminino , Humanos , Masculino , Retina/fisiologia , Testes Visuais/métodos , Adulto Jovem
19.
Doc Ophthalmol ; 141(3): 307-312, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32424630

RESUMO

PURPOSE: To describe a patient with combined central serous chorioretinopathy and achromatopsia. METHODS: Clinical examination, enhanced depth imaging- optical coherence tomography, fundus autofluorescence, fluorescein angiography and electroretinography were used to study a 33-year-old female presented with the complaint of poor vision since childhood in both eyes, which worsened in the left eye (LE) recently. RESULTS: In slit-lamp examination, there was a macular elevation in the LE and macular pigmentary change as well as optic disk pallor in both eyes. Enhanced depth imaging optical coherence tomography revealed central inner/outer segment (IS/OS) disruptions, subretinal fluid and thick choroid. Accessory tests included the full-field ERG with severe reduced photopic response (with relatively normal scotopic responses) and fluorescein angiography (FA), which found distinct leakage points in OD and barely visible hyperfluorescent spots in OS. Based on the history of nystagmus, lifelong stable poor vision, loss of foveal cone thickness with IS/OS disruption and severe reduced photopic response with relatively normal scotopic responses, we determined that the diagnosis was most consistent with achromatopsia (ACHM). On the other hand, OCT and FA findings show the simultaneous occurrence of pachychoroid-related central serous chorioretinopathy in this patient. CONCLUSION: This case highlights a case of CSC and ACHM.


Assuntos
Coriorretinopatia Serosa Central/fisiopatologia , Defeitos da Visão Cromática/fisiopatologia , Adulto , Coriorretinopatia Serosa Central/diagnóstico , Defeitos da Visão Cromática/diagnóstico , Eletrorretinografia , Feminino , Angiofluoresceinografia/métodos , Fundo de Olho , Humanos , Nistagmo Patológico/fisiopatologia , Células Fotorreceptoras de Vertebrados/fisiologia , Microscopia com Lâmpada de Fenda , Tomografia de Coerência Óptica/métodos , Acuidade Visual/fisiologia
20.
Am J Ophthalmol ; 218: 40-53, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32445700

RESUMO

PURPOSE: To characterize the progression of optical gaps and expand the known etiologies of this phenotype. DESIGN: Retrospective cohort study. METHODS: Thirty-six patients were selected based on the identification of an optical gap on spectral-domain optical coherence tomography (OCT) from a large cohort of patients (N = 746) with confirmed diagnoses of inherited retinal dystrophy. The width and height of the gaps in 70 eyes of 36 patients were measured by 2 independent graders using the caliper tool on Heidelberg Explorer. Measurements of outer and central retinal thickness were also evaluated and correlated with gap dimensions. RESULTS: Longitudinal analysis confirmed the progressive nature of optical gaps in patients with Stargardt disease, achromatopsia, occult macular dystrophy, and cone dystrophies (P < .003). Larger changes in gap width were noted in patients with Stargardt disease (78.1 µm/year) and cone dystrophies (31.9 µm/year) compared with patients with achromatopsia (16.2 µm/year) and occult macular dystrophy (15.4 µm/year). Gap height decreased in patients with Stargardt disease (6.5 µm/year; P = .02) but increased in patients with achromatopsia (3.3 µm/year) and occult macular dystrophy (1.2 µm/year). Gap height correlated with measurements of central retinal thickness at the fovea (r = 0.782, P = .00012). Interocular discordance of the gap was observed in 7 patients. Finally, a review of all currently described etiologies of optical gap was summarized. CONCLUSION: The optical gap is a progressive phenotype seen in an increasing number of etiologies. This progressive nature suggests a use as a biomarker in the understanding of disease progression. Interocular discordance of the phenotype may be a feature of Stargardt disease and cone dystrophies.


Assuntos
Biomarcadores , Defeitos da Visão Cromática/diagnóstico por imagem , Distrofias de Cones e Bastonetes/diagnóstico por imagem , Degeneração Macular/diagnóstico por imagem , Retinite Pigmentosa/diagnóstico por imagem , Doença de Stargardt/diagnóstico por imagem , Tomografia de Coerência Óptica , Adolescente , Adulto , Idoso , Proteínas de Ligação ao Cálcio/genética , Criança , Defeitos da Visão Cromática/fisiopatologia , Distrofias de Cones e Bastonetes/fisiopatologia , Progressão da Doença , Eletrorretinografia , Feminino , Humanos , Degeneração Macular/fisiopatologia , Masculino , Proteínas de Membrana/genética , Pessoa de Meia-Idade , Fenótipo , Retina/fisiopatologia , Retinite Pigmentosa/genética , Retinite Pigmentosa/fisiopatologia , Estudos Retrospectivos , Doença de Stargardt/fisiopatologia , Acuidade Visual/fisiologia , Proteínas rab de Ligação ao GTP/genética
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