Numerical analysis of optical vortices generation with nanostructured phase masks.

We study the theoretical formation of optical vortices using a nanostructured gradient index phase mask. We consider structures composed of spatially distributed thermally matched glass nanorods with high and low refractive indices. Influence of effective refractive profile distribution, refractive index contrast of component glasses and charge value on the quality of generation of vortices are discussed. A trade-off between waveguiding and phase modulation effects for various refractive index contrast is presented and analysed.

Patterned edge-illuminated display for clinical examination of visual evoked potentials using simultaneous magnetic resonance imaging.

PURPOSE: Commonly used technologies for visual pattern stimulation cannot operate in a magnetic resonance imaging room because they can interfere with the operation of the scanner and are vulnerable to its electromagnetic and magnetic fields. The aim of this single-center prospective observational study was to introduce a novel, structurally uncomplicated, easy-to-maintain, patterned edge-illuminated display (PEID) device for visual pattern-reversal stimulation, compare it with a commonly used cathode ray tube screen, and verify the equivalence of quantitative assays. MATERIALS AND METHODS: The left and right eyes of 36 healthy participants with undilated pupils were examined on a commercial visual evoked potential (VEP) apparatus and on the PEID device, where pattern-reversal transient VEPs were elicited by checkerboard stimuli with large (0.89°; 0.86°-0.92°) and small (0.21°; 0.20°-0.23°) checks. RESULTS: The PEID device demonstrated the required reliability and dynamic characteristics, as well as precise time-locking required for a VEP diagnosis. The results of Deming's correlation analysis showed that both the commercial cathode ray tube monitor and the PEID device produced identical VEP results within the context of experimental uncertainty. The standard deviation of Deming's regression may indicate the uncertainty of the VEPs measured in clinical practice. The Bland-Altman analysis of the mean showed no significant difference in the amplitude and peak time of VEPs measured on the PEID device compared to that of the commercial cathode ray tube monitor. CONCLUSIONS: The presented PEID device meets all the required standards and can be easily installed in various types of commercial magnetic resonance imaging scanners.

Analysis of retinal function using chromatic pupillography in retinitis pigmentosa and the relationship to electrically evoked phosphene thresholds.

PURPOSE: To analyse pupil responses to specific chromatic stimuli in patients with advanced retinitis pigmentosa (RP) to ascertain whether chromatic pupillography can be used as an objective marker for residual retinal function. To examine correlations between parameters of the pupil response and the perception threshold of electrically evoked phosphenes. METHODS: Chromatic pupillography was performed in 40 patients with advanced RP (visual acuity < 0.02 or visual field ≤5°, non-recordable ERGs) and 40 age-matched healthy subjects. Pupil responses to full-field red (605 nm) and blue (420 nm) stimuli of 28 lx corneal illumination were recorded and analysed for two stimulus durations (1 and 4 seconds). The perception threshold of phosphenes to transcorneal electrostimulation was ascertained and correlated to the pupil responses and visual acuity. RESULTS: Patients with RP showed significantly reduced pupil responses to red and blue stimuli compared with the controls. With red stimuli, pupillary escape could be observed; blue stimuli resulted in a well-preserved postillumination pupil response. Phosphene thresholds were significantly increased in patients with RP and correlated with the parameters of the pupil response if all subjects were considered. Within the RP group alone, this relationship was less pronounced and statistically not significant. CONCLUSIONS: Chromatic pupillography demonstrated a significant decrease in outer retinal photoreceptor responses but a persisting and disinhibited intrinsic photosensitive retinal ganglion cell function in advanced RP. These phenomena may be useful as an objective marker for the efficacy of any interventional treatment for hereditary retinal diseases as well as for the selection of suitable patients for an electronic retinal implant.

Development of a Chromatic Pupillography Protocol for the First Gene Therapy Trial in Patients With CNGA3-Linked Achromatopsia.

Purpose: To establish a feasible and sensitive pupillographic protocol to assess outer and inner retinal function for the first gene therapy trial in achromatopsia patients (ACHM) with mutations in CNGA3. Methods: Twenty-seven CNGA3-ACHM patients and 22 age-matched control subjects were tested using chromatic pupillography. Three different protocols were established to assess the pupillary light reflex parameters and to create the final protocol. In the individual protocols, various stimulus parameters (i.e., intensity, duration, wavelength, adaptation states) were applied to evaluate the impact of these stimuli on the pupillary response in untreated ACHM patients. Results: In the light-adapted conditions, CNGA3-ACHM patients showed significantly reduced maximal amplitudes compared with the control group when using a 1-second high intensity (28-lux corneal illumination) blue or red stimulus (P < 0.005). In the dark-adapted conditions, CNGA3-ACHM patients unexpectedly revealed significantly increased maximal amplitudes when stimulating with red (1 second) or blue (4 ms and 1 second) stimuli of low intensity (0.01-lux corneal illumination; P < 0.05). Pupil responses of CNGA3-ACHM patients after high intensity (28 lux) red and blue 1-second stimuli were within the normal range. Conclusions: Chromatic pupillography demonstrated significant reduced pupil responses to stimuli addressing primarily cone function, an increased sensitivity to rod-favoring stimuli and evidence for disinhibition of intrinsically photosensitive retinal ganglion cells in CNGA3-ACHM patients. A final protocol was established based on these findings. These conclusions may be useful for the objective assessment of efficacy gained by gene therapy or other innovative interventions in this hereditary retinal disorder.