The point-spread function of the eye from 0 degrees to 100 degrees and the pattern electroretinogram

Calculating Retinal Contrast from Scene Content: A Program

This paper describes a computer program for calculating the contrast image on the human retina from an array of scene luminances. We used achromatic transparency targets and measured test target's luminances with meters. We used the CIE standard Glare Spread Function (GSF) to calculate the array of retinal contrast. This paper describes the CIE standard, the calculation and the analysis techniques comparing the calculated retinal image with observer data. The paper also describes in detail the techniques of accurate measurements of HDR scenes, conversion of measurements to input data arrays, calculation of the retinal image, including open source MATLAB code, pseudocolor visualization of HDR images that exceed the range of standard displays, and comparison of observed sensations with retinal stimuli.

History of ocular straylight measurement: A review

The earliest studies on 'disability glare' date from the early 20(th) century. The condition was defined as the negative effect on visual function of a bright light located at some distance in the visual field. It was found that for larger angles (>1 degree) the functional effect corresponded precisely to the effect of a light with a luminosity equal to that of the light that is perceived spreading around such a bright source. This perceived spreading of light was called straylight and by international standard disability glare was defined as identical to straylight. The phenomenon was recognized in the ophthalmological community as an important aspect of the quality of vision and attempts were made to design instruments to measure it. This must not be confused with instruments that assess light spreading over small distances (<1 degree), as originating from (higher order) aberrations and defocus. In recent years a new instrument has gained acceptance (C-Quant) for objective and controllable assessment of straylight in the clinical setting. This overview provides a sketch of the historical development of straylight measurement, as well as the results of studies on the origins of straylight (or disability glare) in the normal eye, and on findings on cataract (surgery) and corneal conditions.

Update on the pattern electroretinogram in glaucoma

PURPOSE

To review the efficacy of the pattern electroretinogram (PERG) in early diagnosis of glaucoma.

METHODS

Stimulation parameters of check size and temporal frequency are considered. Analyses of various peaks (P50, N95, the N95/P50) and Fourier steady-state are considered. The relation to visual field defects is explored.

RESULTS

The PERG is markedly alterated in glaucoma. It shows amplitude reductions in (still) normal areas of the visual field. Optical imaging on the retina needs to be optimal. Higher temporal frequency (>10 reversals/s) improves the sensitivity to detect glaucoma compared with transient stimulation. The ratio between the amplitudes to 0.8 degrees checks and to 16 degrees checks, "PERG ratio," exploits a check size-specific reduction in early glaucoma and reduces variability. Longitudinal studies suggest that the PERG can indicate incipient glaucoma damage before evidence from the visual field.

CONCLUSIONS

The PERG is a demanding electrophysiological technique that can serve as a sensitive biomarker for retinal ganglion cell function. With appropriate paradigms, PERG assists in identifying those patients with elevated interocular pressure in whom glaucoma damage is incipient before visual field changes occur.

Contributions from lateral interaction mechanisms to the human ERG can be studied with a two-frequency method

We present a two-frequency method to investigate lateral interaction components (liERGs) in the human electroretinogram. Adjacent half cycles of sinusoidal gratings were modulated sinusoidally with different temporal frequencies f1 and f2. The liERGs were defined by the Fourier components at the intermodulation frequencies /f1 - f2/ and f1 + f2 which indicate nonlinear interactions between the half cycles. Significant liERGs were found in all subjects with a monotonic increase of the liERG magnitude in the spatial frequency range from f(s)=0.07 to 2.4 cpd. When /f1 - f2/ was below 5 Hz, liERGs were masked by noise intrusions. In a control experiment we demonstrated that the liERGs were not evoked by stray light artifacts. The liERGs may help to further differentiate the responses that are evoked by patterned stimuli within the retina.

Normative data for a user-friendly paradigm for pattern electroretinogram recording

PURPOSE

To provide normative data for a user-friendly paradigm for the pattern electroretinogram (PERG) optimized for glaucoma screening (PERGLA).

DESIGN

Prospective nonrandomized case series.

PARTICIPANTS

Ninety-three normal subjects ranging in age between 22 and 85 years.

METHODS

A circular black-white grating of 25 degrees visual angle, reversing 16.28 times per second, was presented on a television monitor placed inside a Ganzfeld bowl. The PERG was recorded simultaneously from both eyes with undilated pupils by means of skin cup electrodes taped over the lower eyelids. Reference electrodes were taped on the ipsilateral temples. Electrophysiologic signals were conventionally amplified, filtered, and digitized. Six hundred artifact-free repetitions were averaged. The response component at the reversal frequency was isolated automatically by digital Fourier transforms and was expressed as a deviation from the age-corrected average. The procedure took approximately 4 minutes.

MAIN OUTCOME MEASURES

Pattern electroretinogram amplitude ( micro V) and phase (pi rad); response variability (coefficient of variation [CV] = standard deviation [SD] / mean x 100) of amplitude and phase of 2 partial averages that build up the PERG waveform; amplitude ( micro V) of background noise waveform, obtained by multiplying alternate sweeps by +1 and -1; and interocular asymmetry (CV of amplitude and phase of the PERG of the 2 eyes).

RESULTS

On average, the PERG has a signal-to-noise ratio of more than 13:1. The CVs of intrasession and intersession variabilities in amplitude and phase are lower than 10% and 2%, respectively, and do not depend on the operator. The CV of interocular asymmetries in amplitude and phase are 9.8+/-8.8% and 1.5+/-1.4%, respectively. The PERG amplitude and phase decrease with age. Residuals of linear regression lines have normal distribution, with an SD of 0.1 log units for amplitude and 0.019 log units for phase. Age-corrected confidence limits (P<0.05) are defined as +/-2 SD of residuals.

CONCLUSIONS

The PERGLA paradigm yields responses as reliable as the best previously reported using standard protocols. The ease of execution and interpretation of results of PERGLA indicate a potential value for objective screening and follow-up of glaucoma.

Two methods of lens opacity measurements in glaucomas

PURPOSE

Determination of lens opacity is important in aging glaucoma patients, because sensory testing may be influenced by increasing lens opacity. Purpose of this study was to measure lens opacity in normals and glaucoma patients using two different techniques, to compare both methods, and to correlate the results with contrast sensitivity testing.

METHODS

94 glaucomatous eyes, 47 ocular hypertensive eyes, and 79 control eyes were studied using the following devices: opacity lens meter (OLM, objective back scatter method), stray light meter (SLM, subjective forward scatter using flicker light), and temporal contrast sensitivity (full-field flicker test). SLM results were separately analyzed at the lower and upper flicker disappearance. All subjects were younger than 66 years and had no significant cataracts.

RESULTS

In patients and in normal subjects OLM readings and SLM findings elicited at the upper disappearance point are significantly correlated with age and with each other (R >0.45, P<0.001), while SLM at the lower disappearance point shows no such correlation. In normals, but not in patients, SLM at the lower disappearance point is significantly correlated with temporal contrast sensitivity.

CONCLUSIONS

Both devices can be used for quantifying lens opacity in glaucoma. SLM readings with increasing light intensity at the lower disappearance point seems to be more influenced by the individual flicker sensitivity than determination of the upper flicker disappearance. Therefore, using the SLM in glaucoma patients, the threshold measurements based on the upper disappearance of the flicker should be used instead of the suggested mean threshold measurements.

Check size tuning of the pattern electroretingoram: a reappraisal

The pattern electroretinogram was recorded to checkerboard stimuli with a wide range of check sizes and two stimulus field sizes. Check sizes ranged from 0.25 degree to 7 degrees (field size, 16 degrees x 14 degrees) and 0.25 degree to 15 degrees (field size, 32 degrees x 27 degrees) in 14 and seven subjects, respectively. Reversal rate was 4.5/s. For minimal intrusion of blink artifacts the interrupted stimulation technique was employed. The P50 and N95 components of the pattern electroretinogram were evaluated separately. With both stimulus field sizes amplitude of P50 and N95 was maximal between 0.75 degree and 1 degree. With smaller check sizes the amplitude dropped monotonically. With larger check sizes field size played a role: with the 16 degrees x 14 degrees field, P50 gradually dropped to 89% from 1 degree to 7 degrees, which was paralleled by N95 only up to 7 degrees, where N95 dropped to 81% (p < 0.05). With the 32 degrees x 27 degrees field, there was no significant difference in size dependency between P50 and N95 for large check, both components staying constant from 1 degree to 15 degrees. We conclude that there is only minor large-check attenuation of the pattern electroretinogram, especially with a large field. The apparent field-size dependency may explain previous discrepancies in the literature.

Effect of light scatter on the pattern reversal visual evoked response: comparison with psychophysical results

The effect of light scatter on the pattern reversal visual evoked response (PVER) was studied in 6 normal subjects. The results were compared with contrast visual acuity, contrast sensitivity function, and glare disability. Light scatter was induced by translucent acrylic sheets. Visual acuity measured with the low-contrast charts decreased significantly (P < 0.0001) even with a small degree of light scatter. Contrast sensitivity decreased with a small degree of light scatter especially for high spatial frequencies. PVER amplitudes decreased especially at the smaller checks with its peak shifted to larger checks. PVER was equally sensitive to light scatter compared to psychophysical tests.

Dependence of intraocular straylight on pigmentation and light transmission through the ocular wall

The straylight function of the human eye depends on eye color, especially at larger angles of scattering. As a potential cause for this dependence, transmission of light through the ocular wall was measured, using a psychophysical method. For a light-blue eye effective transmission of the iris was 1% for red and 0.2% for green light. Also the eyewall around the iris transmits a significant amount of light. For the dark-brown eyes of pigmented individuals transmission is lower by two orders of magnitude. Although important, transmission proved to be only partly responsible for the pigmentation dependence, the other cause probably being reflection from the fundus.

Functional quantification of diaphany

Intraocular straylight can be measured, in clinical as well as normal cases, by the direct compensation technique. Intraocular straylight is known to originate from the cornea, lens and fundus. We have studied a fourth source: the translucency of the iris and surrounding ocular wall. For lightly-pigmented normal eyes this source proved to be important. In the present paper results are reported from a patient with X-linked megalocornea. He had diaphany of the iris, as is common in these patients, and photophobic complaints. Quantitative measurements showed that the translucency was much increased so that the intraocular straylight was far above the normal level.

Lateral interaction component and local luminance nonlinearities in the human pattern reversal ERG

Two different mechanisms are presumed to contribute to pattern electroretinograms: non linearities of the local luminance response and nonlinear effects of lateral interactions. Previous attempts to discriminate the two components relied on the theoretical MTF of the optics. In this study, techniques of nonlinear systems analysis are used to extract the two components from the response to pattern reversal of different check sizes. The decomposition is based on the structure of the second order pattern reversal kernels alone. Detailed information about the two mechanisms can be gleaned from the kernel structure. The component properties are compared and discussed.

The intraocular straylight function in 129 healthy volunteers; dependence on angle, age and pigmentation

The direct compensation method allows for an accurate (standard deviation below 0.05 log unit) determination of intraocular light scattering between 3.5 and 25 deg of scattering angle and is suitable for untrained subjects. The method was used to study population behaviour and individual variation in 129 volunteers between 20 and 82 yr of age, visual acuity equal to or better than one and no apparent eye pathology. The results indicate straylight to increase with the 4th power of age, doubling at 70. In addition to the age dependence, there was great variation between individuals. Part of this is due to negative correlation with pigmentation.

Red glasses and visual function in retinitis pigmentosa

As a consequence of animal reduction of the light regimes have been tried on patients with retinitis pigmentosa. The trials have been very limited and have not given reason for hope that such reduced light therapy may be beneficial. However, RP patients trying red glasses have reported acute subjective improvement of their visual function. It was the purpose of this study to try to document the reports more objectively. Five visual functions were tested with and without red glasses with the following results: 1. Visual acuity and contrast sensitivity. For one volunteer a small reproducible improvement was found. 2. Color vision. In most cases deterioration was found of already deficient color vision. 3. Visual fields. For volunteers with relatively preserved vision no difference or slight deterioration was found. For the other volunteers slight improvements were found. 4. Intraocular light scatter. No differences were found. 5. Dark adaptation. Improvements were found when the glasses were used as adaptation aid according to the method of Trendelenburg (rod function). For cone function no difference was found upon continuous wearing of red glasses.

IN CONCLUSION

use of red glasses does not seem to be of great benefit as a rule. On the other hand, apart from the reduction in color discrimination no serious disadvantages seem to be inherent in their wear by RP patients.

Pattern electroretinogram can be more than the sum of local luminance responses

It is generally accepted that the pattern electroretinogram for very large spatial elements is the result of local luminance stimulation. Responses due to the luminance differences between elements may be assumed to be relatively unimportant because in the case of large elements only few retinal units are stimulated by gradients. With decreasing pattern element size one wonders to what extent the electroretinogram continues to be based on the local luminance stimulation. We investigated this question using 8 Hz checkerboard reversal and compared the pattern recordings with the recordings resulting from the same stimulus field modulated homogeneously (focal electroretinogram). A 100% modulated checkerboard at retinal level may be considerably less modulated because of imperfect optics of the eye. So the pattern electroretinogram should be compared with homogeneous field stimulation of correspondingly lower modulation depth. On the basis of the optical transfer properties of the eye we compared by subtracting the proper focal electroretinogram from the pattern electroretinogram. The difference response was virtually zero for check sizes larger than 120'. For checks from 60' down the difference response was of the same order of magnitude as the adjusted focal recording. This difference response for eyes with normal optics is largest around 30'; its wave form was found to be rather invariant with check size.