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Dorfman AL, Gauvin M, Vatcher D, Little JM, Polomeno RC, Lachapelle P. Ring analysis of multifocal oscillatory potentials (mfOPs) in cCSNB suggests near-normal ON-OFF pathways at the fovea only. Doc Ophthalmol 2020; 141:99-109. [PMID: 32060756 DOI: 10.1007/s10633-020-09755-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 02/05/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE To investigate the center-periphery distribution of ON and OFF retinal responses in complete congenital stationary night blindness (cCSNB). METHODS Photopic full-field flash ERGs (photopic ffERGs) and OPs (photopic ffOPs) and slow m-sequence (to enhance OP prominence) mfERGs (and filtered mfOPs) evoked by a 37 hexagon stimulus array were recorded from normal subjects and cCSNB patients. Discrete wavelet transform (DWT) analysis of photopic ffERGs and mfERGs was also performed in order to assess the contribution of the ON and OFF retinal pathways (i.e., OFF-to-ON ratio) in both cohorts. RESULTS As expected, the photopic ffERG (and ffOPs) responses in cCSNB were devoid of the first two of the three OPs (i.e., OP2 and OP3 and OP4) normally seen on the ascending limb of the b-wave. A similar finding was also noted in the mfERGs (and mfOPs) of ring 4. In contrast, the mfERGs (and mfOPs) of ring 1 included all three OPs. DWT analysis revealed that while in normal subjects, the OFF-to-ON ratio of mfERGs slightly increased from rings 1 to 4 (from 0.61 ± 0.03 to 0.78 ± 0.04; p < 0.05; median: from 0.62 to 0.79; p < 0.05), in cCSNB this ratio increased significantly more [from 0.73 ± 0.13 (ring 1) to 1.18 ± 0.17 (ring 4); p < 0.05; median: 0.78 to 1.22; p < 0.05], hence from a normal ON-dominated ratio (central ring) to an OFF-dominated ratio (peripheral ring). CONCLUSIONS Our results show a clear discrepancy of ON and OFF mfOP components in cCSNB. Responses originating from the most central ring (i.e., ring 1) disclosed a near-normal electrophysiological contribution (as revealed with the presence of OP2, OP3 and OP4 as well as with the DWT OFF-to-ON ratio) of the retinal ON and OFF pathways in mfERG (and mfOPs) responses compared to responses from the more peripheral ring (and ffOP) which are devoid of the ON OPs (i.e., OP2 and OP3).
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Affiliation(s)
- Allison L Dorfman
- Department of Ophthalmology and Visual Sciences, Montreal Children's Hospital, Research Institute of the McGill University Health Centre, 1001 Boul. Décarie, Glen Site, Block E, Program Mail Drop Point #EM03211 - Office #EM03238, Montreal, QC, H4A 3J1, Canada
| | - Mathieu Gauvin
- Department of Ophthalmology and Visual Sciences, Montreal Children's Hospital, Research Institute of the McGill University Health Centre, 1001 Boul. Décarie, Glen Site, Block E, Program Mail Drop Point #EM03211 - Office #EM03238, Montreal, QC, H4A 3J1, Canada
| | - Dylan Vatcher
- Department of Ophthalmology and Visual Sciences, Montreal Children's Hospital, Research Institute of the McGill University Health Centre, 1001 Boul. Décarie, Glen Site, Block E, Program Mail Drop Point #EM03211 - Office #EM03238, Montreal, QC, H4A 3J1, Canada
| | - John M Little
- Department of Ophthalmology and Visual Sciences, Montreal Children's Hospital, Research Institute of the McGill University Health Centre, 1001 Boul. Décarie, Glen Site, Block E, Program Mail Drop Point #EM03211 - Office #EM03238, Montreal, QC, H4A 3J1, Canada
| | - Robert C Polomeno
- Department of Ophthalmology and Visual Sciences, Montreal Children's Hospital, Research Institute of the McGill University Health Centre, 1001 Boul. Décarie, Glen Site, Block E, Program Mail Drop Point #EM03211 - Office #EM03238, Montreal, QC, H4A 3J1, Canada
| | - Pierre Lachapelle
- Department of Ophthalmology and Visual Sciences, Montreal Children's Hospital, Research Institute of the McGill University Health Centre, 1001 Boul. Décarie, Glen Site, Block E, Program Mail Drop Point #EM03211 - Office #EM03238, Montreal, QC, H4A 3J1, Canada.
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Kim JM, Payne JF, Yan J, Barnes CS. Negative electroretinograms in the pediatric and adult population. Doc Ophthalmol 2012; 124:41-8. [PMID: 22246197 DOI: 10.1007/s10633-011-9301-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Accepted: 12/05/2011] [Indexed: 11/28/2022]
Abstract
Objective To assess the frequency of negative waveform electroretinograms (ERGs) in a tertiary referral center. Design Retrospective chart review. Participants All patients who had an ERG performed at the electrophysiology clinic at Emory University from January 1999 through March 2008 were included in the study. Methods Patients with b-wave amplitude ≤ a-wave amplitude during the dark-adapted bright flash recording, in at least one eye, were identified as having a "negative ERG". Clinical information, such as age, gender, symptoms, best corrected visual acuity, and diagnoses were recorded for these patients when available. Results A total of 1,837 patients underwent ERG testing during the study period. Of those, 73 patients had a negative ERG, for a frequency of 4.0%. Within the adult (≥ 18 years of age) and pediatric populations, the frequencies of a negative ERG were 2.5 and 7.2%, respectively. Among the 73 cases, negative ERGs were more common among male than female patients, 6.7% versus 1.8% (P < 0.0001). Negative ERGs were most common among male children and least common among female adults, 9.6% versus 1.1%, respectively, (P < 0.0001). Overall in this group of patients, the most common diagnoses associated with a negative ERG were congenital stationary night blindness (CSNB, n = 29) and X-linked retinoschisis (XLRS, n = 7). Conclusions The overall frequency of negative ERGs in this large retrospective review was 4.0%. Negative ERGs were most common among male children and least common among female adults. Despite the growing number of new diagnoses associated with negative ERGs, CSNB, and XLRS appear to be the most likely diagnoses for a pediatric patient who presents with a negative ERG.
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Affiliation(s)
- Johnstone M Kim
- Department of Ophthalmology, Emory University, Atlanta, GA, USA
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