Regional variations in local contributions to the primate photopic flash ERG: revealed using the slow-sequence mfERG

Intraocular Adeno-Associated Virus-Mediated Transgene Endothelin-1 Delivery to the Rat Eye Induces Functional Changes Indicative of Retinal Ischemia-A Potential Chronic Glaucoma Model

Endothelin-1 (ET-1) overactivity has been implicated as a factor contributing to glaucomatous neuropathy, and it has been utilized in animal models of retinal ischemia. The functional effects of long-term ET-1 exposure and possible compensatory mechanisms have, however, not been investigated. This was therefore the purpose of our study. ET-1 was delivered into rat eyes via a single intravitreal injection of 500 µM or via transgene delivery using an adeno-associated viral (AAV) vector. Retinal function was assessed using electroretinography (ERG) and the retinal expression of potentially compensatory genes was evaluated by means of qRT-PCR. Acute ET-1 delivery led to vasoconstriction and a significant reduction in the ERG response. AAV-ET-1 resulted in substantial transgene expression and ERG results similar to the acute ET-1 injections and comparable to other models of retinal ischemia. Compensatory changes were observed, including an increase in calcitonin gene-related peptide (CGRP) gene expression, which may both counterbalance the vasoconstrictive effects of ET-1 and provide neuroprotection. This chronic ET-1 ischemia model might be especially relevant to glaucoma research, mimicking the mild and repeated ischemic events in patients with long-term vascular dysfunction. The compensatory mechanisms, and particularly the role of vasodilatory CGRP in mitigating the retinal damage, warrant further investigation with the aim of evaluating new therapeutic strategies.

Origin of Retinal Oscillatory Potentials in the Mouse, a Tool to Specifically Locate Retinal Damage

To determine the origin of oscillatory potentials (OPs), binocular electroretinogram (ERG) recordings were performed under light and dark adaptation on adult healthy C57BL/6J mice. In the experimental group, 1 μL of PBS was injected into the left eye, while the right eye was injected with 1 μL of PBS containing different agents: APB, GABA, Bicuculline, TPMPA, Glutamate, DNQX, Glycine, Strychnine, or HEPES. The OP response depends on the type of photoreceptors involved, showing their maximum response amplitude in the ERG induced by mixed rod/cone stimulation. The oscillatory components of the OPs were affected by the injected agents, with some drugs inducing the complete abolition of oscillations (APB, GABA, Glutamate, or DNQX), whereas other drugs merely reduced the oscillatory amplitudes (Bicuculline, Glycine, Strychnine, or HEPES) or did not even affect the oscillations (TPMPA). Assuming that rod bipolar cells (RBC) express metabotropic Glutamate receptors, GABA_A, GABA_C, and Glycine receptors and that they release glutamate mainly on Glycinergic AII amacrine cells and GABAergic A17 amacrine cells, which are differently affected by the mentioned drugs, we propose that RBC-AII/A17 reciprocal synapses are responsible for the OP generation in the ERG recordings in the mice. We conclude that the reciprocal synapses between RBC and AII/A17 are the basis of the ERG OP oscillations of the light response, and this fact must be taken into consideration in any ERG test that shows a decrease in the OPs' amplitude.

The Development of Electroretinographic Oscillatory Potentials in Healthy Young Children

PURPOSE

This study aimed to summarize the electroretinographic oscillatory potential (OP) responses in healthy young children recorded by RETeval.

METHODS

By using the RETeval system, we recorded the implicit times and amplitudes of the OPs (OP1-5), in 132 healthy children aged from 0 to 11 years old. The age, gender, and data of implicit time and amplitude of each child were recorded and analyzed. Correlation analysis was performed between age and implicit time/amplitude.

RESULTS

No correlation was shown between the implicit times and amplitudes with gender. The implicit times and amplitudes of OP1-5 matured over 10 years of age, with exponential time constants of 1.9, 2.2, 1.8, 1.7, and 1.6 years and 2.1, 2.9, 2.8, 3.0, and 3.2 years, respectively. The majority of the trend occurred within the first 4.6 years.

CONCLUSIONS

In order to diagnose and evaluate vision-related disorders, the OP response is commonly used. The percentiles and age dependence of OP responses calculated and shown in this study could be regarded as reference data in age-matched pediatric patients.

Electroretinography reveals retinal dysfunction in Parkinson's disease despite normal high-resolution optical coherence tomography findings

INTRODUCTION

Parkinson's disease (PD)-associated inner retinal abnormalities, particularly the retinal ganglion cells (RGC) layer, on optical coherence tomography (OCT) have recently gained importance as a biomarker of non-motor involvement of the disease but functional RGC evaluation using photopic negative response (PhNR) has not yet been determined. This study aims to compare structural and functional findings of the retina and optic nerve in PD with healthy controls (CT) including PhNR and OCT.

METHODS

Forty-one eyes of 21 PD patients and 38 eyes of 19 CT underwent ophthalmic examination including visual contrast sensitivity test (CS), OCT, light-adapted full-field electroretinography (ffERG), and PhNR. OCT was used to measure the peripapillary retinal nerve fiber layer, the segmented macular layers, and the choroid. For functional parameters, CS, ffERG (oscillatory potentials, photopic response, 30 Hz-flicker), and PhNR waves were used. Measurements were compared using generalized estimating equation and significance was set at P ≤ 0.05.

RESULTS

The PD group presented a significantly lower mono- and binocular CS, oscillatory potentials amplitude, b-wave amplitude on ffERG (152.3[45.4] vs 187.1[32.7]μV; P = 0.002), and PhNR amplitude (135.0[35.0] vs 156.3[34.1]μV; P = 0.025). There was no statistically significant difference in OCT measurements between groups. No correlation was found between statistically significant measurements and clinical data.

CONCLUSIONS

Functional abnormalities on CS, ffERG, and PhNR can be detected in PD even when structural damages are not observed on OCT. PhNR represents a new potential biomarker in PD. Our findings indicate dysfunction of bipolar, amacrine, and retinal ganglion cells in PD, probably with a cellular dysfunction overcoming morphological damage.

The relation of the multifocal electroretinographic response to macular layer volume

PURPOSE

To determine the association of the multifocal electroretinographic (mfERG) response amplitude with the volumes of the inner, postreceptor, and photoreceptor retinal layers in the region stimulated by each mfERG element.

METHODS

Sixteen healthy, young adult control subjects were studied. Each of the 103 hexagonal elements of the standard, scaled mfERG were aligned, where possible, with patches of retina imaged using optical coherence tomography. Stimuli falling on the fovea and on the optic nerve head were excluded. Linear mixed-effects modeling was then used to derive estimated coefficients (voltage/volume) for the mfERG response throughout the full 80 ms standard epoch. The resulting predicted response amplitudes originating in each layer were then compared to pharmacologically "dissected" mfERGs obtained from other studies in monkey eyes.

RESULTS

Across the duration of the response, the amplitude of the modeled contribution from (1) the inner retina was small-to-modest, (2) the postreceptor retina was larger and contained two prominent peaks, and (3) the photoreceptor response was the largest and most closely paralleled the overall (i.e., intact) response, including late-appearing oscillations. The significance of each layer's contribution was greatest when the absolute amplitude of that layer's response was largest. The contribution of the inner retina was maximally significant in the interval between the prominent troughs and peaks of the intact response. The contributions of the postreceptor and photoreceptor responses were maximally significant at the prominent troughs and peaks of the intact response.

CONCLUSIONS

The results of the model were in good overall agreement with previous interpretations of the cellular contributions to the mfERG. There was also fair agreement with pharmacologically dissected monkey mfERG responses. Thus, the estimations of the contributions of the retinal layers to the mfERG so produced appeared plausible.

Temporal vision: measures, mechanisms and meaning

Time is largely a hidden variable in vision. It is the condition for seeing interesting things such as spatial forms and patterns, colours and movements in the external world, and yet is not meant to be noticed in itself. Temporal aspects of visual processing have received comparatively little attention in research. Temporal properties have been made explicit mainly in measurements of resolution and integration in simple tasks such as detection of spatially homogeneous flicker or light pulses of varying duration. Only through a mechanistic understanding of their basis in retinal photoreceptors and circuits can such measures guide modelling of natural vision in different species and illuminate functional and evolutionary trade-offs. Temporal vision research would benefit from bridging traditions that speak different languages. Towards that goal, I here review studies from the fields of human psychophysics, retinal physiology and neuroethology, with a focus on fundamental constraints set by early vision.

Summary: Simple measures of temporal vision such as the critical flicker frequency can be useful for modelling natural vision only if their relationship to photoreceptor responses and retinal processing is understood.

Pseudorandom full-field electroretinograms reflect different light adaptation mechanisms

PURPOSE

To investigate the magnitude and time course of pseudorandom ffERG during light adaptation.

METHODS

Ten healthy subjects (26 ± 10.1 years) underwent 20 min of dark adaptation, and then the ffERG was evoked by pseudorandom flash sequences (4 ms per flash, 3 cd.s/m²) driven by m-sequences (2¹⁰-1 stimulus steps) using Veris Science software and a Ganzfeld dome over a constant field of light adaptation (30 cd/m²). The base period of the m-sequence was 50 ms. Each stimulation sequence lasting 40 s was repeated at 0, 5, 10, 15 and 20 min of light adaptation. Relative amplitude and latency (corrected by values found at 0 min) of the three components (N1, P1, and N2) of first-order (K₁) and first slice of the second-order (K_2.1) kernel at 5 time points were evaluated. An exponential model was fitted to the mean amplitude and latency data as a function of the light adaptation duration to estimate the time course (τ) of the light adaptation for each component. Repeated one-way ANOVA followed by Tukey post-test was applied to the amplitude and latency data, considering significant values of p < 0.05.

RESULTS

Regarding the K₁ ffERG, N1 K₁, P1 K₁, and N2 K₁ presented an amplitude increase as a function of the light adaptation (N1 K₁ τ value = 2.66 min ± 4.2; P1 K₁ τ value = 2.69 min ± 2.10; and N2 K₁ τ value = 3.49 min ± 2.96). P1 K₁ and N2 K₁ implicit time changed as a function of the light adaptation duration (P1 K₁ τ value = 3.61 min ± 5.2; N2 K₁ τ value = 3.25 min ± 4.8). N1 K₁ had small implicit time changes during the light adaptation. All the K_2,1 components also had nonsignificant changes in amplitude and implicit time during the light adaptation.

CONCLUSIONS

Pseudorandom ffERGs showed different mechanisms of adaptation to retinal light. Our results suggest that K₁ ffERG is generated by retinal mechanisms with intermediate- to long-term light adaptation, while K_2.1 ffERG is generated by retinal mechanism with fast light adaptation course.

Retinal ganglion cell ablation in guinea pigs

Guinea pigs are a common model of human ocular conditions; however, their visual function has not been fully characterized. The purpose of this study was to determine the contributions of retinal ganglion cells to structural and functional measures in guinea pigs. Healthy adult guinea pigs (n = 12) underwent unilateral optic nerve crush. Retinal structure was assessed with spectral domain optical coherence tomography (OCT), and thickness of the ganglion cell/nerve fiber layer (GC/NFL) was determined. Visual function was assessed with optomotor tracking of a drifting grating and light adapted electroretinograms (ERGs). From flash ERGs, a-wave, b-wave, oscillatory potentials (OPs), and photopic negative response (PhNR) were analyzed. From pattern ERGs, N1P1 and P1N2 were analyzed. Histological studies were done at various time points for ganglion cell quantification. Optomotor tracking was absent in optic nerve crush eyes following optic nerve crush. Significant thinning of the GC/NFL was evident four weeks following the crush. Flash ERGs revealed a significant reduction in the OP1 amplitude two weeks following crush (P < 0.01) and in the PhNR amplitude six weeks following crush (P < 0.01). There were no significant changes in a-wave, b-wave, or pattern ERG responses (P > 0.05 for all). In vivo OCT imaging showed progressive thinning of inner retinal layers. Ganglion cell density, quantified histologically, was significantly reduced by 75% in the optic nerve crush eye compared to the control eye at four weeks following crush. These findings indicate that retinal ganglion cells contribute to the PhNR and OP1 components of the full field flash ERG, but not significantly to the pattern ERG in guinea pigs. This study demonstrates that OCT imaging and full field flash ERGs are valuable in assessing retinal ganglion cell loss in vivo in guinea pigs and will help to further establish the guinea pig as a model of human ocular pathologies.

Electroretinography in glaucoma diagnosis

PURPOSE OF REVIEW

Electrophysiological measures of vision function have for decades generated interest among glaucoma researchers and clinicians alike because of their potential to help elucidate pathophysiological processes and sequence of glaucomatous damage, as well as to offer a potential complementary metric of function that might be more sensitive than standard automated perimetry. The purpose of this article is to review the recent literature to provide an update on the role of the electroretinogram (ERG) in glaucoma diagnosis.

RECENT FINDINGS

The pattern reversal ERG (PERG) and the photopic negative response (PhNR) of the cone-driven full-field, focal or multifocal ERG provide objective measures of retinal ganglion cell function and are all sensitive to glaucomatous damage. Recent studies demonstrate that a reduced PERG amplitude is predictive of subsequent visual field conversion (from normal to glaucomatous) and an increased rate of progressive retinal nerve fiber layer thinning in suspect eyes, indicating a potential role for PERG in risk stratification. Converging evidence indicates that some portion of PERG and PhNR abnormality represents a reversible aspect of dysfunction in glaucoma.

SUMMARY

PERG and PhNR responses obtained from the central macula are capable of detecting early-stage, reversible glaucomatous dysfunction.

Correlation between N2 amplitude of multifocal ERGs and retinal sensitivity and retinal nerve fiber layer thickness in glaucomatous eyes

PURPOSE

To determine whether there are significant correlations between the N2 amplitude of the multifocal electroretinograms (mfERGs) and the retinal sensitivity and retinal nerve fiber layer (RNFL) thickness in glaucomatous and normal eyes.

METHODS

Thirty-eight glaucomatous and 11 normal eyes were studied. The mfERGs were elicited by red stimuli presented on a blue background. The responses from the central five elements within a 20° stimulated area were analyzed. The retinal sensitivity was determined by Humphrey Field Analyzer and the RNFL thickness by spectral-domain optical coherence tomography. The correlations between the N2 amplitude and the retinal sensitivity and the RNFL thickness were calculated.

RESULTS

The N2 amplitude was significantly smaller in the glaucomatous eyes than the normal eyes in all areas (P < 0.05). There was a significant correlation between the N2 amplitude and the retinal sensitivity (1/Lambert linear unit) of the HFA for the superior retina (r = 0.36, P = 0.01), for the central retina (r = 0.54, P < 0.0001), and for the inferior retina (r = 0.51, P = 0.0001). There were significant correlations between the N2 amplitude and the RNFL thicknesses in the superior retina (r = 0.49, P = 0.0003), the central retina (r = 0.79, P < 0.0001), and the inferior retina (r = 0.52, P = 0.0001) for both normal and glaucomatous eyes.

CONCLUSIONS

These results indicate that the activity of the retinal ganglion cells contribute to the amplitude of the N2 of the mfERGs and thus can be used as an objective monitor of retinal ganglion cell function.

The Effect of PKCα on the Light Response of Rod Bipolar Cells in the Mouse Retina

PURPOSE

Protein kinase C α (PKCα) is abundantly expressed in rod bipolar cells (RBCs) in the retina, yet the physiological function of PKCα in these cells is not well understood. To elucidate the role of PKCα in visual processing in the eye, we examined the effect of genetic deletion of PKCα on the ERG and on RBC light responses in the mouse.

METHODS

Immunofluorescent labeling was performed on wild-type (WT), TRPM1 knockout, and PKCα knockout (PKC-KO) retina. Scotopic and photopic ERGs were recorded from WT and PKC-KO mice. Light responses of RBCs were measured using whole-cell recordings in retinal slices from WT and PKC-KO mice.

RESULTS

Protein kinase C alpha expression in RBCs is correlated with the activity state of the cell. Rod bipolar cells dendrites are a major site of PKCα phosphorylation. Electroretinogram recordings indicated that loss of PKCα affects the scotopic b-wave, including a larger peak amplitude, longer implicit time, and broader width of the b-wave. There were no differences in the ERG a- or c-wave between PKCα KO and WT mice, indicating no measurable effect of PKCα in photoreceptors or the RPE. The photopic ERG was unaffected consistent with the lack of detectable PKCα in cone bipolar cells. Whole-cell recordings from RBCs in PKC-KO retinal slices revealed that, compared with WT, RBC light responses in the PKC-KO retina are delayed and of longer duration.

CONCLUSIONS

Protein kinase C alpha plays an important modulatory role in RBCs, regulating both the peak amplitude and temporal properties of the RBC light response in the rod visual pathway.

Continuous-wavelet-transform analysis of the multifocal ERG waveform in glaucoma diagnosis

The vast majority of multifocal electroretinogram (mfERG) signal analyses to detect glaucoma study the signals' amplitudes and latencies. The purpose of this paper is to investigate application of wavelet analysis of mfERG signals in diagnosis of glaucoma. This analysis method applies the continuous wavelet transform (CWT) to the signals, using the real Morlet wavelet. CWT coefficients resulting from the scale of maximum correlation are used as inputs to a neural network, which acts as a classifier. mfERG recordings are taken from the eyes of 47 subjects diagnosed with chronic open-angle glaucoma and from those of 24 healthy subjects. The high sensitivity in the classification (0.894) provides reliable detection of glaucomatous sectors, while the specificity achieved (0.844) reflects accurate detection of healthy sectors. The results obtained in this paper improve on the previous findings reported by the authors using the same visual stimuli and database.

The response of the neuronal adaptive system to background illumination and readaptation to dark in the immature retina

PURPOSE

Developmental characteristics of the neuronal adaptive system of the retina, focusing on background light (BGL) adaptation and readaptation functions, were studied by measuring the oscillatory response (SOP) of the electroretinogram (ERG).

METHODS

Digitally filtered and conventional ERGs were simultaneously recorded. Rats aged 15 and 17 days were studied during exposure to BGLs of two mesopic intensities and during readaptation to dark.

RESULTS

Results were compared to adult rats. In 'low mesopic' BGL SOP instantly dropped significantly to about half of its dark-adapted (DA) value contrary to mature rats, in which the SOP significantly increased. In 'high mesopic' BGL SOP decreased to about 20% and 30% of DA values in immature and adult rats, respectively. The process of recovery of SOP in darkness lacked the transient enhancement immediately as BGL was turned off, characteristic of adult rats. There were no major age differences in adaptive behaviour of a-wave. In young rats, recovery of b-wave was relatively slower.

CONCLUSIONS

Properties of BGL adaptation and readaptation functions of the neuronal adaptive system in baby retina differed compared to the adult one by being less forceful and more restrained. Handling of mesopic illumination and recovery in the dark was immature. Development of these functions of the neuronal adaptive system progresses postnatally and lags behind that of the photoreceptor response and seems to be delayed also compared to that of the bipolar response.

Relation between macular retinal ganglion cell/inner plexiform layer thickness and multifocal electroretinogram measures in experimental glaucoma

PURPOSE

We investigated relations between macular retinal ganglion cell plus inner plexiform layer (RGC+IPL) thickness and macular retinal function revealed by multifocal electroretinonography (mfERG) in a nonhuman primate model of experimental glaucoma.

METHODS

Retinal ganglion cell (RGC) structure and function were followed with spectral-domain optical coherence tomography (SD-OCT) and ERGs in five macaques with unilateral experimental glaucoma. Linear regression was used to study correlations in control (Con) and experimental (Exp) eyes between peripapillary retinal nerve fiber layer (RNFL) thickness, macular RGC+IPL thickness, multifocal photopic negative response (mfPhNR) and high-frequency multifocal oscillatory potentials (mfOP) in slow-sequence mfERG, and low-frequency component (mfLFC) in global-flash mfERG. We used ANOVA and paired t-tests to compare glaucoma-related mfERG changes between superior and inferior hemifields, foveal hexagon, inner three rings, and four quadrants of macula.

RESULTS

Average macular RGC+IPL and temporal RNFL thickness were strongly correlated (r(2) = 0.90, P < 0.001). In hexagon-by-hexagon analysis, all three mfERG measures were correlated (P < 0.001) with RGC+IPL thickness for Con (r(2), 0.33-0.51) and Exp eyes (r(2), 0.17-0.35). The RGC structural and functional metrics decreased as eccentricity increased. The reduction in amplitude of mfERG measures in Exp eyes relative to Con eyes was proportionally greater, in general, than the relative thinning of RGC+IPL at the same location for eyes in which structural loss was not evident, or mild to moderate. Although not statistically significant, percent amplitude reduction of mfERG measures was greatest in the inferior temporal quadrant.

CONCLUSIONS

Macular RGC+IPL thickness and mfERG measures of RGC function can be complementary tools in assessing glaucomatous neuropathy.

Alterations of photopic negative response of multifocal electroretinogram in patients with glaucoma

PURPOSE

To determine the effect of glaucoma on the multifocal electroretinograms (ERGs) (mfERGs) elicited by low-frequency stimuli.

METHODS

Forty-four patients with open-angle glaucoma and 15 normal subjects were studied. The stimulus frequency was 6.25 Hz, and the stimulus was a circle with a 6.8° radius that was centered on the fovea (center). MfERGs were also elicited by a quarter of an annulus placed around the macula (superior/temporal; inferior/temporal; superior/nasal; and inferior/nasal quadrants). The radius of the inner border of the annulus was 6.8° and that of the outer border was 20°. The actual sensitivity was determined by standard automated perimetry. The thickness of the ganglion cell complex (GCC) was measured by optical coherence tomography.

RESULTS

The mfERGs consisted of a negative wave (N1) followed by a positive wave (P1), and followed by a slow negative wave (N2). There were no significant differences in the response densities of N1 and P1 between the normal control and glaucomatous eyes in any areas. The N2 response density was significantly reduced with the severity of glaucoma in the center. There was a significant reduction even at an early stage of glaucoma compared to control values. In the center, the N2 response density was significantly correlated with the GCC thickness and mean sensitivity. However, in other stimulus areas, there was no significant reduction of any components of the mfERGs.

CONCLUSIONS

These results suggest that the N2 component of the slow-sequence mfERGs is affected by glaucoma in the central retinal area. Regional variations in the contribution of the retinal ganglion cell activity to the N2 should be considered when examining the mfERGs in glaucoma patients.

Assessment of neuroretinal function in a group of functional amblyopes with documented LGN deficits

PURPOSE

In this study we examine neuroretinal function in five amblyopes, who had been shown in previous functional MRI (fMRI) studies to have compromised function of the lateral geniculate nucleus (LGN), to determine if the fMRI deficit in amblyopia may have its origin at the retinal level.

METHODS

We used slow flash multifocal ERG (mfERG) and compared averaged five ring responses of the amblyopic and fellow eyes across a 35 deg field. Central responses were also assessed over a field which was about 6.3 deg in diameter. We measured central retinal thickness using optical coherence tomography. Central fields were measured using the MP1-Microperimeter which also assesses ocular fixation during perimetry. MfERG data were compared with fMRI results from a previous study.

RESULTS

Amblyopic eyes had reduced response density amplitudes (first major negative to first positive (N1-P1) responses) for the central and paracentral retina (up to 18 deg diameter) but not for the mid-periphery (from 18 to 35 deg). Retinal thickness was within normal limits for all eyes, and not different between amblyopic and fellow eyes. Fixation was maintained within the central 4° more than 80% of the time by four of the five participants; fixation assessed using bivariate contour ellipse areas (BCEA) gave rankings similar to those of the MP-1 system. There was no significant relationship between BCEA and mfERG response for either amblyopic or fellow eye. There was no significant relationship between the central mfERG eye response difference and the selective blood oxygen level dependent (BOLD) LGN eye response difference previously seen in these participants.

CONCLUSIONS

Retinal responses in amblyopes can be reduced within the central field without an obvious anatomical basis. Additionally, this retinal deficit may not be the reason why the LGN BOLD (blood oxygen level dependent) responses are reduced for amblyopic eye stimulation.

The effect of pentobarbital sodium and propofol anesthesia on multifocal electroretinograms in rhesus macaques

We compared the suitability of pentobarbital sodium (PB) and propofol (PF) anesthetics for multifocal electroretinograms (mfERGs) in rhesus macaques. mfERGs were collected from 4 ocularly normal rhesus macaques. All animals were pre-anesthetized with intramuscular ketamine (10-15 mg/kg). Intravenous PB induction/maintenance levels were 15 mg/kg/2-10 mg/kg and for PF, 2-5 mg/kg/6-24 mg/kg/h. There were 3 testing sessions with PB anesthesia and 5-7 testing sessions with PF anesthesia. All PB sessions were carried out before PF. First-order (K1) and second-order (first slice) kernels (K2.1) response density amplitude (RDA), implicit time (IT), and root mean square signal-to-noise ratios (RMS SNR) of the low-frequency (LFC) and high-frequency (HFC) components were evaluated. The use of PF or PB anesthesia resulted in robust, replicable mfERGs in rhesus macaques; however, RMS SNR of K1 LFC in ring and quadrant analyses was significantly larger for PF than for PB. Additionally, K1 RDA under PF was significantly larger than under PB for N1, P1, and P2 components (ring and quadrant) and for N2 (quadrant). PF IT was significantly prolonged (<1 ms) relative to PB IT for N1, P1 (ring), and N1 (quadrant), while PB IT was significantly prolonged (0.8-4.2 ms) relative to PF IT for N2 and P2 (ring and quadrant). K1 HFC and K2.1 LFC did not differ significantly between PB and PF in the ring or quadrant analyses. The response differences found with PB and PF anesthesia likely arise from variable relative effects of the anesthetics on retinal γ-aminobutyric acid (GABA(A)) receptors, and in part, on glycine and on glutamate receptors. Given the advantages of a stable anesthetic plane with continuous intravenous infusion and a smoother, more rapid recovery, PF is an appealing alternative for mfERG testing in rhesus macaques.

Effects of subretinal electrical stimulation in mer-KO mice

PURPOSE

Subretinal electrical stimulation (SES) from microphotodiode arrays protects photoreceptors in the RCS rat model of retinitis pigmentosa. The authors examined whether mer(kd) mice, which share a Mertk mutation with RCS rats, showed similar neuroprotective effects from SES.

METHODS

Mer(kd) mice were implanted with a microphotodiode array at postnatal day (P) 14. Weekly electroretinograms (ERGs) followed by retinal histology at week 4 were compared with those of age-matched controls. RT-PCR for fibroblast growth factor beta (Fgf2), ciliary nerve trophic factor (Cntf), glial-derived neurotrophic factor (Gdnf), insulin growth factor 1 (Igf1), and glial fibrillary acidic protein (Gfap) was performed on retinas at 1 week after surgery. Rates of degeneration using ERG parameters were compared between mer(kd) mice and RCS rats from P28 to P42.

RESULTS

SES-treated mer(kd) mice showed no differences in ERG a- and b-wave amplitudes or photoreceptor numbers compared with controls. However, the expression of Fgf2 and Cntf was greater (6.5 ± 1.9- and 2.5 ± 0.5-fold, respectively; P < 0.02) in SES-treated mer(kd) retinas. Rates of degeneration were faster for dark-adapted maximal b-wave, log σ, and oscillatory potentials in mer(kd) mice than in RCS rats.

CONCLUSIONS

Although SES upregulated Fgf2 in mer(kd) retinas, as reported previously for RCS retinas, this was not accompanied by neuroprotection of photoreceptors. Comparisons of ERG responses from mer(kd) mice and RCS rats across different ages showed inner retinal dysfunction in mer(kd) mice but not in RCS rats. This inner retinal dysfunction and the faster rate of degeneration in mer(kd) mice may produce a retinal environment that is not responsive to neuroprotection from SES.

Loss of the low-frequency component of the global-flash multifocal electroretinogram in primate eyes with experimental glaucoma

PURPOSE

To study relationships between glaucoma-sensitive components identified with frequency-domain analysis of global-flash multifocal electroretinogram (mfERG), regional retinal nerve fiber layer thickness (RNFLT), and local visual field sensitivity (VS).

METHODS

Eleven macaque monkeys, including four controls and seven with unilateral laser-induced trabecular meshwork scarification and ocular hypertension, were observed with optical coherence tomography (OCT), full-field light-adapted flash ERG, 103-hexagon global-flash mfERG (MFOFO), and static perimetry. The effects of experimental glaucoma on mfERG were assessed in the frequency domain. Relations between root mean square (RMS) amplitude of a glaucoma-sensitive frequency range and peripapillary RNFLT (standard 12° OCT circular scan), and between RMS amplitude and VS were studied.

RESULTS

Experimental glaucoma led to a dramatic and consistent power loss in the low-frequency (<25 Hz) band of mfERG. The RMS of this low-frequency component (LFC) correlated significantly with the regional RNFLT. The r(2) of linear fits was 0.39 (P < 0.001) for cross-sectional group data and 0.60 after correction for intersubject variability. The r(2) of linear fits for longitudinal data from individual animals was as high as 0.78 (P < 0.001). Local LFC RMS amplitude also correlated significantly with interpolated VS for hexagons. The r(2) for exponential fits of hexagon LFC RMS amplitudes (inner three rings) versus VS (dB) was 0.29 to 0.52 (P < 0.001) for the group and up to 0.95 in individuals.

CONCLUSIONS

The significant correlations between regional measures of global-flash mfERG, RNFLT, and VS suggest that LFC RMS amplitude provides a useful index for objective quantification of local RGC function and monitoring of early changes in glaucoma.

Multifocal ERG defects associated with insufficient long-term glycemic control in adolescents with type 1 diabetes

PURPOSE

To investigate the relationship between long-term glycemic control and localized neuroretinal function in adolescents with type 1 diabetes (T1D) without diabetic retinopathy (DR).

METHODS

Standard (103 hexagons) and slow-flash (61 hexagons) multifocal ERGs (standard mfERG and sf mfERG) were recorded in 48 patients and 45 control subjects. Hexagons with delayed responses were identified as abnormal. Negative binomial regression analysis was conducted with the number of abnormal hexagons as the outcome variable. Glycated hemoglobin (HbA(1c)) levels, time since diagnosis of T1D, age at diagnosis of T1D, age at testing, and sex were the covariates. Another model replacing HbA(1c) closest to the date of testing with a 1-year average was also generated.

RESULTS

There were more abnormal hexagons for mfOPs in patients than in control subjects (P = 0.005). There was no significant difference in the mean number of abnormal hexagons for standard mfERG responses between patients and control subjects (P = 0.11). Negative binomial regression analysis for the standard mfERG data demonstrated that a 1-unit increase in HbA(1c) was associated with an 80% increase in the number of abnormal hexagons (P = 0.002), when controlling for age at testing. Analysis using the 1-year HbA(1c) averages did not result in significant findings.

CONCLUSIONS

Poor long-term glycemic control is associated with an increase in areas of localized neuroretinal dysfunction in adolescents with T1D and no clinically visible DR. Stricter glucose control during the early stages of the disease may prevent neuroretinal dysfunction in this cohort.

Asymmetrical growth of the photopic hill during the light adaptation effect

In response to progressively stronger flashes delivered against a rod saturating background light, the amplitude of the photopic ERG b-wave first increases, reaches a maximal value (V (max)) and then decreases gradually to a plateau where the amplitude of the b-wave equals that of the a-wave, a phenomenon known as the photopic hill (PH). The purpose of this study was to investigate how the PH grew during the course of the light adaptation (LA) process that follows a period of dark adaptation (DA): the so-called light adaptation effect (LAE). Photopic ERG (time-integrated) luminance-response (LR) functions were obtained prior to (control-fully light adapted) and at 0, 5 and 10 min of LA following a 30-min period of DA. A mathematical model combining a Gaussian and a logistic growth function, suggested to reflect the OFF and ON retinal contribution to the PH respectively, was fitted to the LR functions thus obtained. Our results indicate that the magnitude of the cone ERG LAE is modulated by the stimulus luminance, with b-wave enhancements being maximal for luminance levels that result in the descent of the PH. The Gaussian function grew significantly with LA while the logistic growth function remained basically unchanged. Our findings would therefore suggest that the LAE reflects primarily an increase in the retinal OFF response during LA.

Topographical alterations of inner retinal activity during systemic hyperoxia-hypercapnia in normal subjects and patients with type 1 diabetes

The purpose of this study was to investigate whether an increase in the circulating oxygen supply can alter inner retinal function, assessed by recordings of multifocal oscillatory potentials. We studied 9 subjects with type 1 diabetes (8 without overt retinopathy, one with 2 microaneurysms) and 10 similar-aged normal subjects. The central 60 degrees of the retina was stimulated by an array of 61 hexagonal elements, and mfOP recordings were obtained while breathing room air or carbogen. First-order kernel analysis of the recordings shows 2 potentials (first-order OP1, OP2), whereas second-order kernel analysis produces 3 potentials (second-order OP1, OP2, OP3). Two methods were used to analyze the results: First, we performed a ring analysis for each subject and measured the amplitudes and latencies of the five potentials. We demonstrate that during carbogen inhalation, the control subjects, but not the patients with diabetes, showed significantly increased second-order OP3 amplitudes, for a retinal ring from around 1.8-13 degrees eccentricity. Secondly, a topographical analysis was performed on the amplitude of the second-order OP3 in all 61 traces (from the average recordings of each subject group), which revealed significant alterations not visible in a ring analysis. A similar topographical analysis of the amplitude of the first-order OP2 revealed a small increase in its amplitude during carbogen inhalation for both subject groups. This study demonstrates that some aspects of inner retinal function are modified by the inhalation of carbogen. The reduced effect of carbogen inhalation on the recordings from the patients with diabetes may be due to compromised vascular perfusion in these subjects.

Can central hexagon peak latency provide a clue to fixation within the mfERG

The mfERG has proven to be a useful tool in determining central retinal and macular function. It is, however, reliant on good subject co-operation and fixation. This cannot always be guaranteed due to visual impairment or poor co-operation. Whilst a change in fixation is easy to identify with camera monitoring of the subject, a small eccentric fixation can be difficult to notice or quantify. Whilst the problem of fixation can be obviated by stimulating the retina directly with SLO (Scanning Laser Ophthalmoscope), this is expensive and a certain amount of expertize in optics is required to properly stimulate the retina. In this study, peak latency of response was investigated to see whether it changed across the retina and whether this measure could be used to help assess fixation. Eighteen normal eyes were stimulated using a 60 Hz CRT monitor with only 2 hexagons, one central and one peripheral. These hexagons were presented at three stimulation rates, fast (no filler frames between steps of the m-sequence) and slow (4 and 7 black filler frames between each step of the m-sequence), under all conditions significantly increased central hexagon latencies were noted. In a smaller experiment with 19 hexagons and only 4 subjects, it was noted a significant delay in latency was observed in ring 1 compared to ring 2 and 3 with central fixation, but not when the subjects fixed mid-peripheral and in the periphery to slow stimulation, showing that the central hexagon response was only delayed in the central hexagon when there was adequate fixation. This study suggests that latency could provide a clue to fixation particular at slow rates thereby improving the quality and confidence of recordings made clinically.

The neurovascular retina in retinopathy of prematurity

The continuing worldwide epidemic of retinopathy of prematurity (ROP), a leading cause of childhood visual impairment, strongly motivates further research into mechanisms of the disease. Although the hallmark of ROP is abnormal retinal vasculature, a growing body of evidence supports a critical role for the neural retina in the ROP disease process. The age of onset of ROP coincides with the rapid developmental increase in rod photoreceptor outer segment length and rhodopsin content of the retina with escalation of energy demands. Using a combination of non-invasive electroretinographic (ERG), psychophysical, and image analysis procedures, the neural retina and its vasculature have been studied in prematurely born human subjects, both with and without ROP, and in rats that model the key vascular and neural parameters found in human ROP subjects. These data are compared to comprehensive numeric summaries of the neural and vascular features in normally developing human and rat retina. In rats, biochemical, anatomical, and molecular biological investigations are paired with the non-invasive assessments. ROP, even if mild, primarily and persistently alters the structure and function of photoreceptors. Post-receptor neurons and retinal vasculature, which are intimately related, are also affected by ROP; conspicuous neurovascular abnormalities disappear, but subtle structural anomalies and functional deficits may persist years after clinical ROP resolves. The data from human subjects and rat models identify photoreceptor and post-receptor targets for interventions that promise improved outcomes for children at risk for ROP.

Asymmetry of focal macular photopic negative responses (PhNRs) in monkeys

The photopic negative response (PhNR) is a slow, negative-going wave of the photopic electroretinogram (ERG) that appears after the b-wave. Recent studies have shown that the PhNR originates from the spiking activities of inner retinal neurons including the ganglion cells and their axons. The aim of this study was to determine whether there is any asymmetry in the amplitude of the PhNR elicited from the upper and lower macular areas, and between the nasal and temporal macular areas in rhesus monkeys. To accomplish this, we recorded focal macular PhNRs that were elicited by red hemi-circular stimuli presented on a blue background. We show that the PhNR from the upper macular area was significantly larger than that of the lower macular area, and the PhNR of the nasal macula was significantly larger than that of the temporal macula. These asymmetries were present in the focal PhNR elicited by both brief and long duration stimuli, and the asymmetries were completely eliminated by an intravitreal injection of tetrodotoxin (TTX). These results suggest that the upper-lower and nasal-temporal asymmetries of PhNR in the primate retina are mainly caused by TTX-sensitive spiking activities of inner retinal neurons.

Gamma, fast, and ultrafast waves of the brain: their relationships with epilepsy and behavior

Gamma waves, defined as rhythms from 25 to 100 Hz, are reviewed along with fast (100-400 Hz) and ultrafast (400-800 Hz) activity. Investigations on animals, especially those involving interneurons from the hippocampus, are reviewed. Gamma waves and fast rhythms likely play a role in neural communication, reflecting information from the external world to the brain. These rhythms become evident when the GABA-A system shifts from excitation to inhibition; are seen mainly in the hippocampus, the dentate gyrus, and CA(1)-CA(3) system; and are likely involved in long-term memory and cognitive task performance. These waves are also involved in spreading depression, but especially with epileptiform activity, progressively increasing in frequency from the pre-ictal to the ictal state. After status epilepticus, their presence predicts the development of spontaneous seizures. Gamma waves and fast activity have been studied in all sensory modalities, especially visual systems, providing a mechanism for awareness and processing of visual objects. In humans, gamma waves develop in the young, peak at 4-5 years of age, and are observed especially during alertness and after sensory stimulation. These fast rhythms are seen in the majority of seizures, especially in infantile spasms and during ictal activity in extratemporal and regional onsets, and, if low in amplitude, seem to be a good prognostic sign after seizure surgery. They have been studied in all sensory systems and are associated with selective attention, transient binding of cognitive features, and conscious perception of the external world.

Relative course of retinal nerve fiber layer birefringence and thickness and retinal function changes after optic nerve transection

PURPOSE

To test the hypothesis that alterations of RNFL birefringence precede changes in RNFL thickness in an experimental model of RGC injury and, secondarily, to determine the time course of RGC functional abnormalities relative to RNFL birefringence and thickness changes.

METHODS

RNFL birefringence was measured by scanning laser polarimetry (GDx VCC; Carl Zeiss Meditec, Inc., Dublin, CA). RNFL thickness was measured by spectral domain optical coherence tomography (SD-OCT, Spectralis HRA+OCT; Heidelberg Engineering, GmbH, Heidelberg, Germany). Retinal function was assessed by three forms of electroretinography (ERG): slow-sequence multifocal (mf)ERG (VERIS; EDI, San Mateo, CA); pattern-reversal (P)ERG (Utas-E3000; LKC Technologies, Inc. Gaithersburg, MD); and photopic full-field flash (ff)ERG (Utas-E3000; LKC Technologies). All measurements were obtained in both eyes of four adult rhesus macaque monkeys (Macaca mulatta) during two baseline sessions, and again 1 week and 2 weeks after unilateral optic nerve transection (ONT).

RESULTS

ONT was successfully completed in three subjects. RNFL birefringence declined by 15% 1 week after ONT (P = 0.043), whereas there was no significant change in RNFL thickness (+1%, P = 0.42). Two weeks after ONT, RNFL retardance had declined by 39% (P = 0.018), whereas RNFL thickness had declined by only 15% (P = 0.025). RGC functional abnormalities were present 1 week after ONT, including decreased amplitudes relative to baseline of the mfERG high-frequency components (-65%, P = 0.018), the PERG N95 component (-70%, P = 0.007), and the photopic negative response of the ffERG (-44%, P = 0.005).

CONCLUSIONS

RNFL birefringence declined before and faster than RNFL thickness after ONT. RGC functional abnormalities were present 1 week after ONT, when RNFL thickness had not yet begun to change. RNFL birefringence changes after acute RGC injury are associated with RGC dysfunction. Together, they reflect RGC abnormalities that precede axonal caliber changes and loss.

Contribution of voltage-gated sodium channels to the b-wave of the mammalian flash electroretinogram

Voltage-gated sodium channels (Na(v) channels) in retinal neurons are known to contribute to the mammalian flash electroretinogram (ERG) via activity of third-order retinal neurons, i.e. amacrine and ganglion cells. This study investigated the effects of tetrodotoxin (TTX) blockade of Na(v) channels on the b-wave, an ERG wave that originates mainly from activity of second-order retinal neurons. ERGs were recorded from anaesthetized Brown Norway rats in response to brief full-field flashes presented over a range of stimulus energies, under dark-adapted conditions and in the presence of steady mesopic and photopic backgrounds. Recordings were made before and after intravitreal injection of TTX (approximately 3 microm) alone, 3-6 weeks after optic nerve transection (ONTx) to induce ganglion cell degeneration, or in combination with an ionotropic glutamate receptor antagonist 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX, 200 microm) to block light-evoked activity of inner retinal, horizontal and OFF bipolar cells, or with the glutamate agonist N-methyl-D-aspartate (NMDA, 100-200 microm) to reduce light-evoked inner retinal activity. TTX reduced ERG amplitudes measured at fixed times corresponding to b-wave time to peak. Effects of TTX were seen under all background conditions, but were greatest for mesopic backgrounds. In dark-adapted retina, b-wave amplitudes were reduced only when very low stimulus energies affecting the inner retina, or very high stimulus energies were used. Loss of ganglion cells following ONTx did not affect b-wave amplitudes, and injection of TTX in eyes with ONTx reduced b-wave amplitudes by the same amount for each background condition as occurred when ganglion cells were intact, thereby eliminating a ganglion cell role in the TTX effects. Isolation of cone-driven responses by presenting test flashes after cessation of a rod-saturating conditioning flash indicated that the TTX effects were primarily on cone circuits contributing to the mixed rod-cone ERG. NMDA significantly reduced only the additional effects of TTX on the mixed rod-cone ERG observed under mesopic conditions, implicating inner retinal involvement in those effects. After pharmacological blockade with CNQX, TTX still reduced b-wave amplitudes in cone-isolated ERGs indicating Na(v) channels in ON cone bipolar cells themselves augment b-wave amplitude and sensitivity. This augmentation was largest under dark-adapted conditions, and decreased with increasing background illumination, indicating effects of background illumination on Na(v) channel function. These findings indicate that activation of Na(v) channels in ON cone bipolar cells affects the b-wave of the rat ERG and must be considered when analysing results of ERG studies of retinal function.

The oscillatory potentials of the dark-adapted electroretinogram in retinopathy of prematurity

PURPOSE

To study the development of the electroretinographic (ERG) oscillatory potentials (OPs) in two rat models of ROP and in human subjects with a history of ROP.

METHODS

Sprague-Dawley rats (n = 36) were studied longitudinally. Rat models of ROP were induced, either by exposure to alternating 50%/10% oxygen (50/10 model) from postnatal day (P) 0 to P14 or by exposure to 75% oxygen (75 model) from P7 to P14. Control rats were reared in room air. Infant and adult human subjects with and without a history of ROP (n = 91) were also studied. Dark-adapted ERGs were recorded and filtered to demonstrate the OPs. Discreet Fourier transform (DFT) allowed evaluation of the OP power spectrum. OP energy (E), dominant frequency (F(peak)), and sensitivity (log i(1/2)) were evaluated.

RESULTS

In 50/10 model rats, E was low compared with that in the 75 model rats and control animals. F(peak) (approximately 95 Hz) did not vary with age or group. Intriguingly, log i(1/2) in 75 model rats was greater than that in controls or 50/10 model rats. Human adults with a history of ROP had lower-energy OPs than did the control adults, but infants with a history of ROP had higher-energy OPs than did the control infants. F(peak) was lower (approximately 120 Hz) in infants than in adults (approximately 130 Hz). ROP did not affect log i(1/2) in humans.

CONCLUSIONS

Differences between OPs in healthy rats and healthy humans were substantial, suggesting that OPs in rat models of ROP are unlikely to provide insight into the effects of ROP on human OPs. Indeed, neither ROP model studied showed a pattern of effects similar to that in human ROP.

Wavelet analysis reveals dynamics of rat oscillatory potentials

We characterised the dynamics in the oscillatory potentials (OPs) of the rat electroretinogram (ERG) using a continuous complex Morlet wavelet transform. Dark-adapted (>12h) full field ERG responses were recorded from five anaesthetized (ketamine:xylazine, 60:5mg/kg) adult Long-Evans rats (10-12weeks). Five responses were obtained for brief LED flashes (1-4ms) in a ganzfeld at exposures ranging from -4.2 to 1.58logcdsm(-2). Signals were recorded across a bandwidth of 0.3-1kHz and digitized at 10kHz. Morlet wavelets with frequencies between 50 and 250Hz were correlated with raw ERG signals at 1ms intervals. The amplitude of the correlation at each time and frequency was given by the modulus of the complex wavelet response. Candidate OPs were identified as local peaks within 10% of the maximum amplitude. As flash exposure increased, the amplitude of the OP response increased, the peak OP occurred earlier, and the peak OP frequency increased. OPs at brighter flashes clustered into two groups, peaking at 50ms in the 70 and 130Hz band for moderate intensities, and peaking at 20ms in the 70Hz band and 50ms in the 120Hz band for the highest intensities (>0logcdsm(-2)). These dynamics agree with physiological, pharmacological and clinical studies that suggest several distinct neural mechanisms contribute to OPs. Wavelet analysis reveals important dynamics in OP data that are not evident with traditional analytical approaches.

Effects of Spectral Characteristics of Ganzfeld Stimuli on the Photopic Negative Response (PhNR) of the ERG

PURPOSE

To determine flash and background colors that best isolate the photopic negative response (PhNR) and maximize its amplitude in the primate ERG.

METHODS

Photopic full-field flash ERGs were recorded from anesthetized macaque monkeys before and after pharmacologic blockade of Na(+)-dependent spiking activity with tetrodotoxin (TTX, 1 to 2 muM, n = 3), blockade of ionotropic glutamatergic transmission with cis-2,3 piperidine dicarboxylic acid (PDA, 3.3-3.8 mM, n = 3) or laser-induced monocular experimental glaucoma (n = 6), and from six normal human subjects. Photopically matched colored flashes of increasing stimulus strengths were presented on scotopically matched blue, white, or yellow backgrounds of 100 scot cd/m(2) using an LED-based stimulator.

RESULTS

PhNRs that could be eliminated by TTX or severe experimental glaucoma were present in responses to brief (<5 ms) and long-duration (200 ms) stimuli of all color combinations. In normal monkey and human eyes for brief low-energy flashes, PhNR amplitudes were highest for red flashes on blue backgrounds and blue flashes on yellow backgrounds. For high-energy flashes, amplitudes were more similar for all color combinations. For long-duration stimuli, the PhNR(on) at light onset in monkeys was larger for red and blue stimuli, regardless of background color, than for spectrally broader flashes, except for stimuli >17.7 cd/m(2) when PhNR(on)s were all of similar amplitude. For red flashes, eliminating the PhNR(on) pharmacologically or by glaucoma removed the slowly recovering negative wave that normally followed the transient b-wave and elevated the whole ON response close to the level of the b-wave peak. However, for white, blue, and green flashes, a lower-amplitude plateau that could be removed by PDA remained.

CONCLUSIONS

For weak to moderate flash strengths, the best stimulus for maximizing PhNR amplitude is one that primarily stimulates one cone type, on a background with minimal adaptive effect on cones. For stronger stimuli, differences in amplitude are smaller. For long-duration stimuli, red best isolates the PhNR(on) because it minimizes the overlapping lower-level plateau that originates from the activity of second-order hyperpolarizing retinal neurons.

Oscillatory potentials of the slow-sequence multifocal ERG in primates extracted using the Matching Pursuit method

This study used the Matching Pursuit (MP) method, a time-frequency analysis, to identify and characterize oscillatory potentials (OPs) in the primate electroretinogram (ERG). When the slow-sequence mfERG from the macular region of the retina was matched with Gabor functions, OPs were identified in two distinct bands: a high-frequency band peaking around 150 Hz that contributes to early OPs, and a low-frequency band peaking around 80 Hz that contributes to both early and late OPs. Pharmacological blockade and experimental glaucoma studies showed that the high-frequency OPs depend upon sodium-dependent spiking activity of retinal ganglion cells, whereas the low-frequency OPs depend primarily upon non-spiking activity of amacrine cells, and more distal retinal activity.

Neuronal adaptation in the human retina: a study of the single oscillatory response in dark adaptation and mesopic background illumination

PURPOSE

The single oscillatory response in complete dark adaptation (DA) and the effect of mesopic illumination were studied in order to investigate the behaviour of the neuronal adaptation system as reflected in the oscillatory potentials (OPs) of the electroretinogram (ERG).

METHODS

The rapid oscillatory and slow components (a- and b-waves) of single ERGs were simultaneously recorded in nine healthy, young subjects in response to first flash after both DA of 45 mins and light adaptation to a steady background light (BGL) of low mesopic intensity.

RESULTS

Two low-amplitude oscillatory peaks were present in the single response to the first flash recorded in DA. There was no increase in the summed amplitudes of the OPs (SOP) when recorded in the single response to the first flash in mesopic BGL. However, the morphology of the oscillatory response altered. The first OP was reduced and a third oscillatory peak appeared.

CONCLUSIONS

We conclude that early, scotopically related OPs may indeed be activated in the single response to the first flash in DA (i.e. without using conditioning flashes). Secondly, on its own, adaptation to mesopic BGL does not seem to trigger enhancement of the overall oscillatory response. The altered single oscillatory response to the first flash apparent in the mesopic BGL comprises a third cone-associated OP and seems to reflect a reorganization of the retinal microcircuitry from a predominantly rod-activated system to one of mixed rod/cone neuronal activity in the inner part of the retina at the level at which individual OPs have their respective origins.

The multifocal electroretinogram (mfERG) in the pig

PURPOSE

To establish a method allowing multifocal electroretinography (mfERG) recording with simultaneous fundus monitoring on anaesthetized pigs. In addition we characterize the peaks of the porcine mfERG trace, and compare the visual streak area with the optic nerve head, a known non-response area. Finally we illustrate the feasibility of the method by performing mfERG after an induced laser burn in the visual streak.

METHODS

Fifteen pigs underwent mfERG recordings at baseline, and after 1 and 6 weeks of observation. One pig was evaluated before and after retinal diode laser treatment in the visual streak.

RESULTS

The porcine mfERG trace appears similar to the human mfERG trace, and can be described by three peaks named N1, P1 and N2. Significantly faster implicit time was found in the visual streak regarding N1 (P < 0.001) than in areas outside the visual streak. Amplitudes of all three peaks were increased in the visual streak (P < 0.005). The laser-treated area was characterized by a response similar to what is found at the location of the optic nerve head.

CONCLUSION

Porcine mfERG is similar in appearance to the human response and can be described by the same three peaks. Significantly higher amplitudes of all three peaks are found in the visual streak when compared to the optic nerve head and inferior retina. We have detected the functional deficit caused by a laser burn at the size of 3 x 3 mm.

Evaluation of inner retinal function in myopia using oscillatory potentials of the multifocal electroretinogram

PURPOSE

Oscillatory potentials have been suggested to arise from the inner retina at the level of amacrine cells and inner plexiform layer and they are thought to provide a non-invasive assessment of inner retinal function. We sought to investigate the response dynamics of the inner retina of adult emmetropes and myopes by analysing the oscillatory potentials of the multifocal electroretinogram (mfERG) in these groups.

METHODS

Eleven emmetropes and 18 myopes underwent mfERG testing using VERIS 5.1.5X. Myopes were further separated based on whether their myopia was stable (n=9) or progressing (n=9). Oscillatory potentials were recorded using a modified mfERG stimulation technique, the slow flash paradigm, and they were extracted using band-pass filtering from 100 to 300 Hz. The slow flash mfERG stimulus array consisted of 103-scaled hexagons and flickered according to a pseudorandom binary m-sequence (2(13)-1). Amplitudes and implicit times of the first-order oscillatory potentials were analysed.

RESULTS

There were significant differences in the implicit time of the oscillatory potentials of the emmetropes, stable myopes and progressing myopes (F(2,25)=3.663, p=0.043). Progressing myopes had significantly shorter implicit times compared to emmetropes (p=0.026 by 1.0-4.7 ms) and stable myopes (p=0.043 by 0.8-1.3 ms), whereas implicit times of stable myopes and emmetropes were similar. There were no statistically significant differences in amplitude of the oscillatory potentials between the groups (F(2,25)=0.890, p=0.426).

CONCLUSIONS

Significant differences in multifocal oscillatory potentials between stable and progressing myopes were found. This finding is further evidence of an inner retinal involvement in human myopia progression and may suggest an underlying alteration to dopaminergic or GABAergic retinal systems.

Effect of spatial frequency of stimulus on focal macular ERGs in monkeys : fmacERG dependence on the spatial-frequency

PURPOSE

To determine the effect of the spatial frequency of a small grating stimulus centered on the macula on the focal macular ERGs (fmacERGs) of monkeys.

METHODS

fmacERGs were recorded from eight eyes of four adult monkeys (Macaca fuscata). The spatial frequency of the stimulus was changed from 0.25 to 8 cycles/degree. The luminance of the light bars was 10 cd/m(2), and the contrast was 95%. The stimulus was flashed on and off with an on duration of 100 ms and an off duration of 150 ms (4 Hz). The stimulus was centered on the fovea and subtended 12.7 degrees at the cornea. The luminance of the steady light-adapting background was 3.5 cd/m(2). The location of the stimulus on the retina was monitored throughout the recordings. The effects of the spatial frequency of the stimulus on the amplitudes and implicit times of the a-waves, b-waves, and oscillatory potentials (OPs) were determined. fmacERGs were also recorded following intravitreal tetrodotoxin (TTX).

RESULTS

The amplitudes of the a- and b-waves did not change with changes in the spatial frequency of the stimulus. The OPs, on the other hand, responded best to the lowest spatial frequency, and the OPs after the first two were attenuated at intermediate and higher frequencies (Wilcoxon signed-rank test: P < 0.05). TTX reduced all OP wavelets in monkeys.

CONCLUSIONS

The OPs of the photopic macular ERGs are affected by the spatial frequency of the stimulus and are reduced by TTX, consistent with their being generated by inner retinal neurons.

L:M-cone ratio estimates of the outer and inner retina and its impact on sex differences in ERG amplitudes

The relative number of L- and M-cones varies greatly between individuals. Differences in the relative number of L- and M-cones may also contribute to the sex difference in the ERG response amplitude reported several times. We therefore investigated the relative number of L- and M-cones and its impact on sex differences in ERG amplitudes. Multifocal ERG (mfERG) and multifocal oscillatory potentials (mfOP) combined with a cone silent substitution technique were used to investigate outer and inner retinal signals recorded from 7 female and 7 male trichromats. L:M ratios were estimated from peak amplitude as well as from area under curve (AUC) analysis. For mfERGs the L:M ratios estimates were independent of the method of analysis, while for mfOPs, differences were found which are possibly due to an artefact in the calculation of ratios for small responses. There was a tendency for lower L:M ratios in female than in male subjects for both analysis of mfERG and mfOP responses. The (L+M)-response amplitudes at both sites were slightly higher and the L:M ratios were lower for female than for male observers. Because the magnitude of the ERG amplitude differences is larger than could be explained by L:M-ratio and axial length differences, we conclude that it may be due to a direct effect of sex hormones on ion channel function.

A multifocal electroretinogram model predicting the development of diabetic retinopathy

The prevalence of diabetes has been accelerating at an alarming rate in the last decade; some describe it as an epidemic. Diabetic eye complications are the leading cause of blindness in adults aged 25-74 in the United States. Early diagnosis and development of effective preventatives and treatments of diabetic retinopathy are essential to save sight. We describe efforts to establish functional indicators of retinal health and predictors of diabetic retinopathy. These indicators and predictors will be needed as markers of the efficacy of new therapies. Clinical trials aimed at either prevention or early treatments will rely heavily on the discovery of sensitive methods to identify patients and retinal locations at risk, as well as to evaluate treatment effects. We report on recent success in revealing local functional changes of the retina with the multifocal electroretinogram (mfERG). This objective measure allows the simultaneous recording of responses from over 100 small retinal patches across the central 45 degrees field. We describe the sensitivity of mfERG implicit time measurement for revealing functional alterations of the retina in diabetes, the local correspondence between functional (mfERG) and structural (vascular) abnormalities in eyes with early nonproliferative retinopathy, and longitudinal studies to formulate models to predict the retinal sites of future retinopathic signs. A multivariate model including mfERG implicit time delays and 'person' risk factors achieved 86% sensitivity and 84% specificity for prediction of new retinopathy development over one year at specific locations in eyes with some retinopathy at baseline. A preliminary test of the model yielded very positive results. This model appears to be the first to predict, quantitatively, the retinal locations of new nonproliferative diabetic retinopathy development over a one-year period. In a separate study, the predictive power of a model was assessed over one- and two-year follow-ups. This permitted successful prediction of new retinopathy development in eyes with and without retinopathy at baseline. Finally, we briefly describe our current research efforts to (a) locally predict future sight-threatening diabetic macular edema, (b) investigate local retinal function change in adolescent patients with diabetes, and (c) better understand the physiological bases of the mfERG delays. The ability to predict the retinal locations of future retinopathy based on mfERG implicit time provides clinicians a powerful tool to screen, follow-up, and even consider early prophylactic treatment of the retinal tissue in diabetic patients. It also aids identification of 'at risk' populations for clinical trials of candidate therapies, which may greatly reduce their cost by decreasing the size of the needed sample and the duration of the trial.

The s-Wave of the Multifocal Electroretinogram in Cats

PURPOSE

To characterize the s-wave of the multifocal electroretinogram (mfERG) in cats, and to determine the contribution of the inner retina to the s-wave by examining the effects of tetrodotoxin (TTX) and N-methyl D: -aspartate (NMDA) injected into the vitreous cavity.

METHODS

mfERGs were recorded from 15 eyes of 15 male cats under general anesthesia. The stimulus consisted of 37 elements, and the luminance of the bright and the black elements were 200 and 4 cd/m2, respectively. The stimuli were presented in a pseudorandom binary m-sequence at six different base periods (bpds) from 13.3 to 426.7 ms. Fifty microliters of 7.0 microM TTX followed by 50 microl of 4.0 mM NMDA were injected into the vitreous cavity.

RESULTS

The shape of the mfERGs in the cats resembled that in humans. The s-wave appeared on the descending limb of P1, as seen in human mfERGs, in 11 eyes, and the s-wave amplitude increased significantly as the bpd was increased. TTX and NMDA resulted in the disappearance of the s-wave at all bpds, while the amplitude of P1 remained unchanged.

CONCLUSIONS

The s-wave is present in the mfERG in the cat, and its loss following injections of TTX and NMDA supports the view that the s-wave reflects the function of the ganglion cells and their axons.

Examination of short binary sequences for mfERG recording

The mfERG, when first introduced by Erich Sutter used long sequences with short periods (approximately 15 ms) between steps (flashes). Since then a number of studies have introduced slower or modified sequences to emphasise Oscillatory Potentials (OPs), Optic Nerve Head Components (ONHC) or the s-wave. With this reduction in the rate of presentation many of the investigators have reduced the length of the sequence to allow a shorter recording period. This is also desirable for patient comfort and co-operation in diagnostic investigations. When reducing the length of the sequence there is a risk that it will be too short to ensure orthogonality of the first order component and all significant higher order components, particularly when a large number of areas (hexagons) are stimulated. This paper aims to verify that a short sequence (using the sequence used by the Roland Retiscan stimulating 19 hexagons) is capable of keeping responses of both first and higher orders separate for each stimulating area. The sequence was investigated by placing photodiodes connected to a Diagnosys Espion and then exported to Excel and MATLAB for analysis. It was determined that the sequences used were m-sequences length n = 9. The photodiode only responded to flashes of light so was unable to detect a correcting 0 at the end of sequence. The sequences driving each hexagon were then determined and found to be shifted 26 steps from each other. The correlation coefficients between all sequences was found to be -1/(2n -1). The sequences to decode the second order kernels were determined and the correlation coefficients between each of these sequences, and between these and the original sequences, were also -1/(2n -1). This work provides a mathematical validation of the use of short sequences for slow mfERG, and describes an empirical test method.

Changes in implicit time of the multifocal electroretinogram response following contrast adaptation

PURPOSE

Contrast adaptation, produced by prolonged viewing of high contrast gratings, has been suggested to occur at both retinal and cortical locations within the visual pathway. We sought to investigate the characteristics of retinal contrast adaptation using the multifocal electroretinogram (mfERG).

METHODS

Twenty subjects, with a mean age of 27.8 +/- 5.3 years, underwent mfERG testing using VERIS I. The mfERG was measured after 10 minutes of adaptation to 94% contrast, 5 cyc/deg, sinusoidal, vertical gratings and to an equi-luminance blank control. The mfERG stimulus array consisted of 61-scaled hexagons and flickered according to a pseudorandom binary m-sequence (213-1). Changes in amplitude and implicit time of the first-order kernel were analyzed to determine the effect of contrast adaptation on retinal responses.

RESULTS

Adaptation to the vertical grating pattern produced a 2.5 ms increase in implicit time, and the response delay was greatest in the more peripheral parts of the retina (7.6 degrees to 30 degrees ). Contrast adaptation did not produce statistically significant changes to the amplitude of the mfERG waveform.

CONCLUSIONS

Contrast adaptation produced by prolonged viewing of high contrast gratings had a significant effect on retinal responses. It has been suggested that contrast adaptation may play a role in the development of nearwork induced myopia; further work investigating retinal contrast adaptation in myopic individuals may be of interest.

ERG oscillatory potentials in infants

PURPOSE

Study the scotopic and photopic oscillatory potentials (OPs) of the electroretinogram (ERG) in 10-week old infants.

METHODS

Term-born 10-week old infants (n = 15) and adults (n = 12) were tested. Full-field ERGs were recorded under scotopic and photopic conditions. The records were filtered (75-300 Hz) to demonstrate the oscillatory wavelets. The amplitudes and implicit times of the infants' OPs were compared to those in adults and also to amplitudes of the saturated photoreceptor responses.

RESULTS

In infants, the mean OP amplitudes are similar in scotopic and photopic conditions and do not vary significantly with OP number. Infants' OPs are significantly smaller than in adults, with scotopic OPs averaging 19% of that in adults and photopic OPs averaging 47%, whereas the amplitudes of the saturated photoreceptor responses are 43% and 66% of those in adults. Mean interpeak intervals are similar in infants and adults, indicating oscillatory behavior at a frequency of 155 Hz in scotopic conditions and 135 Hz in photopic conditions.

CONCLUSIONS

In young infants, the OPs are relatively immature compared to the photoreceptor responses, with the immaturity of the scotopic responses being more marked than that of the photopic responses.