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Dysli M, Abegg M, Kerkeni H, Kalla R, Tappeiner C. Unilateral corneal arcus and conjunctival vessel alterations in cranial autonomic dysregulation: A case report. Eur J Ophthalmol 2023; 33:NP91-NP94. [PMID: 36325686 DOI: 10.1177/11206721221136426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
BACKGROUND Cranial autonomic dysregulation is a common symptom of patients suffering from cluster headache or migraine. The peripheral vascular dysfunction may increase the risk for ischemic or hemorrhagic strokes, myocardial infarction, retinal vasculopathy, cardiovascular mortality, and peripheral artery diseases. Furthermore, it may also manifest with ocular symptoms, e.g., increased lacrimation, conjunctival injection, and facial swelling. CASE PRESENTATION We here report a case of a patient with migraine and ocular signs of a vascular dysregulation that have led to persisting changes of conjunctival vessels and to a corneal arcus. CONCLUSIONS Autonomic vascular dysregulation may not only cause headaches but also persisting changes of ocular tissues, e.g., conjunctival vessel alterations and a corneal arcus.
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Affiliation(s)
- Muriel Dysli
- Department of Ophthalmology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Mathias Abegg
- Department of Ophthalmology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Hassen Kerkeni
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Roger Kalla
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Christoph Tappeiner
- Department of Ophthalmology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
- Department of Ophthalmology, Pallas Kliniken, Olten, Switzerland
- Department of Ophthalmology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
- Department of Ophthalmology, San Raffaele Scientific Institute, University Vita-Salute, Milan, Italy
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2
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Bruegger D, Grabe HM, Vicini R, Dysli M, Lussi D, Abegg M. Detection of Relative Afferent Pupillary Defects Using Eye Tracking and a VR Headset. Transl Vis Sci Technol 2023; 12:22. [PMID: 37367721 PMCID: PMC10309159 DOI: 10.1167/tvst.12.6.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 06/01/2023] [Indexed: 06/28/2023] Open
Abstract
Purpose The purpose of this study was to assess the feasibility of detecting relative afferent pupillary defects (RAPDs) using a commercial virtual reality headset equipped with an eye tracker. Methods This is a cross-sectional study in which we compare the new computerized RAPD test with the traditional clinical standard using the swinging flashlight test. Eighty-two participants including 20 healthy volunteers aged 10 to 88 years were enrolled in this study. We present a bright/dark stimulus alternating between the eyes every 3 seconds using a virtual reality headset, and we simultaneously record changes in pupil size. To determine the presence of an RAPD, we developed an algorithm analyzing the pupil size differences. For the assessment of the performance of the automated and the manual measurement a post hoc impression based on all available data is created. The accuracy of the manual clinical evaluation and the computerized method is compared using confusion matrices and the gold standard of the post hoc impression. The latter is based on all available clinical information. Results We found that the computerized method detected RAPD with a sensitivity of 90.2% and an accuracy of 84.4%, as compared to the post hoc impression. This was not significantly different from the clinical evaluation with a sensitivity of 89.1% and an accuracy of 88.3%. Conclusions The presented method offers an accurate, easy to use, and fast method to measure an RAPD. In contrast to today's clinical practice, the measures are quantitative and objective. Translational Relevance Computerized testing of Relative Afferent Pupillary Defects (RAPD) using a VR-headset and eye-tracking reaches non-inferior performance compared with senior neuro-ophthalmologists.
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Affiliation(s)
- Dominik Bruegger
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences (GCB), University of Bern, Bern, Switzerland
| | - Hilary M. Grabe
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Rino Vicini
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Muriel Dysli
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - David Lussi
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Mathias Abegg
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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3
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Petroulia VD, Brügger D, Hoepner R, Vicini R, Winklehner A, Abegg M, Wagner F. MRI signs helpful in the differentiation of patients with anterior ischaemic optic neuropathy and optic neuritis. Br J Ophthalmol 2023; 107:121-126. [PMID: 34281903 DOI: 10.1136/bjophthalmol-2021-319537] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 07/01/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND/AIMS The aim of this study was to identify specific MRI characteristics of anterior ischaemic optic neuropathy (AION) and optic neuritis (ON) that would aid in the differentiation between these two diagnoses. METHODS We retrospectively analysed a consecutive case series including all patients with an MRI study of brain and orbit and the clinical diagnosis of either ON or AION. We examined the scans for restricted diffusion of the optic nerve, optic sheath diameter, enhancement and location of enhancement of the optic nerve and distribution of the white matter lesions. RESULTS Fifty patients met the inclusion criteria. We found an accuracy of 0.98 for the discrimination between AION and ON based solely on parameters extracted from MRI data. Dominance analysis to determine the most influential parameters showed that the enhancement pattern of the optic nerve and distribution of the white matter lesions had the biggest impact on the classification and led to a discrimination accuracy of 0.9 when used alone. CONCLUSION In patients with an inconclusive clinical diagnosis, optic nerve enhancement pattern and distribution of white matter lesions can aid in the diagnosis and differentiation between AION and ON. Diffusion-weighted imaging did not add significant information to the diagnosis or help to differentiate between the two conditions.
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Affiliation(s)
| | - Dominik Brügger
- Ophthalmology, Inselspital University Hospital Bern, Bern, Switzerland
| | - Robert Hoepner
- Neurology, Inselspital University Hospital Bern, Bern, Switzerland
| | - Rino Vicini
- Ophthalmology, Inselspital University Hospital Bern, Bern, Switzerland
| | - Anna Winklehner
- Diagnostic and Interventional Neuroradiology, Inselspital University Hospital Bern, Bern, Switzerland
| | - Mathias Abegg
- Ophthalmology, University of Bern, Bern, Switzerland
| | - Franca Wagner
- Diagnostic and Interventional Neuroradiology, Inselspital University Hospital Bern, Bern, Switzerland
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Runge AK, Remlinger J, Abegg M, Ferrazzini T, Brügger D, Weigt-Usinger K, Lücke T, Gold R, Salmen A. Retinal layer segmentation in a cohort of healthy children via optical coherence tomography. PLoS One 2022; 17:e0276958. [PMID: 36327296 PMCID: PMC9632928 DOI: 10.1371/journal.pone.0276958] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Abstract
Background High-resolution optical coherence tomography (OCT) allows the detection of macular pathology and involvement of the optic nerve in a wide spectrum of diseases. For the differentiation of diseased and healthy status, normal values of retinal layer segmentation are critical. Yet, normative values mostly cover adult populations with only sparse data for paediatric cohorts. We present data of retinal layer characteristics via OCT in a healthy paediatric cohort. Methods This prospective cross-sectional study screened 75 healthy children (male = 42, female = 33, range 4–17 years) without visual problems. OCT was performed with a peripapillary ring and macula scan protocol to determine paediatric normative values for routine parameters (peripapillary retinal nerve fibre layer thickness (pRNFL), total macular volume (TMV), macular retinal thickness (RT)). The macula scan (6mm grid) was segmented using the device-inherent automated segmentation software (Heidelberg Eye Explorer) for retinal layers: RNFL, ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL) in 9 segments each and mean of the 9 segments. Results We obtained OCT data of 72 children with mean age 12.49 years (standard deviation, SD, 2.18; minimum 3.93). Mean global pRNFL was 102.20 μm (SD 8.24), mean TMV 8.81 mm3 (0.30) and mean RT (all segments) 318.22 μm (10.19). Segmented macular retinal layer thicknesses (mean of all segments) were: RNFL 27.67 μm (2.14), GCL 41.94 μm (2.50), IPL 34.97 μm (2.10), INL 35.18 μm (2.15), OPL 29.06 μm (2.24), ONL 68.35 μm (6.20). Conclusion The OCT is a useful non-invasive imaging technique for the examination of the retina in children with short duration, high imaging resolution and no known adverse effects. Normative values may serve as a comparator for different neuropaediatric disorders and are first presented with this study using an up-to-date and standardized OCT imaging technique.
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Affiliation(s)
- Anna-Katharina Runge
- Department of Neurology, Inselspital, Bern University Hospital, and Department of Biomedical Research, University of Bern, Bern, Switzerland.,Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jana Remlinger
- Department of Neurology, Inselspital, Bern University Hospital, and Department of Biomedical Research, University of Bern, Bern, Switzerland.,Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Mathias Abegg
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Thomas Ferrazzini
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Dominik Brügger
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Thomas Lücke
- Department of Neuropaediatrics, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Ralf Gold
- Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Anke Salmen
- Department of Neurology, Inselspital, Bern University Hospital, and Department of Biomedical Research, University of Bern, Bern, Switzerland.,Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
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5
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Petzold A, Fraser CL, Abegg M, Alroughani R, Alshowaeir D, Alvarenga R, Andris C, Asgari N, Barnett Y, Battistella R, Behbehani R, Berger T, Bikbov MM, Biotti D, Biousse V, Boschi A, Brazdil M, Brezhnev A, Calabresi PA, Cordonnier M, Costello F, Cruz FM, Cunha LP, Daoudi S, Deschamps R, de Seze J, Diem R, Etemadifar M, Flores-Rivera J, Fonseca P, Frederiksen J, Frohman E, Frohman T, Tilikete CF, Fujihara K, Gálvez A, Gouider R, Gracia F, Grigoriadis N, Guajardo JM, Habek M, Hawlina M, Martínez-Lapiscina EH, Hooker J, Hor JY, Howlett W, Huang-Link Y, Idrissova Z, Illes Z, Jancic J, Jindahra P, Karussis D, Kerty E, Kim HJ, Lagrèze W, Leocani L, Levin N, Liskova P, Liu Y, Maiga Y, Marignier R, McGuigan C, Meira D, Merle H, Monteiro MLR, Moodley A, Moura F, Muñoz S, Mustafa S, Nakashima I, Noval S, Oehninger C, Ogun O, Omoti A, Pandit L, Paul F, Rebolleda G, Reddel S, Rejdak K, Rejdak R, Rodriguez-Morales AJ, Rougier MB, Sa MJ, Sanchez-Dalmau B, Saylor D, Shatriah I, Siva A, Stiebel-Kalish H, Szatmary G, Ta L, Tenembaum S, Tran H, Trufanov Y, van Pesch V, Wang AG, Wattjes MP, Willoughby E, Zakaria M, Zvornicanin J, Balcer L, Plant GT. Diagnosis and classification of optic neuritis. Lancet Neurol 2022; 21:1120-1134. [PMID: 36179757 DOI: 10.1016/s1474-4422(22)00200-9] [Citation(s) in RCA: 62] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 03/16/2022] [Accepted: 04/20/2022] [Indexed: 11/28/2022]
Abstract
There is no consensus regarding the classification of optic neuritis, and precise diagnostic criteria are not available. This reality means that the diagnosis of disorders that have optic neuritis as the first manifestation can be challenging. Accurate diagnosis of optic neuritis at presentation can facilitate the timely treatment of individuals with multiple sclerosis, neuromyelitis optica spectrum disorder, or myelin oligodendrocyte glycoprotein antibody-associated disease. Epidemiological data show that, cumulatively, optic neuritis is most frequently caused by many conditions other than multiple sclerosis. Worldwide, the cause and management of optic neuritis varies with geographical location, treatment availability, and ethnic background. We have developed diagnostic criteria for optic neuritis and a classification of optic neuritis subgroups. Our diagnostic criteria are based on clinical features that permit a diagnosis of possible optic neuritis; further paraclinical tests, utilising brain, orbital, and retinal imaging, together with antibody and other protein biomarker data, can lead to a diagnosis of definite optic neuritis. Paraclinical tests can also be applied retrospectively on stored samples and historical brain or retinal scans, which will be useful for future validation studies. Our criteria have the potential to reduce the risk of misdiagnosis, provide information on optic neuritis disease course that can guide future treatment trial design, and enable physicians to judge the likelihood of a need for long-term pharmacological management, which might differ according to optic neuritis subgroups.
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Bruegger D, Koth AL, Dysli M, Goldblum D, Abegg M, Tschopp M, Tappeiner C. Evaluation of the Reddesa Chart, a New Red Desaturation Testing Method, for Optic Neuritis Screening and Grading in Clinical Routine. Front Neurol 2022; 13:898064. [PMID: 35873783 PMCID: PMC9301372 DOI: 10.3389/fneur.2022.898064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/13/2022] [Indexed: 11/21/2022] Open
Abstract
Background Optic neuritis usually leads to reduced color sensitivity. Most often, the change of red color, the so-called red desaturation, is tested in clinical routine. The aim of this study was to test the feasibility of the Reddesa chart, a new red desaturation test based on polarization, as a screening method for optic neuropathy. Methods A total of 20 patients with unilateral optic neuritis and 20 healthy controls were included in this prospective pilot study. Ophthalmological examination included assessment of best corrected visual acuity (BCVA), slit lamp examination, fundoscopy, testing of relative afferent pupillary defect (RAPD) and red desaturation with the red cup test and the Reddesa chart. Results The mean BCVA in the optic neuritis group was 0.76 ± 0.36 in the affected eye (95% of eyes with RAPD, 75% of eyes with difference in the Reddesa test) and 1.28 ± 0.24 in the healthy eye, whereas in the control group, BCVA was 1.14 ± 0.11 in the right eye and 1.15 ± 0.14 in the left eye (none of the eyes with RAPD or abnormal Reddesa test). In our study, the Reddesa test showed a positive predictive value of 100% and a negative predictive value of 80% for detecting optic neuritis. Conclusion The Reddesa chart allows to quantify red desaturation and has the potential to be implemented as a screening test in clinical routine.
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Affiliation(s)
- Dominik Bruegger
- Department of Ophthalmology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Anna-Lucia Koth
- Department of Ophthalmology, Inselspital, Bern University Hospital, Bern, Switzerland
- Augenpraxis Untertor, Winterthur, Switzerland
| | - Muriel Dysli
- Department of Ophthalmology, Inselspital, Bern University Hospital, Bern, Switzerland
- Department of Ophthalmology, Cantonal Hospital Aarau, Aarau, Switzerland
| | - David Goldblum
- Pallas Kliniken, Olten, Switzerland
- Department of Ophthalmology, Pallas Klinik, Olten, Switzerland
| | - Mathias Abegg
- Department of Ophthalmology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Markus Tschopp
- Department of Ophthalmology, Inselspital, Bern University Hospital, Bern, Switzerland
- Department of Ophthalmology, Cantonal Hospital Aarau, Aarau, Switzerland
| | - Christoph Tappeiner
- Pallas Kliniken, Olten, Switzerland
- Department of Ophthalmology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
- University of Bern, Bern, Switzerland
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7
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Schmid RD, Remlinger J, Abegg M, Hoepner R, Hoffmann R, Lukas C, Saft C, Salmen A. No optical coherence tomography changes in premanifest Huntington's disease mutation carriers far from disease onset. Brain Behav 2022; 12:e2592. [PMID: 35511084 PMCID: PMC9226796 DOI: 10.1002/brb3.2592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/01/2022] [Accepted: 04/04/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Spectral-domain optical coherence tomography (OCT) may detect retinal changes as a biomarker in neurodegenerative diseases like manifest Huntington's disease (HD). We investigate macular retinal layer thicknesses in a premanifest HD (pre-HD) cohort and healthy controls (HC). METHODS Pre-HD mutation carriers underwent standardized ratings and a preset macular OCT scan. Thickness values were determined for each sector of all macular retinal layers, the mean of all sectors and the mean of the inner ring (IR, 3 mm) after segmentation (Heyex segmentation batch). HC were retrospectively included from an existing database. The IR thickness of the ganglion cell layer (GCL), retinal nerve fiber layer (RNFL), GCL + inner plexiform layer (GCIPL), and total retina were included in the exploratory correlation analyses with paraclinical ratings and compared to HC. RESULTS The analyses comprised n = 24 pre-HD participants (n = 10 male, n = 14 female) and n = 38 HC (n = 14 male, n = 24 female). Retinal layer parameters did not correlate with paraclinical ratings. Expected correlations between established HD biomarkers were robust. The IR thicknesses of the GCL, GCIPL, and total retina did not differ between pre-HD and HC. The IR thickness of the RNFL was significantly higher in pre-HD participants (pre-HD: 23.22 μm (standard deviation 2.91), HC: 21.26 μm (1.90), p = .002). DISCUSSION In this cross-sectional cohort of genetically determined pre-HD participants, neurodegenerative features were not detected with retinal layer segmentation. Since our pre-HD collective was more than 16 years before disease onset, OCT may not be sensitive enough to detect early changes.
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Affiliation(s)
- Rahel Dominique Schmid
- Department of Ophthalmology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.,Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Jana Remlinger
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.,Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Mathias Abegg
- Department of Ophthalmology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Robert Hoepner
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Rainer Hoffmann
- Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Huntington Center NRW, Bochum, Germany.,Department of Neuropsychiatry, Huntington Center South, kbo-Isar-Amper-Klinikum, Taufkirchen (Vils), Germany
| | - Carsten Lukas
- Institute of Neuroradiology, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Carsten Saft
- Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Huntington Center NRW, Bochum, Germany
| | - Anke Salmen
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.,Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Huntington Center NRW, Bochum, Germany
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Kerkeni H, Brügger D, Mantokoudis G, Abegg M, Zee DS. Pharmacological and Behavioral Strategies to Improve Vision in Acquired Pendular Nystagmus. Am J Case Rep 2022; 23:e935148. [PMID: 35780294 PMCID: PMC9260699 DOI: 10.12659/ajcr.935148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Patient: Female, 49-year-old
Final Diagnosis: Acquired pendular nystagmus • multiple sclerosis
Symptoms: Oscillopsia
Medication: —
Clinical Procedure: Blink • visual acuity
Specialty: Neurology • Ophthalmology
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Affiliation(s)
- Hassen Kerkeni
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Dominik Brügger
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Georgios Mantokoudis
- Department of Otorhinolaryngology, Head and Neck Surgery, lnselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Mathias Abegg
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - David S. Zee
- Department of Neurology, Ophthalmology, Otolaryngology-Head and Neck Surgery, Johns Hopkins Hospital, Baltimore, USA, MD
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Remlinger J, Madarasz A, Guse K, Hoepner R, Bagnoud M, Meli I, Feil M, Abegg M, Linington C, Shock A, Boroojerdi B, Kiessling P, Smith B, Enzmann V, Chan A, Salmen A. Antineonatal Fc Receptor Antibody Treatment Ameliorates MOG-IgG-Associated Experimental Autoimmune Encephalomyelitis. Neurol Neuroimmunol Neuroinflamm 2022; 9:9/2/e1134. [PMID: 35027475 PMCID: PMC8759074 DOI: 10.1212/nxi.0000000000001134] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 12/03/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND OBJECTIVES Myelin oligodendrocyte glycoprotein antibody-associated disorder (MOGAD) is a rare, autoimmune demyelinating CNS disorder, distinct from multiple sclerosis and neuromyelitis optica spectrum disorder. Characterized by pathogenic immunoglobulin G (IgG) antibodies against MOG, a potential treatment strategy for MOGAD is to reduce circulating IgG levels, e.g., by interference with the IgG recycling pathway mediated by the neonatal Fc receptor (FcRn). Although the optic nerve is often detrimentally involved in MOGAD, the effect of FcRn blockade on the visual pathway has not been assessed. Our objective was to investigate effects of a monoclonal anti-FcRn antibody in murine MOG-IgG-associated experimental autoimmune encephalomyelitis (EAE). METHODS We induced active MOG35-55 EAE in C57Bl/6 mice followed by the application of a monoclonal MOG-IgG (8-18C5) 10 days postimmunization (dpi). Animals were treated with either a specific monoclonal antibody against FcRn (α-FcRn, 4470) or an isotype-matched control IgG on 7, 10, and 13 dpi. Neurologic disability was scored daily on a 10-point scale. Visual acuity was assessed by optomotor reflex. Histopathologic hallmarks of disease were assessed in the spinal cord, optic nerve, and retina. Immune cell infiltration was visualized by immunohistochemistry, demyelination by Luxol fast blue staining and complement deposition and number of retinal ganglion cells by immunofluorescence. RESULTS In MOG-IgG-augmented MOG35-55 EAE, anti-FcRn treatment significantly attenuated neurologic disability over the course of disease (mean area under the curve and 95% confidence intervals (CIs): α-FcRn [n = 27], 46.02 [37.89-54.15]; isotype IgG [n = 24], 66.75 [59.54-73.96], 3 independent experiments), correlating with reduced amounts of demyelination and macrophage infiltration into the spinal cord. T- and B-cell infiltration and complement deposition remained unchanged. Compared with isotype, anti-FcRn treatment prevented reduction of visual acuity over the course of disease (median cycles/degree and interquartile range: α-FcRn [n = 16], 0.50 [0.48-0.55] to 0.50 [0.48-0.58]; isotype IgG [n = 17], 0.50 [0.49-0.54] to 0.45 [0.39-0.51]). DISCUSSION We show preserved optomotor response and ameliorated course of disease after anti-FcRn treatment in an experimental model using a monoclonal MOG-IgG to mimic MOGAD. Selectively targeting FcRn might represent a promising therapeutic approach in MOGAD.
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Affiliation(s)
- Jana Remlinger
- From the Department of Neurology (J.R., A.M., K.G., R.H., M.B., I.M., A.C., A. Salmen), Inselspital, Bern University Hospital and University of Bern; Department of Biomedical Research (J.R., A.M., K.G., R.H., M.B., I.M., V.E., A.C., A. Salmen), and Graduate School for Cellular and Biomedical Sciences (J.R., A.M., M.B.), University of Bern; Department of Ophthalmology (M.F., M.A., V.E.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Institute of Infection (C.L.), Immunity and Inflammation, University of Glasgow; UCB Pharma (A. Shock, B.S.), Slough, United Kingdom; and UCB Pharma (B.B., P.K.), Monheim-am-Rhein, Germany
| | - Adrian Madarasz
- From the Department of Neurology (J.R., A.M., K.G., R.H., M.B., I.M., A.C., A. Salmen), Inselspital, Bern University Hospital and University of Bern; Department of Biomedical Research (J.R., A.M., K.G., R.H., M.B., I.M., V.E., A.C., A. Salmen), and Graduate School for Cellular and Biomedical Sciences (J.R., A.M., M.B.), University of Bern; Department of Ophthalmology (M.F., M.A., V.E.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Institute of Infection (C.L.), Immunity and Inflammation, University of Glasgow; UCB Pharma (A. Shock, B.S.), Slough, United Kingdom; and UCB Pharma (B.B., P.K.), Monheim-am-Rhein, Germany
| | - Kirsten Guse
- From the Department of Neurology (J.R., A.M., K.G., R.H., M.B., I.M., A.C., A. Salmen), Inselspital, Bern University Hospital and University of Bern; Department of Biomedical Research (J.R., A.M., K.G., R.H., M.B., I.M., V.E., A.C., A. Salmen), and Graduate School for Cellular and Biomedical Sciences (J.R., A.M., M.B.), University of Bern; Department of Ophthalmology (M.F., M.A., V.E.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Institute of Infection (C.L.), Immunity and Inflammation, University of Glasgow; UCB Pharma (A. Shock, B.S.), Slough, United Kingdom; and UCB Pharma (B.B., P.K.), Monheim-am-Rhein, Germany
| | - Robert Hoepner
- From the Department of Neurology (J.R., A.M., K.G., R.H., M.B., I.M., A.C., A. Salmen), Inselspital, Bern University Hospital and University of Bern; Department of Biomedical Research (J.R., A.M., K.G., R.H., M.B., I.M., V.E., A.C., A. Salmen), and Graduate School for Cellular and Biomedical Sciences (J.R., A.M., M.B.), University of Bern; Department of Ophthalmology (M.F., M.A., V.E.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Institute of Infection (C.L.), Immunity and Inflammation, University of Glasgow; UCB Pharma (A. Shock, B.S.), Slough, United Kingdom; and UCB Pharma (B.B., P.K.), Monheim-am-Rhein, Germany
| | - Maud Bagnoud
- From the Department of Neurology (J.R., A.M., K.G., R.H., M.B., I.M., A.C., A. Salmen), Inselspital, Bern University Hospital and University of Bern; Department of Biomedical Research (J.R., A.M., K.G., R.H., M.B., I.M., V.E., A.C., A. Salmen), and Graduate School for Cellular and Biomedical Sciences (J.R., A.M., M.B.), University of Bern; Department of Ophthalmology (M.F., M.A., V.E.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Institute of Infection (C.L.), Immunity and Inflammation, University of Glasgow; UCB Pharma (A. Shock, B.S.), Slough, United Kingdom; and UCB Pharma (B.B., P.K.), Monheim-am-Rhein, Germany
| | - Ivo Meli
- From the Department of Neurology (J.R., A.M., K.G., R.H., M.B., I.M., A.C., A. Salmen), Inselspital, Bern University Hospital and University of Bern; Department of Biomedical Research (J.R., A.M., K.G., R.H., M.B., I.M., V.E., A.C., A. Salmen), and Graduate School for Cellular and Biomedical Sciences (J.R., A.M., M.B.), University of Bern; Department of Ophthalmology (M.F., M.A., V.E.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Institute of Infection (C.L.), Immunity and Inflammation, University of Glasgow; UCB Pharma (A. Shock, B.S.), Slough, United Kingdom; and UCB Pharma (B.B., P.K.), Monheim-am-Rhein, Germany
| | - Moritz Feil
- From the Department of Neurology (J.R., A.M., K.G., R.H., M.B., I.M., A.C., A. Salmen), Inselspital, Bern University Hospital and University of Bern; Department of Biomedical Research (J.R., A.M., K.G., R.H., M.B., I.M., V.E., A.C., A. Salmen), and Graduate School for Cellular and Biomedical Sciences (J.R., A.M., M.B.), University of Bern; Department of Ophthalmology (M.F., M.A., V.E.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Institute of Infection (C.L.), Immunity and Inflammation, University of Glasgow; UCB Pharma (A. Shock, B.S.), Slough, United Kingdom; and UCB Pharma (B.B., P.K.), Monheim-am-Rhein, Germany
| | - Mathias Abegg
- From the Department of Neurology (J.R., A.M., K.G., R.H., M.B., I.M., A.C., A. Salmen), Inselspital, Bern University Hospital and University of Bern; Department of Biomedical Research (J.R., A.M., K.G., R.H., M.B., I.M., V.E., A.C., A. Salmen), and Graduate School for Cellular and Biomedical Sciences (J.R., A.M., M.B.), University of Bern; Department of Ophthalmology (M.F., M.A., V.E.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Institute of Infection (C.L.), Immunity and Inflammation, University of Glasgow; UCB Pharma (A. Shock, B.S.), Slough, United Kingdom; and UCB Pharma (B.B., P.K.), Monheim-am-Rhein, Germany
| | - Christopher Linington
- From the Department of Neurology (J.R., A.M., K.G., R.H., M.B., I.M., A.C., A. Salmen), Inselspital, Bern University Hospital and University of Bern; Department of Biomedical Research (J.R., A.M., K.G., R.H., M.B., I.M., V.E., A.C., A. Salmen), and Graduate School for Cellular and Biomedical Sciences (J.R., A.M., M.B.), University of Bern; Department of Ophthalmology (M.F., M.A., V.E.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Institute of Infection (C.L.), Immunity and Inflammation, University of Glasgow; UCB Pharma (A. Shock, B.S.), Slough, United Kingdom; and UCB Pharma (B.B., P.K.), Monheim-am-Rhein, Germany
| | - Anthony Shock
- From the Department of Neurology (J.R., A.M., K.G., R.H., M.B., I.M., A.C., A. Salmen), Inselspital, Bern University Hospital and University of Bern; Department of Biomedical Research (J.R., A.M., K.G., R.H., M.B., I.M., V.E., A.C., A. Salmen), and Graduate School for Cellular and Biomedical Sciences (J.R., A.M., M.B.), University of Bern; Department of Ophthalmology (M.F., M.A., V.E.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Institute of Infection (C.L.), Immunity and Inflammation, University of Glasgow; UCB Pharma (A. Shock, B.S.), Slough, United Kingdom; and UCB Pharma (B.B., P.K.), Monheim-am-Rhein, Germany
| | - Babak Boroojerdi
- From the Department of Neurology (J.R., A.M., K.G., R.H., M.B., I.M., A.C., A. Salmen), Inselspital, Bern University Hospital and University of Bern; Department of Biomedical Research (J.R., A.M., K.G., R.H., M.B., I.M., V.E., A.C., A. Salmen), and Graduate School for Cellular and Biomedical Sciences (J.R., A.M., M.B.), University of Bern; Department of Ophthalmology (M.F., M.A., V.E.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Institute of Infection (C.L.), Immunity and Inflammation, University of Glasgow; UCB Pharma (A. Shock, B.S.), Slough, United Kingdom; and UCB Pharma (B.B., P.K.), Monheim-am-Rhein, Germany
| | - Peter Kiessling
- From the Department of Neurology (J.R., A.M., K.G., R.H., M.B., I.M., A.C., A. Salmen), Inselspital, Bern University Hospital and University of Bern; Department of Biomedical Research (J.R., A.M., K.G., R.H., M.B., I.M., V.E., A.C., A. Salmen), and Graduate School for Cellular and Biomedical Sciences (J.R., A.M., M.B.), University of Bern; Department of Ophthalmology (M.F., M.A., V.E.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Institute of Infection (C.L.), Immunity and Inflammation, University of Glasgow; UCB Pharma (A. Shock, B.S.), Slough, United Kingdom; and UCB Pharma (B.B., P.K.), Monheim-am-Rhein, Germany
| | - Bryan Smith
- From the Department of Neurology (J.R., A.M., K.G., R.H., M.B., I.M., A.C., A. Salmen), Inselspital, Bern University Hospital and University of Bern; Department of Biomedical Research (J.R., A.M., K.G., R.H., M.B., I.M., V.E., A.C., A. Salmen), and Graduate School for Cellular and Biomedical Sciences (J.R., A.M., M.B.), University of Bern; Department of Ophthalmology (M.F., M.A., V.E.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Institute of Infection (C.L.), Immunity and Inflammation, University of Glasgow; UCB Pharma (A. Shock, B.S.), Slough, United Kingdom; and UCB Pharma (B.B., P.K.), Monheim-am-Rhein, Germany
| | - Volker Enzmann
- From the Department of Neurology (J.R., A.M., K.G., R.H., M.B., I.M., A.C., A. Salmen), Inselspital, Bern University Hospital and University of Bern; Department of Biomedical Research (J.R., A.M., K.G., R.H., M.B., I.M., V.E., A.C., A. Salmen), and Graduate School for Cellular and Biomedical Sciences (J.R., A.M., M.B.), University of Bern; Department of Ophthalmology (M.F., M.A., V.E.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Institute of Infection (C.L.), Immunity and Inflammation, University of Glasgow; UCB Pharma (A. Shock, B.S.), Slough, United Kingdom; and UCB Pharma (B.B., P.K.), Monheim-am-Rhein, Germany
| | - Andrew Chan
- From the Department of Neurology (J.R., A.M., K.G., R.H., M.B., I.M., A.C., A. Salmen), Inselspital, Bern University Hospital and University of Bern; Department of Biomedical Research (J.R., A.M., K.G., R.H., M.B., I.M., V.E., A.C., A. Salmen), and Graduate School for Cellular and Biomedical Sciences (J.R., A.M., M.B.), University of Bern; Department of Ophthalmology (M.F., M.A., V.E.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Institute of Infection (C.L.), Immunity and Inflammation, University of Glasgow; UCB Pharma (A. Shock, B.S.), Slough, United Kingdom; and UCB Pharma (B.B., P.K.), Monheim-am-Rhein, Germany
| | - Anke Salmen
- From the Department of Neurology (J.R., A.M., K.G., R.H., M.B., I.M., A.C., A. Salmen), Inselspital, Bern University Hospital and University of Bern; Department of Biomedical Research (J.R., A.M., K.G., R.H., M.B., I.M., V.E., A.C., A. Salmen), and Graduate School for Cellular and Biomedical Sciences (J.R., A.M., M.B.), University of Bern; Department of Ophthalmology (M.F., M.A., V.E.), Inselspital, Bern University Hospital and University of Bern, Switzerland; Institute of Infection (C.L.), Immunity and Inflammation, University of Glasgow; UCB Pharma (A. Shock, B.S.), Slough, United Kingdom; and UCB Pharma (B.B., P.K.), Monheim-am-Rhein, Germany.
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10
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Brueggemann A, Bicvic A, Goeldlin M, Kalla R, Kerkeni H, Mantokoudis G, Abegg M, Kolníková M, Mohaupt M, Bremova-Ertl T. Effects of Acetyl-DL-Leucine on Ataxia and Downbeat-Nystagmus in Six Patients With Ataxia Telangiectasia. J Child Neurol 2022; 37:20-27. [PMID: 34620022 DOI: 10.1177/08830738211028394] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND There is no authorized treatment for ataxia telangiectasia (AT). As cerebellar symptoms of storage diseases were improved by acetyl-DL-leucine (ADLL), the authors hypothesized a symptomatic and disease-modifying effect in AT upon supplementation with ADLL. METHODS Six patients were treated with ADLL 3 g/day for 1 week followed by 5g/day for 3 weeks to 1 year. Cerebellar ataxia was evaluated by validated scales. Gaze-holding, saccades and smooth pursuit were examined by video-oculography. Measurements took place at baseline, at 1 month of therapy in 5 patients, and after 6 and 12 months in 1 patient. RESULTS The Scale for Assessment and Rating of Ataxia changed from the baseline, mean, (SD, min-max) of 22.1 (5.88, 11-28.5) to 18 points (5.39, 8.5-23.5) after 1 month on medication (P = .0028). All patients demonstrated gaze-holding deficits; 3 patients had central-position downbeat-nystagmus. Mean slow-phase velocity of this nystagmus with the gaze straight-ahead changed from 5.57°/s (1.8, 3.53-6.99) to 4.7°/s (0.79, 3.97-5.56) after 1 month on treatment (1.35, -2.56-4.17) (P = .046). INTERPRETATION ADLL may improve ataxia and ocular stability in AT patients, while the molecular basis still remains to be elucidated. A multicentric, rater-blinded, phase II trial currently investigates the effects of acetyl-L-leucine in AT (NCT03759678).
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Affiliation(s)
- Adriana Brueggemann
- Department of Internal Medicine, Sonnenhofspital, Lindenhofgruppe, Bern, Switzerland.,Shares the first author place
| | - Antonela Bicvic
- Department of Neurology, University Hospital Bern (Inselspital) and University of Bern, Bern, Switzerland.,Shares the first author place
| | - Martina Goeldlin
- Department of Neurology, University Hospital Bern (Inselspital) and University of Bern, Bern, Switzerland
| | - Roger Kalla
- Department of Neurology, University Hospital Bern (Inselspital) and University of Bern, Bern, Switzerland
| | - Hassen Kerkeni
- Department of Neurology, University Hospital Bern (Inselspital) and University of Bern, Bern, Switzerland
| | - Georgios Mantokoudis
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital Bern (Inselspital) and University of Bern, Bern, Switzerland
| | - Mathias Abegg
- Department of Ophthalmology, University Hospital Bern (Inselspital) and University of Bern, Bern, Switzerland
| | - Miriam Kolníková
- Comenius University Children's Hospital, Department of Child Neurology, Bratislava, Slovak Republic
| | - Markus Mohaupt
- Department of Internal Medicine, Sonnenhofspital, Lindenhofgruppe, Bern, Switzerland.,Department of Neurology, University Hospital Bern (Inselspital) and University of Bern, Bern, Switzerland
| | - Tatiana Bremova-Ertl
- Department of Internal Medicine, Sonnenhofspital, Lindenhofgruppe, Bern, Switzerland.,Department of Neurology, University Hospital Bern (Inselspital) and University of Bern, Bern, Switzerland.,Center for Rare Diseases, Institute for Clinical Chemistry, University Hospital Bern (Inselspital) and University of Bern, Bern, Switzerland.,German Center for Vertigo and Balance Disorders, Ludwig-Maximilians University Hospital, Campus Grosshadern, Munich, Germany
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11
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Belachew NF, Almiri W, Encinas R, Hakim A, Baschung S, Kaesmacher J, Dobrocky T, Schankin CJ, Abegg M, Piechowiak EI, Raabe A, Gralla J, Mordasini P. Evolution of MRI Findings in Patients with Idiopathic Intracranial Hypertension after Venous Sinus Stenting. AJNR Am J Neuroradiol 2021; 42:1993-2000. [PMID: 34620591 DOI: 10.3174/ajnr.a7311] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/22/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The correlation between imaging findings and clinical status in patients with idiopathic intracranial hypertension is unclear. We aimed to examine the evolution of idiopathic intracranial hypertension-related MR imaging findings in patients treated with venous sinus stent placement. MATERIALS AND METHODS Thirteen patients with idiopathic intracranial hypertension (median age, 26.9 years) were assessed for changes in the CSF opening pressure, transstenotic pressure gradient, and symptoms after venous sinus stent placement. Optic nerve sheath diameter, posterior globe flattening and/or optic nerve protrusion, empty sella, the Meckel cave, tonsillar ectopia, the ventricles, the occipital emissary vein, and subcutaneous fat were evaluated on MR imaging before and 6 months after venous sinus stent placement. Data are expressed as percentages, medians, or correlation coefficients (r) with P values. RESULTS Although all patients showed significant reductions of the CSF opening pressure (31 versus 21 cm H2O; P = .005) and transstenotic pressure gradient (22.5 versus 1.5 mm Hg; P = .002) and substantial improvement of clinical symptoms 6 months after venous sinus stent placement, a concomitant reduction was observed only for posterior globe involvement (61.5% versus 15.4%; P = .001), optic nerve sheath diameter (6.8 versus 6.1 mm; P < .001), and subcutaneous neck fat (8.9 versus 7.4 mm; P = .001). Strong correlations were observed between decreasing optic nerve sheath diameters and improving nausea/emesis (right optic nerve sheath diameter, r = 0.592, P = .033; left optic nerve sheath diameter, r = 0.718, P = .006), improvement of posterior globe involvement and decreasing papilledema (r = 0.775, P = .003), and decreasing occipital emissary vein diameter and decreasing headache frequency (r = 0.74, P = .035). Decreasing transstenotic pressure gradient at 6 months strongly correlated with decreasing empty sella (r = 0.625, P = .022) and regressing cerebellar ectopia (r = 0.662, P = .019). CONCLUSIONS Most imaging findings persist long after normalization of intracranial pressure and clinical improvement. However, MR imaging findings related to the optic nerve may reflect treatment success.
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Affiliation(s)
- N F Belachew
- From the Department of Diagnostic and Interventional Neuroradiology (N.F.B., W.A., R.E., A.H., J.K., T.D., E.I.P., J.G., P.M.)
| | - W Almiri
- From the Department of Diagnostic and Interventional Neuroradiology (N.F.B., W.A., R.E., A.H., J.K., T.D., E.I.P., J.G., P.M.)
| | - R Encinas
- From the Department of Diagnostic and Interventional Neuroradiology (N.F.B., W.A., R.E., A.H., J.K., T.D., E.I.P., J.G., P.M.)
| | - A Hakim
- From the Department of Diagnostic and Interventional Neuroradiology (N.F.B., W.A., R.E., A.H., J.K., T.D., E.I.P., J.G., P.M.)
| | - S Baschung
- Faculty of Medicine (S.B.), University of Bern, Bern, Switzerland
| | - J Kaesmacher
- From the Department of Diagnostic and Interventional Neuroradiology (N.F.B., W.A., R.E., A.H., J.K., T.D., E.I.P., J.G., P.M.)
- Department of Diagnostic, Interventional and Pediatric Radiology (J.K.)
| | - T Dobrocky
- From the Department of Diagnostic and Interventional Neuroradiology (N.F.B., W.A., R.E., A.H., J.K., T.D., E.I.P., J.G., P.M.)
| | | | - M Abegg
- Department of Ophthalmology (M.A.)
| | - E I Piechowiak
- From the Department of Diagnostic and Interventional Neuroradiology (N.F.B., W.A., R.E., A.H., J.K., T.D., E.I.P., J.G., P.M.)
| | - A Raabe
- Department of Neurosurgery (A.R.), Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - J Gralla
- From the Department of Diagnostic and Interventional Neuroradiology (N.F.B., W.A., R.E., A.H., J.K., T.D., E.I.P., J.G., P.M.)
| | - P Mordasini
- From the Department of Diagnostic and Interventional Neuroradiology (N.F.B., W.A., R.E., A.H., J.K., T.D., E.I.P., J.G., P.M.)
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12
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Bruegger D, Abegg M. Prediction of cortical theta oscillations in humans for phase-locked visual stimulation. J Neurosci Methods 2021; 361:109288. [PMID: 34274403 DOI: 10.1016/j.jneumeth.2021.109288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/09/2021] [Accepted: 07/10/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND The timing of an event within an oscillatory phase is considered to be one of the key strategies used by the brain to code and process neural information. Whereas existing methods of studying this phenomenon are chiefly based on retrospective analysis of electroencephalography (EEG) data, we now present a method to study it prospectively. New method: We present a system that allows for the delivery of visual stimuli at a specific phase of the cortical theta oscillation by fitting a sine to raw surface EEG data to estimate and predict the phase. One noteworthy feature of the method is that it can minimize potentially confounding effects of previous trials by using only a short sequence of past data. RESULTS In a trial with 10 human participants we achieved a significant phase locking with an inter-trial phase coherence of 0.39. We demonstrated successful phase locking on synthetic signals with a signal-to-noise ratio of less than - 20 dB. Comparison with existing method(s): We compared the new method to an autoregressive method published in the literature and found the new method was superior in mean phase offset, circular standard deviation, and prediction latency. CONCLUSIONS By fitting sine waves to raw EEG traces, we locked visual stimuli to arbitrary phases within the theta oscillatory cycle of healthy humans.
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Affiliation(s)
- D Bruegger
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Switzerland; Graduate School for Cellular and Biomedical Sciences (GCB), University of Bern, Switzerland.
| | - M Abegg
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Switzerland.
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13
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Belachew NF, Baschung S, Almiri W, Encinas R, Kaesmacher J, Dobrocky T, Schankin CJ, Abegg M, Piechowiak EI, Raabe A, Gralla J, Mordasini P. Correction to: Casper Versus Precise Stent for the Treatment of Patients with Idiopathic Intracranial Hypertension. Clin Neuroradiol 2021; 31:863-864. [PMID: 34255091 PMCID: PMC8463349 DOI: 10.1007/s00062-021-01055-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- Nebiyat F Belachew
- Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, and University of Bern, Freiburgstraße 18, 3010, Bern, Switzerland.
| | | | - William Almiri
- Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, and University of Bern, Freiburgstraße 18, 3010, Bern, Switzerland
| | - Ruben Encinas
- Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, and University of Bern, Freiburgstraße 18, 3010, Bern, Switzerland
| | - Johannes Kaesmacher
- Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, and University of Bern, Freiburgstraße 18, 3010, Bern, Switzerland.,Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Tomas Dobrocky
- Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, and University of Bern, Freiburgstraße 18, 3010, Bern, Switzerland
| | - Christoph J Schankin
- Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Mathias Abegg
- Department of Ophthalmology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Eike I Piechowiak
- Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, and University of Bern, Freiburgstraße 18, 3010, Bern, Switzerland
| | - Andreas Raabe
- Department of Neurosurgery, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Jan Gralla
- Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, and University of Bern, Freiburgstraße 18, 3010, Bern, Switzerland
| | - Pasquale Mordasini
- Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, and University of Bern, Freiburgstraße 18, 3010, Bern, Switzerland
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14
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Belachew NF, Baschung S, Almiri W, Encinas R, Kaesmacher J, Dobrocky T, Schankin CJ, Abegg M, Piechowiak EI, Raabe A, Gralla J, Mordasini P. Casper Versus Precise Stent for the Treatment of Patients with Idiopathic Intracranial Hypertension. Clin Neuroradiol 2021; 31:853-862. [PMID: 34003319 PMCID: PMC8463398 DOI: 10.1007/s00062-021-01024-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/15/2021] [Indexed: 11/29/2022]
Abstract
Purpose We hypothesized that due to its specific characteristics, the CasperTM RX carotid stent (CP) might be particularly suitable for venous sinus stenting (VSS) in patients with idiopathic intracranial hypertension (IIH). To test this theory, we compared it to the commonly used Precise Pro RXTM stent (PP). Methods A total of 15 patients with IIH (median age 28.7 years) were reviewed retrospectively. Technical aspects as well as peri- and postinterventional complication rates were examined in patients treated with CP (n = 10) and the PP (n = 5). Improvements in cerebrospinal fluid opening pressure (CSF OP), transstenotic pressure gradient (TSPG) and clinical symptoms were also assessed. Results Stent delivery was easier and more successful with the CP than the PP (difficult/failed stent delivery 0.0% versus 57.1%) and consequently achieved with less attempts (≥ 2: 0.0% versus 40.0%). No severe peri- or postinterventional complications or instances of in-stent thrombosis and/or stenosis were observed during follow-up. Improvement of CSF OP and TSPG immediately after VSS as well as at 6‑month follow-up was comparable between the CP and PP group. Both groups showed substantial and similar decreases in intensity and frequency of headache. Almost all patients with other IIH-related symptoms showed either improvement or complete resolution of those symptoms after VSS. All patients who were available for interview (n = 12/15) reported a substantial improvement in quality of life. Conclusion VSS using the CP seems to be safe and effective. The CP may reduce the risk of difficult or failed stent delivery in patients with challenging intracranial venous anatomy. Supplementary Information The online version of this article (10.1007/s00062-021-01024-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nebiyat F Belachew
- Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, and University of Bern, Freiburgstraße 18, 3010, Bern, Switzerland.
| | | | - William Almiri
- Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, and University of Bern, Freiburgstraße 18, 3010, Bern, Switzerland
| | - Ruben Encinas
- Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, and University of Bern, Freiburgstraße 18, 3010, Bern, Switzerland
| | - Johannes Kaesmacher
- Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, and University of Bern, Freiburgstraße 18, 3010, Bern, Switzerland.,Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Tomas Dobrocky
- Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, and University of Bern, Freiburgstraße 18, 3010, Bern, Switzerland
| | - Christoph J Schankin
- Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Mathias Abegg
- Department of Ophthalmology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Eike I Piechowiak
- Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, and University of Bern, Freiburgstraße 18, 3010, Bern, Switzerland
| | - Andreas Raabe
- Department of Neurosurgery, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Jan Gralla
- Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, and University of Bern, Freiburgstraße 18, 3010, Bern, Switzerland
| | - Pasquale Mordasini
- Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, and University of Bern, Freiburgstraße 18, 3010, Bern, Switzerland
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15
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Kucur ŞS, Häckel S, Stapelfeldt J, Odermatt J, Iliev ME, Abegg M, Sznitman R, Höhn R. Comparative Study Between the SORS and Dynamic Strategy Visual Field Testing Methods on Glaucomatous and Healthy Subjects. Transl Vis Sci Technol 2020; 9:3. [PMID: 33344047 PMCID: PMC7718825 DOI: 10.1167/tvst.9.13.3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 09/22/2020] [Indexed: 11/30/2022] Open
Abstract
Purpose To clinically validate the noninferiority of the sequentially optimized reconstruction strategy (SORS) when compared to the dynamic strategy (DS). Methods SORS is a novel perimetry testing strategy that evaluates a subset of test locations of a visual field (VF) test pattern and estimates the untested locations by linear approximation. When testing fewer locations, SORS has been shown in computer simulations to bring improvements in speed over conventional perimetry tests, while maintaining acquisition at high-quality acquisition. To validate SORS, a prospective clinical study was conducted at the Department of Ophthalmology of Bern University Hospital, over 12 months. Eighty-three subjects (32 healthy and 51 glaucoma patients with early to moderate visual field loss) of 114 participants were included in the study. The subjects underwent perimetry tests on an Octopus 900 (Haag-Streit, Köniz, Switzerland) using the G pattern with both DS and SORS. The acquired sensitivity thresholds (ST) by both tests were analyzed and compared. Results DS-acquired VFs were used as a reference. High correlations between individual STs (r ≥ 0.74), as well as between mean defect values (r ≥ 0.88) given by DS and SORS were obtained. The mean absolute error of SORS was under 3 dB with a 70% reduction in acquisition time. SORS overestimated healthy VFs while slightly underestimating glaucomatous VFs. Qualitatively, SORS acquisition yielded VF with detectable defect patterns, albeit some isolated and small defects were occasionally missed. Conclusions This clinical study showed that for healthy and glaucomatous patients, SORS-acquired VFs sufficiently correlated with the DS-acquired VFs with up to 70% reduction in acquisition time. Translational Relevance This clinical study suggests that the novel perimetry strategy SORS could be used in routine clinical practice with comparable utility to the current standard DS, whereby providing a shorter and more comfortable perimetry experience.
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Affiliation(s)
- Şerife Seda Kucur
- Artificial Intelligence in Medical Imaging Laboratory, ARTORG Center for, Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Sebastian Häckel
- Department of Ophthalmology, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Jan Stapelfeldt
- Artificial Intelligence in Medical Imaging Laboratory, ARTORG Center for, Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | | | - Milko E Iliev
- Department of Ophthalmology, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Mathias Abegg
- Department of Ophthalmology, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Raphael Sznitman
- Artificial Intelligence in Medical Imaging Laboratory, ARTORG Center for, Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Rene Höhn
- Department of Ophthalmology, University Hospital Bern, University of Bern, Bern, Switzerland
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16
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Veselaj K, Kamber N, Briner M, Friedli C, Diem L, Guse K, Miclea A, Wiest R, Wagner F, Grabe H, Abegg M, Horn MP, Bigi S, Chan A, Hoepner R, Salmen A. Evaluation of diagnostic criteria and red flags of myelin oligodendrocyte glycoprotein encephalomyelitis in a clinical routine cohort. CNS Neurosci Ther 2020; 27:426-438. [PMID: 33047894 PMCID: PMC7941167 DOI: 10.1111/cns.13461] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 09/05/2020] [Accepted: 09/23/2020] [Indexed: 11/28/2022] Open
Abstract
Aims Myelin oligodendrocyte glycoprotein antibodies (MOG‐IgG) have been proposed to define “MOG encephalomyelitis” (MOG‐EM), with published diagnostic and “red flag” criteria. We aimed to evaluate these criteria in a routine clinical setting. Methods We retrospectively analyzed patients with borderline/positive MOG‐IgG and applied the diagnostic and red flag criteria to determine likelihood of MOG‐EM diagnosis. Para‐/clinical parameters were described and analyzed with chi‐square test. Results In total, 37 patients fulfilled MOG‐EM diagnostic criteria (female‐to‐male ratio: 1.6:1, median onset age: 28.0 years [IQR 18.5‐40.5], n = 8 with pediatric onset). In 24/37, red flags were present, predominantly MOG‐IgG at assay cutoff and/or MRI lesions suggestive of multiple sclerosis (MS). As proposed in the consensus criteria, these patients should rather be described as “possible” MOG‐EM. Of these, we classified 13 patients as “unlikely” MOG‐EM in the presence of the red flag “borderline MOG‐IgG” with negative MOG‐IgG retest or coincidence of ≥1 additional red flag. This group mainly consisted of patients diagnosed with MS (n = 11). Frequency of cerebrospinal fluid (CSF‐)—specific oligoclonal bands (OCB) is significantly lower in definite vs possible and unlikely MOG‐EM (P = .0005). Conclusion Evaluation of diagnostic and red flag criteria, MOG‐IgG retesting (incl. change of assay), and CSF‐specific OCB are relevant in clinical routine cohorts to differentiate MOG‐EM from MS.
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Affiliation(s)
- Krenar Veselaj
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nicole Kamber
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Myriam Briner
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christoph Friedli
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Lara Diem
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Kirsten Guse
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andrei Miclea
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Roland Wiest
- Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Franca Wagner
- Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Hilary Grabe
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Mathias Abegg
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Michael P Horn
- Department of Clinical Chemistry, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sandra Bigi
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Department of Pediatrics, Division of Child Neurology, University Children's Hospital Bern, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andrew Chan
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Robert Hoepner
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Anke Salmen
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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17
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Vicini R, Brügger D, Abegg M, Salmen A, Grabe HM. Differences in morphology and visual function of myelin oligodendrocyte glycoprotein antibody and multiple sclerosis associated optic neuritis. J Neurol 2020; 268:276-284. [PMID: 32785840 PMCID: PMC7815569 DOI: 10.1007/s00415-020-10097-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 07/14/2020] [Accepted: 07/20/2020] [Indexed: 12/28/2022]
Abstract
Background Myelin oligodendrocyte glycoprotein immunoglobulin G associated optic neuritis (MOG-ON) is a recently described entity. Recent studies have shown that MOG-ON has a more severe clinical presentation than classic optic neuritis (ON).
Objective This study aimed to define morphological characteristics of MOG-ON, correlate these with clinical characteristics and compare them with multiple sclerosis associated ON (MS-ON) and healthy controls (CTRL). Methods In a retrospective study, we included MOG-ON and MS-ON patients seen between 2011 and 2018 at the University Hospital Bern. Data from clinical examination, perimetry, and optical coherence tomography (OCT) were analyzed. Results A total of 66 eyes of 43 patients were included; 22 MS-ON and 33 CTRL eyes were sex- and age-matched to 11 MOG-ON eyes. We found significantly worse visual acuity at nadir, but better recovery and thinner global peripapillary retinal nerve fiber layer thickness in MOG-ON patients compared to MS-ON patients. Both groups exhibited irregular thinning of the macular ganglion cell layer. Furthermore, the visual acuity and visual field parameters correlated to retinal layer thickness only in MOG-ON eyes. Conclusion In comparison to MS-ON, MOG-ON is associated with more prominent acute vision loss and more pronounced global thinning of the pRNFL. Both entities result in similar final visual acuity and atrophy of the macular ganglion cell layer.
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Affiliation(s)
- Rino Vicini
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, 3010, Bern, Switzerland
| | - Dominik Brügger
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, 3010, Bern, Switzerland
| | - Mathias Abegg
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, 3010, Bern, Switzerland
| | - Anke Salmen
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Hilary Michelle Grabe
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, 3010, Bern, Switzerland.
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18
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Mühlemann F, Grabe H, Fok A, Wagner F, Brügger D, Sheldon CA, Abegg M. Homonymous hemiatrophy of ganglion cell layer from retrochiasmal lesions in the visual pathway. Neurology 2019; 94:e323-e329. [PMID: 31848256 DOI: 10.1212/wnl.0000000000008738] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 07/18/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine the temporal evolution, morphology, and frequency of macular ganglion cell atrophy in patients with retrochiasmal lesions of the visual pathway. METHODS In a consecutive retrospective case series, we identified 47 patients with homonymous hemianopia and accessible macular optical coherence tomography scans. We estimated the time of lesion onset and the location of the lesion within the afferent visual pathway. Using semiautomatic layer segmentation, we determined ganglion cell layer thickness in areas projecting to the side of the retrochiasmal lesion and compared it with ganglion cell layer thickness on the healthy side. RESULTS We found that retrochiasmal lesions at any level may be associated with an atrophy of ganglion cells. This atrophy respects the vertical midline through the fovea and thus the anatomic separation of the nasal and temporal visual field. The vertical line separating the affected from the unaffected side has significantly less tilt as compared with the disc-fovea angle. Lesions of the optic tract are associated with earlier macular ganglion cell atrophy than retrogeniculate lesions. Macular ganglion cell atrophy may be present in cases with normal peripapillary nerve fiber layer analysis and vice versa. CONCLUSIONS Macular ganglion cell layer thickness shows a topographic hemiatrophy in retrochiasmal lesions, which manifests earlier for tract lesions than for retrogeniculate lesions. This additional examination of ganglion cell homonymous hemiatrophy has a higher sensitivity in detecting retrograde transsynaptic degeneration than the analysis of the peripapillary nerve fiber layer alone.
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Affiliation(s)
- Fabian Mühlemann
- From the Departments of Ophthalmology (F.M., H.G., D.B., M.A.) and Diagnostic and Interventional Neuroradiology (F.W.), Inselspital, Bern University Hospital and University of Bern, Switzerland; and the Department of Ophthalmology & Visual Sciences (A.F., C.A.S.), University of British Columbia, Vancouver, Canada
| | - Hilary Grabe
- From the Departments of Ophthalmology (F.M., H.G., D.B., M.A.) and Diagnostic and Interventional Neuroradiology (F.W.), Inselspital, Bern University Hospital and University of Bern, Switzerland; and the Department of Ophthalmology & Visual Sciences (A.F., C.A.S.), University of British Columbia, Vancouver, Canada
| | - Anthony Fok
- From the Departments of Ophthalmology (F.M., H.G., D.B., M.A.) and Diagnostic and Interventional Neuroradiology (F.W.), Inselspital, Bern University Hospital and University of Bern, Switzerland; and the Department of Ophthalmology & Visual Sciences (A.F., C.A.S.), University of British Columbia, Vancouver, Canada
| | - Franca Wagner
- From the Departments of Ophthalmology (F.M., H.G., D.B., M.A.) and Diagnostic and Interventional Neuroradiology (F.W.), Inselspital, Bern University Hospital and University of Bern, Switzerland; and the Department of Ophthalmology & Visual Sciences (A.F., C.A.S.), University of British Columbia, Vancouver, Canada
| | - Dominik Brügger
- From the Departments of Ophthalmology (F.M., H.G., D.B., M.A.) and Diagnostic and Interventional Neuroradiology (F.W.), Inselspital, Bern University Hospital and University of Bern, Switzerland; and the Department of Ophthalmology & Visual Sciences (A.F., C.A.S.), University of British Columbia, Vancouver, Canada
| | - Claire A Sheldon
- From the Departments of Ophthalmology (F.M., H.G., D.B., M.A.) and Diagnostic and Interventional Neuroradiology (F.W.), Inselspital, Bern University Hospital and University of Bern, Switzerland; and the Department of Ophthalmology & Visual Sciences (A.F., C.A.S.), University of British Columbia, Vancouver, Canada
| | - Mathias Abegg
- From the Departments of Ophthalmology (F.M., H.G., D.B., M.A.) and Diagnostic and Interventional Neuroradiology (F.W.), Inselspital, Bern University Hospital and University of Bern, Switzerland; and the Department of Ophthalmology & Visual Sciences (A.F., C.A.S.), University of British Columbia, Vancouver, Canada.
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19
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Kucur ŞS, Márquez-Neila P, Abegg M, Sznitman R. Patient-attentive sequential strategy for perimetry-based visual field acquisition. Med Image Anal 2019; 54:179-192. [PMID: 30933865 DOI: 10.1016/j.media.2019.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 03/08/2019] [Accepted: 03/14/2019] [Indexed: 11/28/2022]
Abstract
Perimetry is a non-invasive clinical psychometric examination used for diagnosing ophthalmic and neurological conditions. At its core, perimetry relies on a subject pressing a button whenever they see a visual stimulus within their field of view. This sequential process then yields a 2D visual field image that is critical for clinical use. Perimetry is painfully slow however, with examinations lasting 7-8 minutes per eye. Maintaining high levels of concentration during that time is exhausting for the patient and negatively affects the acquired visual field. We introduce PASS, a novel perimetry testing strategy, based on reinforcement learning, that requires fewer locations in order to effectively estimate 2D visual fields. PASS uses a selection policy that determines what locations should be tested in order to reconstruct the complete visual field as accurately as possible, and then separately reconstructs the visual field from sparse observations. Furthermore, PASS is patient-specific and non-greedy. It adaptively selects what locations to query based on the patient's answers to previous queries, and the locations are jointly selected to maximize the quality of the final reconstruction. In our experiments, we show that PASS outperforms state-of-the-art methods, leading to more accurate reconstructions while reducing between 30% and 70% the duration of the patient examination.
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Affiliation(s)
- Şerife Seda Kucur
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
| | - Pablo Márquez-Neila
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Mathias Abegg
- Department of Ophthalmology, Bern University Hospital, Inselspital, Bern, Switzerland
| | - Raphael Sznitman
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
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20
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Feil M, Abegg M, Abegg M. Timing of concurrent visual stimuli determines modulation of saccadic amplitude. J Vis 2018; 18:8. [PMID: 30347095 DOI: 10.1167/18.11.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The temporal relation of competing visual stimuli may determine the corresponding oculomotor response. In this study we systematically varied the temporal coincidence of two conflicting stimuli and investigated saccades that were elicited from such stimuli. We varied the time of presentation of two identical spatially separated stimuli between 0 and +165 ms and measured the amplitude of the saccade elicited by these stimuli using infrared eye tracking. In the first experiment, all stimuli were shown for 36 ms only. In the second experiment, stimuli remained on the screen until the subsequent stimulus appeared, whereas in the third experiment all stimuli were removed after saccade onset. Up to an interstimulus interval of 82 ms, we found a significant shift of the saccadic endpoint toward the location of the second stimulus as compared to saccades toward the first stimulus alone. The strongest saccadic bias was observed if a stimulus was shown 36 ms after or before another stimulus. In contrast, time intervals longer than 82 ms elicited saccade adaptation-that is, the saccadic landing point gradually moved toward the second location over time. In more than 99% of trials, the second stimulus appeared before the saccade reached its endpoint. The timing of a conflicting stimulus determines the associated saccadic response: Simultaneous presentation of two stimuli results in a saccadic endpoint at an averaged intermediate position, short interstimulus intervals result in a strong shift of the saccadic endpoint toward the location of the second of two consecutive stimuli, and longer interstimulus intervals elicit saccade adaptation. The timing of two stimuli thus is associated with distinct processes, which complement each other in order to provide an optimal oculomotor response.
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Affiliation(s)
- Moritz Feil
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Meinrad Abegg
- Forest Resources and Management, WSL Swiss Federal Institute for Forest, Snow and Landscape Research WSL, Birmensdorf, Switzerland
| | - Mathias Abegg
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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21
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Borruat FX, Dysli M, Voide N, Abegg M. Acetazolamide Reduces Retinal Inner Nuclear Layer Thickness in Microcystic Macular Edema Secondary to Optic Neuropathy. Eur Neurol 2018. [DOI: 10.1159/000487665] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Optic neuropathy (ON) is commonly complicated by microcystic macular edema (MME), that is, small vertical cystoid spaces in the inner nuclear layer (INL) of the macula. We performed a retrospective consecutive case series of 14 eyes from 11 patients with ON and MME that were treated with oral acetazolamide, acting on cellular water transport. Contralateral eyes without MME were used as controls. Segmentation of images obtained with OCT was used to determine changes of individual retinal layer thickness during treatment. Retinal INL thickness consistently decreased in all eyes after 2–3 weeks of treatment. Recurrence of MME was observed after treatment cessation. No significant change of retinal thickness was found in contralateral unaffected eyes. Visual function did not change with treatment. Acetazolamide significantly improved the MME in eyes with ON. However, visual function did not. Acetazolamide is a treatment option for MME associated with ON but without an impact on the visual function.
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22
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Morsdorf F, Kükenbrink D, Schneider FD, Abegg M, Schaepman ME. Close-range laser scanning in forests: towards physically based semantics across scales. Interface Focus 2018; 8:20170046. [PMID: 29503725 DOI: 10.1098/rsfs.2017.0046] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2017] [Indexed: 11/12/2022] Open
Abstract
Laser scanning with its unique measurement concept holds the potential to revolutionize the way we assess and quantify three-dimensional vegetation structure. Modern laser systems used at close range, be it on terrestrial, mobile or unmanned aerial platforms, provide dense and accurate three-dimensional data whose information just waits to be harvested. However, the transformation of such data to information is not as straightforward as for airborne and space-borne approaches, where typically empirical models are built using ground truth of target variables. Simpler variables, such as diameter at breast height, can be readily derived and validated. More complex variables, e.g. leaf area index, need a thorough understanding and consideration of the physical particularities of the measurement process and semantic labelling of the point cloud. Quantified structural models provide a framework for such labelling by deriving stem and branch architecture, a basis for many of the more complex structural variables. The physical information of the laser scanning process is still underused and we show how it could play a vital role in conjunction with three-dimensional radiative transfer models to shape the information retrieval methods of the future. Using such a combined forward and physically based approach will make methods robust and transferable. In addition, it avoids replacing observer bias from field inventories with instrument bias from different laser instruments. Still, an intensive dialogue with the users of the derived information is mandatory to potentially re-design structural concepts and variables so that they profit most of the rich data that close-range laser scanning provides.
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Affiliation(s)
- F Morsdorf
- Remote Sensing Laboratories, Department of Geography, University of Zürich, Winterthurerstrasse 190, 8057 Zürich, Switzerland.,URPP Global Change and Biodiversity, University of Zürich, Winterthurerstrasse 190, 8057 Zürich, Switzerland
| | - D Kükenbrink
- Remote Sensing Laboratories, Department of Geography, University of Zürich, Winterthurerstrasse 190, 8057 Zürich, Switzerland
| | - F D Schneider
- Remote Sensing Laboratories, Department of Geography, University of Zürich, Winterthurerstrasse 190, 8057 Zürich, Switzerland.,URPP Global Change and Biodiversity, University of Zürich, Winterthurerstrasse 190, 8057 Zürich, Switzerland
| | - M Abegg
- Remote Sensing Laboratories, Department of Geography, University of Zürich, Winterthurerstrasse 190, 8057 Zürich, Switzerland.,Forest Resources and Management, WSL Swiss Federal Institute for Forest, Snow and Landscape Research WSL, Zürcherstrasse 111, 8903 Birmensdorf, Switzerland
| | - M E Schaepman
- Remote Sensing Laboratories, Department of Geography, University of Zürich, Winterthurerstrasse 190, 8057 Zürich, Switzerland.,URPP Global Change and Biodiversity, University of Zürich, Winterthurerstrasse 190, 8057 Zürich, Switzerland
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Abstract
PURPOSE Macular optical coherence tomography (OCT) analysis can be used for quantitative measures of optic nerve atrophy at a location far from the optic nerve head. This recently led to the finding of microcystic macular edema (MME), that is vacuolar inclusions in the macular inner nuclear layer, in some glaucoma patients. The involvement of individual retinal layers is yet unclear in glaucoma. In this study we systematically investigated glaucoma-induced changes in macular layers to evaluate whether glaucoma-associated damage extends beyond the macular ganglion cell layer. PATIENTS AND METHODS We included 218 consecutive patients and 282 eyes with confirmed primary open-angle glaucoma or pseudoexfoliation glaucoma, and macular OCT in a cross-sectional observational study. Eyes were screened for presence of MME. Thickness of individual retinal layers was determined using a semiautomatic segmentation algorithm. Peripapillary nerve fiber layer thickness and mean defect in visual field testing were extracted from OCT and medical records, respectively. Results were compared with a small group of eyes with no apparent glaucoma. RESULTS We found MME in 5 eyes from 5 primary open-angle glaucoma patients and 3 eyes of 3 pseudoexfoliation glaucoma patients (2.8%). MME was confined to the inner nuclear layer in a perifoveal ring and was associated with thinning of the ganglion cell layer and thickening of the macular inner nuclear layer. Glaucoma eyes without MME showed a significant inverse correlation of inner nuclear layer thickness with glaucoma severity. CONCLUSIONS Glaucomatous damage leads to a gradual thickening of the inner nuclear layer, which leads to MME in more severe glaucoma cases. These changes, along with nerve fiber loss and ganglion cell loss, may be summarized as glaucoma-associated retrograde maculopathy.
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Affiliation(s)
- Jacqueline Brazerol
- *Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland †Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
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24
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Feil M, Moser B, Abegg M. The interaction of pupil response with the vergence system. Graefes Arch Clin Exp Ophthalmol 2017; 255:2247-2253. [DOI: 10.1007/s00417-017-3770-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 07/19/2017] [Accepted: 07/31/2017] [Indexed: 10/19/2022] Open
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25
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Ebneter A, Jaggi D, Abegg M, Wolf S, Zinkernagel MS. Relationship Between Presumptive Inner Nuclear Layer Thickness and Geographic Atrophy Progression in Age-Related Macular Degeneration. ACTA ACUST UNITED AC 2016; 57:OCT299-306. [DOI: 10.1167/iovs.15-18865] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Andreas Ebneter
- Department of Ophthalmology Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland 2Department of Clinical Research, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Damian Jaggi
- Department of Ophthalmology Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Mathias Abegg
- Department of Ophthalmology Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sebastian Wolf
- Department of Ophthalmology Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland 3Bern Photographic Reading Center, University of Bern, Bern, Switzerland
| | - Martin S. Zinkernagel
- Department of Ophthalmology Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland 2Department of Clinical Research, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland 3Bern Photographic Reading Center, University of Bern, Bern, Switzerland
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Abstract
Purpose Subjects with albinism usually suffer from nystagmus and reduced visual acuity, which may impair reading performance. The contribution of nystagmus to decreased reading ability is not known. Low vision and nystagmus may have an additive effect. We aimed to address this question by motion compensation of the nystagmus in affected subjects and by simulating nystagmus in healthy controls. Methods Reading speed and eye movements were assessed in 9 subjects with nystagmus associated with albinism and in 12 healthy controls. We compared the reading ability with steady word presentation and with words presented on a gaze contingent display where words move in parallel to the nystagmus and thus correct for the nystagmus. As the control, healthy subjects were asked to read words and texts in steady reading conditions as well as text passages that moved in a pattern similar to nystagmus. Results Correcting nystagmus with a gaze contingent display neither improved nor reduced the reading speed for single words. Subjects with nystagmus and healthy participants achieved comparable reading speed when reading steady texts. However, movement of text in healthy controls caused a significantly reduced reading speed and more regressive saccades. Conclusions Our results argue against nystagmus as the rate limiting factor for reading speed when words were presented in high enough magnification and support the notion that other sensory visual impairments associated with albinism (for example reduced visual acuity) might be the primary causes for reading impairment.
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Affiliation(s)
- Muriel Dysli
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- * E-mail:
| | - Mathias Abegg
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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27
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Abstract
Zusammenfassung. Ein gewichtiger Teil des Lebens beinhaltet visuelle Aktivität. Das Sehen spielt bei fast jeder menschlichen Tätigkeit eine so wichtige Rolle, dass bei einer beliebigen psychischen und physischen Störung häufig der Verdacht aufkommt, die Ursache für die Störung liege im visuellen System. Lesestörung ist der Prototyp einer solchen Störung. Entsprechend gab und gibt es heute noch eine Vielzahl von Versuchen, mittels Training und Augenübungen Defizite verschiedenster Art zu überwinden. In krassem Gegensatz zu der Fülle von Trainingsangeboten steht die Evidenz für den Nutzen solcher Therapien. Es gibt nur ganz wenige Situationen, in denen ein visuelles Training gewinnbringend eingesetzt werden kann. Es scheint, dass das visuelle System so weit optimiert ist, dass menschliche Einflussversuche keine zusätzliche Verbesserung erzielen können.
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Affiliation(s)
- Mathias Abegg
- Universitätsklinik für Augenheilkunde, Inselspital Bern
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Abstract
Low vision therapy, such as magnifiers or contrast enhancement, is widely used. Scientific evidence proving its efficacy is scarce however. The objective of this study was to investigate whether the benefits of magnification and contrast enhancement depended on the origin of low vision. For this purpose we measured reading speed with artificially induced low vision in 12 healthy subjects in conditions of a simulated central scotoma, blurred vision and oscillopsia. Texts were either blurred, set in motion or blanked at the gaze position by using eye tracking and gaze contingent display. The simulated visual impairment was calibrated such that all types of low vision caused equal reading impairment. We then tested the effect of magnification and contrast enhancement among the different types of low vision. We found that reading speed improved with increasing magnification and with higher contrast in all conditions. The effect of magnification was significantly different in the three low vision conditions: The gain from magnification was highest in simulated blur and least in central scotoma. Magnification eventually led to near normal reading speed in all conditions. High contrast was less effective than high magnification and the effect of contrast enhancement was similar in all low vision conditions. From these results we conclude that the type of low vision determines the benefit that can be expected from magnification. Contrast enhancement leads to similar improved reading speed in all low vision types. We provide evidence that supports the use of low vision aids.
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Affiliation(s)
- Michael Christen
- Department of Ophthalmology, Inselspital, Bern University Hospital, and University of Bern, Switzerland
| | - Mathias Abegg
- Department of Ophthalmology, Inselspital, Bern University Hospital, and University of Bern, Switzerland
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Abstract
Visual exploration of natural scenes imposes demands that differ between the upper and the lower visual hemifield. Yet little is known about how ocular motor performance is affected by the location of visual stimuli or the direction of a behavioural response. We compared saccadic latencies between upper and lower hemifield in a variety of conditions, including short-latency prosaccades, long-latency prosaccades, antisaccades, memory-guided saccades and saccades with increased attentional and selection demand. All saccade types, except memory guided saccades, had shorter latencies when saccades were directed towards the upper field as compared to downward saccades (p
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Bär S, Hauf M, Barton JJS, Abegg M. The neural network of saccadic foreknowledge. Exp Brain Res 2015; 234:409-18. [PMID: 26497988 DOI: 10.1007/s00221-015-4468-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 10/08/2015] [Indexed: 10/22/2022]
Abstract
Foreknowledge about upcoming events may be exploited to optimize behavioural responses. In a previous work, using an eye movement paradigm, we showed that different types of partial foreknowledge have different effects on saccadic efficiency. In the current study, we investigated the neural circuitry involved in processing of partial foreknowledge using functional magnetic resonance imaging. Fourteen subjects performed a mixed antisaccade, prosaccade paradigm with blocks of no foreknowledge, complete foreknowledge or partial foreknowledge about stimulus location, response direction or task. We found that saccadic foreknowledge is processed primarily within the well-known oculomotor network for saccades and antisaccades. Moreover, we found a consistent decrease in BOLD activity in the primary and secondary visual cortex in all foreknowledge conditions compared to the no-foreknowledge conditions. Furthermore we found that the different types of partial foreknowledge are processed in distinct brain areas: response foreknowledge is processed in the frontal eye field, while stimulus foreknowledge is processed in the frontal and parietal eye field. Task foreknowledge, however, revealed no positive BOLD correlate. Our results show different patterns of engagement in the saccade-related neural network depending upon precisely what type of information is known ahead.
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Dysli M, Abegg M. Gaze Dependent Vergence Adaptation. J Vis 2015. [DOI: 10.1167/15.12.825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Abstract
New-onset impairment of ocular motility will cause incomitant strabismus, i.e., a gaze-dependent ocular misalignment. This ocular misalignment will cause retinal disparity, that is, a deviation of the spatial position of an image on the retina of both eyes, which is a trigger for a vergence eye movement that results in ocular realignment. If the vergence movement fails, the eyes remain misaligned, resulting in double vision. Adaptive processes to such incomitant vergence stimuli are poorly understood. In this study, we have investigated the physiological oculomotor response of saccadic and vergence eye movements in healthy individuals after shifting gaze from a viewing position without image disparity into a field of view with increased image disparity, thus in conditions mimicking incomitance. Repetitive saccadic eye movements into a visual field with increased stimulus disparity lead to a rapid modification of the oculomotor response: (a) Saccades showed immediate disconjugacy (p < 0.001) resulting in decreased retinal image disparity at the end of a saccade. (b) Vergence kinetics improved over time (p < 0.001). This modified oculomotor response enables a more prompt restoration of ocular alignment in new-onset incomitance.
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Affiliation(s)
- Muriel Dysli
- Department of Ophthalmology, Inselspital, Bern University Hospital, and University of Bern, Switzerland
| | - Fabian Keller
- Department of Ophthalmology, Inselspital, Bern University Hospital, and University of Bern, Switzerland
| | - Mathias Abegg
- Department of Ophthalmology, Inselspital, Bern University Hospital, and University of Bern, Switzerland
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Dysli M, Vogel N, Abegg M. Reading performance is not affected by a prism induced increase of horizontal and vertical vergence demand. Front Hum Neurosci 2014; 8:431. [PMID: 24987346 PMCID: PMC4060573 DOI: 10.3389/fnhum.2014.00431] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 05/28/2014] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Dyslexia is the most common developmental reading disorder that affects language skills. Latent strabismus (heterophoria) has been suspected to be causally involved. Even though phoria correction in dyslexic children is commonly applied, the evidence in support of a benefit is poor. In order to provide experimental evidence on this issue, we simulated phoria in healthy readers by modifying the vergence tone required to maintain binocular alignment. METHODS Vergence tone was altered with prisms that were placed in front of one eye in 16 healthy subjects to induce exophoria, esophoria, or vertical phoria. Subjects were to read one paragraph for each condition, from which reading speed was determined. Text comprehension was tested with a forced multiple choice test. Eye movements were recorded during reading and subsequently analyzed for saccadic amplitudes, saccades per 10 letters, percentage of regressive (backward) saccades, average fixation duration, first fixation duration on a word, and gaze duration. RESULTS Acute change of horizontal and vertical vergence tone does neither significantly affect reading performance nor reading associated eye movements. CONCLUSION Prisms in healthy subjects fail to induce a significant change of reading performance. This finding is not compatible with a role of phoria in dyslexia. Our results contrast the proposal for correcting small angle heterophorias in dyslexic children.
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Affiliation(s)
- Muriel Dysli
- Department of Ophthalmology, Inselspital, University of Bern Bern, Switzerland ; Graduate School for Cellular and Biomedical Sciences, University of Bern Bern, Switzerland
| | - Nicolas Vogel
- Department of Ophthalmology, Inselspital, University of Bern Bern, Switzerland
| | - Mathias Abegg
- Department of Ophthalmology, Inselspital, University of Bern Bern, Switzerland
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Abstract
Prior studies have shown an ‘alternate antisaccade-goal bias’, in that the saccadic landing points of antisaccades were displaced towards the location of antisaccade goals used in other trials in the same experimental block. Thus the motor response in one trial induced a spatial bias of a motor response in another trial. In this study we investigated whether sensory information, i.e. the location of a visual stimulus, might have a spatial effect on a motor response too. Such an effect might be attractive as for the alternate antisaccade-goal bias or repulsive. For this purpose we used block of trials with either antisaccades, prosaccades or mixed trials in order to study the alternate-trial biases generated by antisaccade goals, antisaccade stimuli, and prosaccade goals. in contrast to the effects of alternate antisaccade goals described in prior studies, alternate antisaccade stimuli generated a significant repulsive bias of about 1.8°: furthermore, if stimulus and motor goal coincide, as with an alternate prosaccade, the repulsive effect of a stimulus prevails, causing a bias of about 0.9°. Taken together with prior results, these findings may reflect averaging of current and alternate trial activity in a salience map, with excitatory activity from the motor response and inhibitory activity from the sensory input..
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Abegg M, Zinkernagel M, Wolf S. Re: Rönnbäck et al.: Imaging of the macula indicates early completion of structural deficit in autosomal-dominant optic atrophy (Ophthalmology 2013;120:2672–7). Ophthalmology 2014; 121:e29-30. [DOI: 10.1016/j.ophtha.2013.11.044] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Accepted: 11/19/2013] [Indexed: 11/28/2022] Open
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Dysli C, Quellec G, Abegg M, Menke MN, Wolf-Schnurrbusch U, Kowal J, Blatz J, La Schiazza O, Leichtle AB, Wolf S, Zinkernagel MS. Quantitative Analysis of Fluorescence Lifetime Measurements of the Macula Using the Fluorescence Lifetime Imaging Ophthalmoscope in Healthy Subjects. ACTA ACUST UNITED AC 2014; 55:2106-13. [DOI: 10.1167/iovs.13-13627] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Chantal Dysli
- Department of Ophthalmology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Gwénolé Quellec
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Mathias Abegg
- Department of Ophthalmology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Marcel N. Menke
- Department of Ophthalmology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Ute Wolf-Schnurrbusch
- Department of Ophthalmology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Jens Kowal
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | | | | | - Alexander B. Leichtle
- University Institute of Clinical Chemistry Department of Hematology, Oncology, Infectiology, Laboratory Medicine and Hospital Pharmacy Center of Laboratory Medicine, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Sebastian Wolf
- Department of Ophthalmology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Martin S. Zinkernagel
- Department of Ophthalmology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
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Abegg M, Dysli M, Wolf S, Kowal J, Dufour P, Zinkernagel M. Microcystic macular edema: retrograde maculopathy caused by optic neuropathy. Ophthalmology 2013; 121:142-149. [PMID: 24139122 DOI: 10.1016/j.ophtha.2013.08.045] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 08/29/2013] [Accepted: 08/30/2013] [Indexed: 11/16/2022] Open
Abstract
PURPOSE To investigate retrograde axonal degeneration for its potential to cause microcystic macular edema (MME), a maculopathy that has been previously described in patients with demyelinating disease. To identify risk factors for MME and to expand the anatomic knowledge on MME. DESIGN Retrospective case series. PARTICIPANTS We included 117 consecutive patients and 180 eyes with confirmed optic neuropathy of variable etiology. Patients with glaucoma were excluded. METHODS We determined age, sex, visual acuity, etiology of optic neuropathy, and the temporal and spatial characteristics of MME. Eyes with MME were compared with eyes with optic neuropathy alone and to healthy fellow eyes. With retinal layer segmentation we quantitatively measured the intraretinal anatomy. MAIN OUTCOME MEASURES Demographic data, distribution of MME in the retina, and thickness of retinal layers were analyzed. RESULTS We found MME in 16 eyes (8.8%) from 9 patients, none of whom had multiple sclerosis or neuromyelitis optica. The MME was restricted to the inner nuclear layer (INL) and had a characteristic perifoveal circular distribution. Compared with healthy controls, MME was associated with significant thinning of the ganglion cell layer and nerve fiber layer, as well as a thickening of the INL and the deeper retinal layers. Youth is a significant risk factor for MME. CONCLUSIONS Microcystic macular edema is not specific for demyelinating disease. It is a sign of optic neuropathy irrespective of its etiology. The distinctive intraretinal anatomy suggests that MME is caused by retrograde degeneration of the inner retinal layers, resulting in impaired fluid resorption in the macula.
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Affiliation(s)
- Mathias Abegg
- Department of Ophthalmology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.
| | - Muriel Dysli
- Department of Ophthalmology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Sebastian Wolf
- Department of Ophthalmology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Jens Kowal
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Pascal Dufour
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Martin Zinkernagel
- Department of Ophthalmology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
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Rastgardani T, Lau V, Barton JJS, Abegg M. Trial history biases the spatial programming of antisaccades. Exp Brain Res 2012; 222:175-83. [DOI: 10.1007/s00221-012-3201-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Accepted: 07/20/2012] [Indexed: 10/27/2022]
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Sheldon CA, Abegg M, Sekunova A, Barton JJ. The word-length effect in acquired alexia, and real and virtual hemianopia. Neuropsychologia 2012; 50:841-51. [DOI: 10.1016/j.neuropsychologia.2012.01.020] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Revised: 01/17/2012] [Accepted: 01/17/2012] [Indexed: 11/25/2022]
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Abegg M, Sharma N, Barton JJ. Antisaccades generate two types of saccadic inhibition. Biol Psychol 2012; 89:191-4. [DOI: 10.1016/j.biopsycho.2011.10.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2011] [Revised: 10/03/2011] [Accepted: 10/08/2011] [Indexed: 11/27/2022]
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Egli M, Goldblum D, Kipfer A, Rohrer K, Tappeiner C, Abegg M, Berger L, Schoetzau A, Iliev ME. Assessment of a new Goldmann applanation tonometer. Br J Ophthalmol 2012; 96:42-6. [DOI: 10.1136/bjo.2010.182469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sheldon C, Abegg M, Sekunova A, Barton J. The word length effect in virtual hemianopia, real hemianopia, and alexia. J Vis 2011. [DOI: 10.1167/11.11.859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Scheel M, Abegg M, Lanyon LJ, Mattman A, Barton JJ. White and gray matter alterations in adults with Niemann-Pick disease type C: a cross-sectional study. Neurology 2011; 76:201; author reply 201-2. [PMID: 21220727 DOI: 10.1212/wnl.0b013e3181fe7341] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Abegg M, Manoach DS, Barton JJ. Knowing the future: Partial foreknowledge effects on the programming of prosaccades and antisaccades. Vision Res 2011; 51:215-21. [DOI: 10.1016/j.visres.2010.11.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2009] [Revised: 11/12/2010] [Accepted: 11/15/2010] [Indexed: 10/18/2022]
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Affiliation(s)
- Sara Ann Simpson
- Department of Medicine, niversity of British Columbia, Vancouver V5Z 3N9, Canada
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Van der Stigchel S, Nijboer TCW, Bergsma DP, Abegg M, Barton JJS. Anomalous global effects induced by ‘blind’ distractors in visual hemifield defects. Brain Cogn 2010; 74:66-73. [PMID: 20637537 DOI: 10.1016/j.bandc.2010.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2009] [Revised: 03/14/2010] [Accepted: 06/21/2010] [Indexed: 11/28/2022]
Affiliation(s)
- S Van der Stigchel
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, The Netherlands.
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Abstract
Studies of memory-guided saccades in monkeys show an upward bias, while studies of antisaccades in humans show a diagonal effect, a deviation of endpoints toward the 45° diagonal. To determine if these two different spatial biases are specific to different types of saccades, we studied prosaccades, antisaccades and memory-guided saccades in humans. The diagonal effect occurred not with prosaccades but with antisaccades and memory-guided saccades with long intervals, consistent with hypotheses that it originates in computations of goal location under conditions of uncertainty. There was a small upward bias for memory-guided saccades but not prosaccades or antisaccades. Thus this bias is not a general effect of target uncertainty but a property specific to memory-guided saccades.
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Simpson S, Abegg M, Barton JJ. Short Term Adaptation of Visual Search Strategies in Simulated Hemianopia. J Vis 2010. [DOI: 10.1167/10.7.1127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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