Cone-driven strong flash electroretinograms in healthy adults: Prevalence of negative waveforms

PURPOSE

Both rod and cone-driven signals contribute to the electroretinogram (ERG) elicited by a standard strong flash in the dark. Negative ERGs usually reflect inner retinal dysfunction. However, in diseases where rod photoreceptor function is selectively lost, a negative waveform might represent the response of the dark-adapted cone system. To investigate the dark-adapted cone-driven waveform in healthy individuals, we delivered flashes on a dim blue background, designed to saturate the rods, but minimally adapt the cones.

METHODS

ERGs were recorded, using conductive fibre electrodes, in adults from the TwinsUK cohort. Responses to 13 cd m-2 s white xenon flashes (similar to the standard DA 10 flash), delivered on a blue background, were analysed. Photopic and scotopic strengths of the background were 1.3 and 30 cd m-2, respectively; through a dilated pupil, this is expected to largely saturate the rods, but adapt the cones much less than the standard ISCEV background.

RESULTS

Mean (SD) participant age was 62.5 (11.3) years (93% female). ERGs from 203 right and 204 left eyes were included, with mean (SD) b/a ratios of 1.22 (0.28) and 1.18 (0.28), respectively (medians, 1.19 and 1.17). Proportions with negative waveforms were 23 and 26%, respectively. Right and left eye b/a ratios were strongly correlated (correlation coefficient 0.74, p < 0.0001). We found no significant correlation of b/a ratio with age.

CONCLUSIONS

Over 20% of eyes showed b/a ratios less than 1, consistent with the notion that dark-adapted cone-driven responses to standard bright flashes can have negative waveforms. The majority had ratios greater than 1. Thus, whilst selective loss of rod function can yield a negative waveform (with reduced a-wave) in some, our findings also suggest that loss of rod function can occur without necessarily yielding a negative ERG. One potential limitation is possible mild cone system adaptation by the background.

A multiscale continuum model of the vertebrate outer retina: The temporal dynamics of background-induced flicker enhancement

The retina is a part of the central nervous system that is accessible, well documented, and studied by researchers spanning the clinical, experimental, and theoretical sciences. Here, we mathematically model the subcircuits of the outer plexiform layer of the retina on two spatial scales: that of an individual synapse and that of the scale of the receptive field (hundreds to thousands of synapses). To this end we formulate a continuum spine model (a partial differential equation system) that incorporates the horizontal cell syncytium and its numerous processes (spines) within cone pedicles. With this multiscale modeling approach, detailed biophysical mechanisms at the synaptic level are retained while scaling up to the receptive field level. As an example of its utility, the model is applied to study background-induced flicker enhancement in which the onset of a dim background enhances the center flicker response of horizontal cells. Simulation results, in comparison with flicker enhancement data for square, slit, and disk test regions, suggest that feedback mechanisms that are voltage-axis modulators of cone calcium channels (for example, ephaptic and/or pH feedback) are robust in capturing the temporal dynamics of background-induced flicker enhancement. The value and potential of this continuum spine approach is that it provides a framework for mathematically modeling the input-output properties of the entire receptive field of the outer retina while implementing the latest models for transmission mechanisms at the synaptic level.