Biomedical subjects

Karen Holopigian

Publications and source records attributed to Karen Holopigian.

11 recordsLinked to original sources

PubMed2004

The multifocal visual evoked potential: an objective measure of visual fields?

We examined the effects of inter-modal attention and mental arithmetic on Humphrey visual field sensitivity and multifocal visual evoked potential (mfVEP) amplitude. Four normally sighted subjects (ages ranging from 24 to 58 years) participated in this study. Monocular visual field sensitivity was measured under two conditions: (1) standard testing condition and (2) while the subject performed a Paced Auditory Serial Addition Task (PASAT). Monocular mfVEPs were recorded in response to a 60-sector stimulus. The checkerboard pattern in each sector was contrast reversed according to a binary m-sequence. mfVEPs were recorded under two conditions: (1) standard testing conditions and (2) while the subject performed a PASAT. We found that, when compared to the no-task condition, all subjects had locations of significantly reduced Humphrey visual field sensitivities when performing the PASAT. In contrast, there were no significant decreases in mfVEP amplitude in any sector for any of the subjects while performing the PASAT. Our findings indicate that divided attention and ongoing mental processes did not affect the mfVEP. Therefore, the mfVEP provides an objective measure of visual field function that may be useful for some patients with unreliable automated static perimetry results.

Adult↗

PubMed2004

Test-retest reliability of the multifocal electroretinogram and humphrey visual fields in patients with retinitis pigmentosa.

We examined the reliability of Humphrey visual field thresholds and multifocal electroretinogram (mfERG) amplitudes and timing in a group of patients with Retinitis Pigmentosa (RP). Eight patients with RP and seven control subjects were tested five times: at baseline (visit #0), at three weekly follow-up visits (visits #1 - #3), and at three months (visit #4). For the Humphrey thresholds, differences between dB values on repeat visits were obtained. Differences between log values on repeat visits were calculated for mfERG amplitude and implicit time. We used the standard deviations of these difference scores as a measure of reliability and the means of the difference scores as a measure of progression. We found that the majority of the patients' repeat data were more variable than that of the control subjects for both the Humphrey and mfERG. We found no single factor that predicted the magnitude, or the variance, of the SD of differences scores for the patients. We recommend that each patient's reliability be assessed individually. Ultimately, the choice of an outcome measure must be guided by its reliability, as well as its ability to assess the visual function of interest.

Adult↗

PubMed2004

Rod and cone photoreceptor function in patients with cone dystrophy.

PURPOSE: To determine the extent of rod and cone photoreceptor dysfunction in patients with cone dystrophy using psychophysical and electrophysiological tests. METHODS: Ten patients with cone dystrophy participated. Rod and cone system psychophysical thresholds were measured as a function of retinal eccentricity. Bright-flash full-field electroretinograms were obtained under dark-adapted (rod-mediated) and light-adapted (cone-mediated) conditions. The a-wave data were fitted with a model based on photopigment transduction to obtain values for log Rmax (maximum response) and log S (sensitivity). b-Wave parameters were also examined by fitting a nonlinear, saturating function (the Naka-Rushton equation) to the rod-mediated responses. Oscillatory potentials were measured to the cone-mediated high-intensity flashes. RESULTS: On average, the rod-mediated psychophysical thresholds were elevated by 0.5 log unit. These threshold elevations did not differ significantly with retinal eccentricity. In contrast, cone-mediated psychophysical thresholds were elevated up to 3.0 log units. Threshold elevation was greatest in the central retinal locations. For rod-mediated conditions, the a-wave Rmax parameter was significantly reduced in three patients; the a-wave log S parameter was within normal limits. The rod-mediated b-wave Rmax parameter was reduced in six patients; log k was abnormal in one patient. For cone-mediated conditions, the a-wave Rmax parameter was reduced in six patients and the a-wave log S parameter was reduced in two patients. The cone system oscillatory potentials were abnormal in nine patients. CONCLUSIONS: Patients with cone dystrophy show different patterns of psychophysical rod versus cone system sensitivity losses with retinal eccentricity. The full-field electrophysiological data indicate that most of the patients had abnormal cone photoreceptor function. Some patients also showed rod photoreceptor abnormalities. The rod system changes were smaller than the cone system changes.

Adult↗

PubMed2004

Multidimensional visual field maps: relationships among local psychophysical and local electrophysiological measures.

Multidimensional psychophysical and electrophysical maps of the central retina are essential for assessing the functioning of the diseased retina. In this study, grating acuity, contrast sensitivity, duration for letter identification, multifocal electroretinograms, and Humphrey visual field thresholds were measured at equivalent positions throughout the central 20 degrees. We found that the rates of sensitivity loss were not equivalent for all psychophysical measures. The rate of loss in the duration required for letter identification as a function of eccentricity was the steepest, followed by acuity and contrast sensitivity. The rate of loss in luminance sensitivity as measured in the Humphrey visual field was the shallowest. The pattern of losses also varied across meridians. Specifically, the rate of loss as a function of eccentricity was highest in the vertical meridian and lowest in the horizontal meridian. These maps and the correlations among measures as a function of retinal position serve as a baseline so that we can examine disease effects throughout the retina. In addition, the development of vision rehabilitation programs focused on eccentric viewing training should consider the differential sensitivities of the peripheral retina.

Adult↗

PubMed2003

Electrophysiology.

Numerous electrophysiologic tests are available for use in the clinic. When properly recorded and analyzed, these tests provide important diagnostic and prognostic information about the site and nature of the disease process. If the results from these tests are combined with psychophysical findings (color vision, acuity, visual fields), their usefulness in defining disease can be further extended.

Electrophysiology↗

PubMed2003

The effect of variably tinted spectacle lenses on visual performance in cataract subjects.

PURPOSE: A body of clinical and laboratory evidence suggests that tinted spectacle lenses may have an effect on visual performance. The aim of this study was to quantify the effects of spectacle lens tint on the visual performance of 25 subjects with cataracts. METHODS: Cataracts were scored based on best-corrected acuity and by comparison with the Lens Opacity Classification System (LOCS III) plates. Visual performance was assessed by measuring contrast sensitivity with and without glare (Morphonome software version 4.0). The effect of gray, brown, yellow, green and purple tinting was evaluated. RESULTS: All subjects demonstrated an increase in contrast thresholds under glare conditions regardless of lens tint. However, brown and yellow lens tints resulted in the least amount of contrast threshold increase. Gray lens tint resulted in the largest contrast threshold increase. CONCLUSIONS: Individuals with lenticular changes may benefit from brown or yellow spectacle lenses under glare conditions.

Aged↗

PubMed2003

Multifocal electroretinography as a function of age: the importance of normative values for older adults.

PURPOSE: To determine the influence of age on local electroretinographic responses in humans. METHODS: Multifocal electroretinograms (mfERGs) were obtained from 62 normally sighted subjects ranging in age from 21 to 81 years. A stimulus array of 103 scaled hexagons was used to measure electrical signals within a retinal area approximately 46 degrees in diameter. Commonly reported mfERG methods were used to quantify the responses: peak-to-peak amplitudes and implicit times, scalar product amplitude, and amplitude and time scales derived from the algorithm of Hood and Li, published in 1997. RESULTS: Regression analysis showed significant linear relationships of amplitude and timing measures with age. The rates of losses were 10.5% per decade for peak-to-peak amplitude, 11.7% per decade for scalar product amplitude, and 9.5% per decade for a-scale. The rate of amplitude reduction was highest in the central 3 degrees. Age had less influence on implicit time measures. The rates of timing losses were 1.4% per decade for the N1 component and 1.0% per decade for both the P1 component and the t-scale measure. Using predicted interval ranges, the age was calculated at which 50% of the expected values would fall below the lower 95% prediction interval band of younger subjects. CONCLUSIONS: The age-associated mfERG alterations are presented to emphasize the importance of appropriate normative data in interpretation of mfERGs.

Adult↗

PubMed2002

A method for comparing psychophysical and multifocal electroretinographic increment thresholds.

The multifocal electroretinogram (mfERG) has been commonly used as a method for obtaining objective visual fields. Although qualitative comparisons have been good, quantitative comparisons between the results from mfERG and the results from Humphrey Visual Field Analyser (HVFA) have found variable degrees of agreement depending upon the mfERG response parameter examined and/or the disease studied. Lack of agreement may be due to differences in methodology, differences in the sites of response generation, and/or differences derived from comparing suprathreshold versus threshold responses. In addition, the two procedures are performed at different levels of adaptation. We developed an approach for matching stimulus parameters and compared mfERG and psychophysical thresholds to assess the effects of technique and level of adaptation on the two responses. Psychophysical and mfERG thresholds were obtained as a function of the adaptation level (1.5-4.0 log td) and retinal location. The derived increment threshold-versus-intensity functions for both measures were fitted using the equation logT=logT(0)+log((A+A(0))/A(0))(n). We found that the values of A(0) for the mfERG data were one log unit higher than those for the psychophysical data. In addition, the value of the slope (n) for the mfERG data was shallower (0.8) than that of the psychophysical data (1.0). Predictions were made about comparisons of HVFA threshold and mfERG amplitude data in patients with retinal disease based upon a two-site model of adaptation. The data for some groups of patients could be best-fitted with a model of a disease acting at a site distal to all gain changes, whereas data from other patients were best fitted with a model of a disease acting at a site proximal to all retinal gain. The relationship between the Humphrey visual field threshold losses and mfERG amplitude reductions depends upon the site and mechanism of a particular disease process and the model of retinal gain assumed. In no case is a one-to-one relationship between the losses in the two measures predicted.

Adaptation, Ocular↗

PubMed2002

The spatial distribution of selective attention assessed using the multifocal visual evoked potential.

To determine the manner in which attention is distributed among numerous locations in the visual space, we used a multifocal recording technique that allowed simultaneous recordings of evoked cortical activity from 12 visual field areas out to 23.6 degrees. We found that multifocal visual evoked potential (mfVEP) amplitude was larger when a region of visual space was attended than when it was not attended. The magnitude of this effect was inversely related to visual field eccentricity and there was no attention-related modulation of VEP amplitude for the most eccentric region. In addition, we found that mfVEP amplitudes in the regions contiguous to the attended region could also be larger, depending upon their spatial relationship to the attended region. Specifically, amplitudes in more central regions on the 'meridian of attention' were larger when the subject attended anywhere along that meridian.

Attention↗

PubMed2002

Effect of variable tinted spectacle lenses on visual performance in control subjects.

PURPOSE: To evaluate quantitatively the effects of tinted spectacle lenses on visual performance in individuals without visual pathology. METHODS: Twenty-five subjects were assessed by measuring contrast sensitivity with and without glare. Gray, brown, yellow, green, purple, and blue lens tints were evaluated. Measurements were repeated with each lens tint and with a clear lens, and the order was counterbalanced within and between subjects. Glare was induced with a modified brightness acuity tester. RESULTS: All subjects demonstrated an increase in contrast thresholds under glare conditions for all lens tints. However, purple and blue lens tints resulted in the least amount of contrast threshold increase; the yellow lens tint resulted in the largest contrast threshold increase. CONCLUSIONS: Purple and blue lens tints may improve contrast sensitivity in control subjects under glare conditions.

Adult↗

PubMed2002

Local cone and rod system function in progressive cone dystrophy.

PURPOSE: To compare the patterns of local cone and rod system impairment in patients with progressive cone dystrophy (CD) using psychophysical and electrophysiological techniques. METHODS: Local cone system function was assessed by measuring cone system thresholds (visual fields) and cone-mediated multifocal electroretinograms (mfERGs). Rod system function was assessed by measuring rod system thresholds (visual fields) and rod-mediated mfERGs. The results in a group of eight patients with CD were compared with those in an age-similar control group. RESULTS: All the patients had abnormal cone system visual field thresholds and cone-mediated mfERGs. Cone system psychophysical thresholds were elevated for targets presented within the central 10 degrees, but were within normal limits for targets at peripheral locations. Cone-mediated mfERG measures of amplitude scale and time scale were abnormal for most of the hexagons tested. Most of the rod-mediated psychophysical thresholds and mfERGs were within normal limits. Rod system losses tended to be patchy and scattered throughout the area tested. CONCLUSIONS: There was poor correspondence among local measures of cone and rod system losses in these patients with CD. The results suggest that the spatial pattern of cone system losses in this disease differs from the spatial pattern of rod system losses.

Adolescent↗