Discriminating between early glaucoma and ocular hypertension: diagnostic accuracy of pattern electroretinogram and confocal scanning laser optic disc morphometry.
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Electroretinography↗
Biomedical subjects
M Piccardi
Publications and source records attributed to M Piccardi.
Retinal sensitivity to flicker modulation: reduced by early age-related maculopathy.
PURPOSE: To evaluate retinal, cone-mediated flicker sensitivity (CFS) in age-related maculopathy (ARM) by quantifying response gain and threshold of the focal electroretinogram (FERG) to flicker modulation. METHODS: Nineteen patients with ARM (visual acuity > or =20/30) and 11 age-matched control subjects were examined. Twelve patients had less than 20 soft drusen in the macular region and no hyper-/hypopigmentation (early lesion), whereas seven had more than 20 soft drusen and/or focal hyper-/hypopigmentation (advanced lesion). Macular (18 degree ) FERGs were elicited by a sinusoidally flickering (41 Hz) uniform field (on a light-adapting background) whose modulation depth was varied between 16.5% and 94%. Amplitude and phase of the response's fundamental harmonic were measured. RESULTS: In both control subjects and patients with ARM, log FERG amplitude increased with log stimulus modulation depth with a straight line (power law) relation. However, the slope (or gain) of the function was, on average, steeper in control subjects than in patients with either early or advanced lesions. Mean FERG threshold, estimated from the value of the log modulation depth that yielded a criterion response, did not differ between control subjects and patients with early lesions but was increased (0.35 log units) compared with control subjects in those with advanced lesions. In both patient groups, but not in control subjects, mean FERG phase tended to delay with decreasing stimulus modulation depth. CONCLUSIONS: Retinal CFS losses can be detected in ARM by evaluating the FERG as a function of flicker modulation depth. Reduced response gain and phase delays, with normal thresholds, are associated with early lesions. Increased response thresholds, in addition to gain and phase abnormalities, may reflect more advanced lesions. Evaluating CFS by FERG may directly document different stages of macular dysfunction in ARM.
Aged↗
The fundamental and second harmonic of the photopic flicker electroretinogram: temporal frequency-dependent abnormalities in retinitis pigmentosa.
OBJECTIVES: The flicker electroretinogram (FERG) consists mainly of a linear (fundamental, 1F) and a non linear (second harmonic, 2F) component. Previous results indicate that 2F originates more proximally in the retina than 1F, and that retinitis pigmentosa (RP) may affect 2F to a greater extent than 1F. The aim of this study was to evaluate FERG 1F and 2F abnormalities in RP as a function of the stimulus temporal frequency (TF). METHODS: Twelve patients with typical RP and 10 age-matched controls were examined. FERGs were recorded in response to uniform fields (18 degrees) presented in the macula on a light-adapting background. Stimuli were flickered sinusoidally at different, closely spaced TFs between 3.7 and 52 Hz. Amplitudes and phases of the Fourier analysed 1F and 2F components were measured. Components' apparent latencies were estimated from the rate at which phase lagged with TF. RESULTS: When compared to controls, mean 1F amplitudes of patients were reduced at both low (3.7-12.6 Hz) and high (14-52 Hz) TFs, with greatest losses (0.5 log units) around the peaks (3.7 and 41 Hz) of the normal TF function. Mean 2F amplitudes were reduced mainly at low TFs, with greatest losses (0.5 log units) at 5-8 Hz. On average, the shape of the 2F, but not 1F amplitude versus TF function, differed between patients and controls, showing a selective attenuation at low TFs. Mean 1F apparent latencies were delayed at both low and high TFs, with greater delays at low (85 ms) than at high (33 ms) TFs. Mean 2F apparent latencies were delayed only at low TFs (58 ms). CONCLUSIONS: In RP, 1F and 2F phase delays as well as 2F amplitude losses are dependent on TF, suggesting that FERG generators' subpopulations in both distal and proximal retina are differentially affected. Analysis of the FERG TF response is potentially useful to characterize cone system dysfunction in different genetic subtypes of RP.
Adolescent↗
The spatial tuning of steady state pattern electroretinogram in multiple sclerosis.
In normal subjects, the steady-state electroretinogram in response to contrast reversing gratings (PERG), is spatially band-pass tuned in amplitude, with a maximum at intermediate spatial frequencies and an attenuation at lower and higher ones. The amplitude attenuation at low spatial frequencies is believed to reflect centre-surround antagonistic interactions in the receptive fields of inner retinal neurons. The aim of this study was to evaluate the PERG spatial tuning in multiple sclerosis (MS) patients without a previous optic neuritis history. Steady- state PERGs in response to counterphase-modulated (8 Hz) sinusoidal gratings of variable spatial frequency (0.6, 1.0, 1.4, 2.2 and 4.8 c/deg), were recorded from 18 patients with definite or probable MS and no history of optic neuritis (ON-). Nine of them had no signs of subclinical optic nerve demyelination (asymptomatic) in either eye, while nine had symptoms or signs of optic pathways involvement (symptomatic) in one or both eyes. Results were compared with those obtained from 10 MS patients with a previous history of optic neuritis (ON+) in one or both eyes, as well as from 21 age-matched controls. The amplitudes and phases of the responses' 2nd harmonics were measured. Compared with the controls, asymptomatic ON- patients showed selective losses in mean PERG amplitudes at medium and high (1.0-4.8 c/deg) spatial frequencies. Symptomatic ON- patients and ON+ patients had reductions in mean PERG amplitudes, with respect to controls, involving the whole spatial frequency range, but with greater losses at medium-high (1.0-4.8 c/deg) than at lower spatial frequencies. In all patients' groups, the average PERG spatial tuning function differed significantly from that of the controls, assuming a low-pass instead of the normal band-pass shape. The PERG phase was delayed in ON+ but not in ON- patients, as compared to controls. However, the phase delay was independent of spatial frequency. In both ON- and ON+ patients, losses in PERG amplitude and spatial tuning tended to be associated with corresponding abnormalities in perimetric sensitivity, visual acuity, colour vision and transient visual evoked potential (VEP) latency. The results indicate that abnormalities of the spatial tuning of steady-state PERG can be found in MS patients without either optic neuritis or signs of subclinical optic nerve demyelination. These changes may reflect a retinal dysfunction, developing early in the course of MS, due to a loss of specific subpopulations of inner neurons, changes in lateral interactions of their receptive fields, or both.
Adolescent↗
Detection of glaucomatous damage in patients with osteo-odontokeratoprosthesis.
BACKGROUND: Osteo-odontokeratoprosthesis (OOKP) is an autologous transplantation procedure in which the cornea is replaced by an optical cylinder glued to a biological support. Patients undergoing OOKP surgery may develop a secondary glaucoma whose diagnosis, by means of standard diagnostic procedures, is often doubtful. METHODS: In the present study pattern electroretinograms (PERGs), visual evoked potentials (VEPs), contrast sensitivity, and automated threshold perimetry (Humphrey 30-2) were evaluated in 19 OOKP treated patients with postoperative visual acuities > or = 0.8. Nine patients had had a preoperative secondary glaucoma, while the remaining 10 had no history of glaucoma and normal posterior pole. RESULTS: Results were compared with those obtained from either normal control subjects or from ordinary glaucoma patients. PERG amplitudes and contrast and perimetric sensitivities were reduced in both groups of OOKP patients when compared with normal controls. However, these losses were significantly greater in OOKP patients with glaucoma compared with those with normal posterior pole. VEPs were reduced, compared with controls, only in OOKP patients with glaucoma. These VEP losses were similar to those found in ordinary glaucoma patients. CONCLUSION: Among the tests employed, VEPs showed the best accuracy (79%) in discriminating between glaucomatous and non-glaucomatous OOKP treated eyes. The present results suggest a possible use of the VEP technique for detecting glaucomatous dysfunction after OOKP.
Adult↗
Macular dysfunction in multiple sclerosis revealed by steady-state flicker and pattern ERGs.
Recent evidence indicates that the 2nd harmonics of steady-state (8 Hz) electroretinograms to either sinusoidal flicker (FERG) or to counterphased gratings (PERG) presented in the macular region (9 degrees) represent different subsets of generators in the inner retina. We evaluated the steady-state macular FERG and PERG 2nd harmonics (2F and 2P, respectively) in 19 normal subjects (19 eyes) and in 23 multiple sclerosis patients (44 eyes; 25 eyes with a history of clinical optic neuritis, and 19 eyes with no history of optic neuritis, subclinical eyes). The mean 2F and 2P amplitudes were significantly reduced, as compared to controls, in both subclinical and optic neuritis eyes. The 2P phase was significantly delayed, as compared to controls, in subclinical eyes, whereas 2F phase was delayed in eyes with optic neuritis. 2F was outside the 95% confidence limits (in amplitude or phase) in 11/19 subclinical eyes and in 25/25 optic neuritis eyes. 2P was outside the normal range in 12/19 subclinical eyes and in 24/25 optic neuritis eyes. These results show that FERG and PERG 2nd harmonics are significantly altered in multiple sclerosis eyes with or without a clinical history of optic neuritis. This finding suggests a dysfunction of inner macular layers which may result from direct retinal involvement or retrograde degeneration.
Adolescent↗
High affinity binding sites for 1-methyl-4-phenyl-pyridinium ion (MPP+) are present in mouse brain.
The possible involvement of 1-methyl-4-phenyl-pyridinium ion (MPP+) in the toxicity of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) prompted us to search for and characterize [3H]MPP+ binding sites in the mouse. Our data show that [3H]MPP+ binds saturably and with high affinity to mouse brain membranes. Scatchard analysis resulted in one straight line. The apparent KD was 15 +/- 1 nM and the Bmax 245 +/- 30 fmol/mg protein. The distribution of [3H]MPP+ binding sites shows a regional variation: the hypothalamus having highest binding and the cerebellum the lowest. Several compounds failed to inhibit [3H]MPP+ binding whereas only analogues of MPP+, MPTP and paraquat were able to antagonize this binding to brain. Specific binding with analogous characteristics also occurs in peripheral tissues. Considering the postulated role of MPP+ in MPTP neurotoxicity, further studies on [3H]MPP+ binding sites might be relevant to elucidate the mechanisms of this toxicity.
1-Methyl-4-phenylpyridinium↗