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Biomedical subjects

T Berninger

Publications and source records attributed to T Berninger.

At least 19 recordsLinked to original sources
PubMed2003

[Scanning laser ophthalmoscope multifocal electroretinography and microperimetry in patients with Stargardt's disease].

PURPOSE: We used a scanning laser ophthalmoscope (SLO) evoked multifocal electroretinography (mf-ERG) to evaluate retinal function in patients with Stargardt's disease. SLO microperimetry could demonstrate the size of central retinal scotoma very well in these patients. The aim of the examination was to correlate the results of SLO mf-ERG and SLO microperimetry. METHODS: In four patients with Stargardt's disease SLO mf-ERG and SLO microperimetry were performed. The area of measurement in the SLO mfERG had a 24 degrees diameter (12 degrees visual angle) at the posterior pole of the eye. Stimulation was done using a helium-neon laser (632.8 nm). Simultaneous control of fixation was made using a infrared laser (730 nm). SLO microperimetry was performed with stimuli having the size of Goldmann III stimuli and the intensities 0 dB, 12 dB and 20 dB. In this study the reduction of SLO mfERG amplitudes was correlated to graded stimulus intensities in the SLO microperimetry. RESULTS: The area of reduced retinal function in the SLO mf-ERG measurement could be well correlated to the size of the scotoma in the SLO microperimetry, using the stimulus Goldmann III with the intensity 20 dB. CONCLUSION: SLO mfERG and SLO microperimetry are sensitive methods for quantifying functional deficits and are therefore useful for performing a detailed examination of the retina.

Adult↗
PubMed2003

Detecting chloroquine retinopathy: electro-oculogram versus colour vision.

AIM: To investigate the relative sensitivity and specificity of two tests of retinal function (the electro-oculogram (EOG) and a computerised colour vision test) in screening for ocular toxicity caused by chloroquine and hydroxychloroquine. METHODS: 93 patients with rheumatic diseases receiving long term chloroquine and hydroxychloroquine therapy were followed for an average of 2.6 years. Clinical examination, an EOG, and a quantitative test of colour vision were carried out every 6 months. RESULTS: Mild fundus changes were observed in 38 patients. Four patients developed typical bull's eye maculopathy, three of whom had received 250, 365, and 550 g total dose of chloroquine, and one 1500 g of hydroxychloroquine. Statistical analysis of all patients showed that for those with no fundus changes or stippled pigmentation a number showed elevation of tritan threshold, so that if macular stippling is a sign of mild retinopathy the test on tritan changes has a 64% sensitivity and 63% specificity for an upper threshold value of 7%. All four patients with bull's eye lesions showed a marked disturbance of tritan colour vision, with a threshold of 14.8%, a sensitivity of 75%, and a specificity of 94%. For protan colour vision a threshold of 10% gives 75% sensitivity and 91% specificity. By contrast, neither an absolute nor a relative EOG reduction was a valid criterion for early or late chloroquine retinopathy. In advanced retinopathy an Arden coefficient (AQ) <180% yields 50% sensitivity and 54% specificity. When AQ <160% is the threshold, sensitivity does not increase but specificity rises to 82%. Occurrence of marked corneal deposits on clinical examination yields 50% sensitivity and 90% specificity in this situation. CONCLUSION: Screening for chloroquine retinopathy can be improved by using a sensitive colour test. Disturbance of the tritan axis appears to occur first. A normal test result on computerised colour testing virtually excludes any retinopathy by antimalarials. The EOG is of little diagnostic value.

Aging↗
PubMed2001

X-linked ocular albinism (Nettleship-Falls): a novel 29-bp deletion in exon 1. Carrier detection by ophthalmic examination and DNA analysis.

BACKGROUND: Mutations in the OA1 gene on the short arm of the X chromosome are known to cause X-linked ocular albinism (x1OA) in males. A four-generation family with this disorder, including asymptomatic carrier females, was investigated by molecular analysis of the OA1 gene. METHODS: DNA samples were available from 22 individuals of this family, including 6 affected males and 6 obligate carriers. The nine exons of the OA1 gene were amplified and further analyzed by SSCP and sequencing. RESULTS: A detailed clinical examination of the index patient and two female carriers showed the typical signs of ocular albinism. Visual evoked potential responses showed markedly asymmetrical responses from the two hemispheres in the affected person as well as in the carriers, as a result of misrouting and decussation of optic nerve fibers. Molecular genetic analysis demonstrated a previously undescribed 29-bp deletion at position 225-253 in exon 1 of the OA1 gene, which segregated in the family. CONCLUSION: Clinical examination combined with molecular genetic analysis enhances the potential for a precise diagnosis for persons at risk of x1OA and provide an accurate basis for genetic counseling.

Adult↗
PubMed1999

S-cone ERGs elicited by a simple technique in normals and in tritanopes.

PURPOSE: To measure changes in the relative spectral sensitivities of the dark adapted and light adapted ERG and thus to establish the possible contribution of rods to the 'blue cone' ERG elicited by flashes of blue light. BACKGROUND: Short wavelength stimuli in the light-adapted eye evoke small rounded b-waves which have been considered to be S-cone responses. We have recorded such responses from tritanopes, which called the assumptions into question. METHODS: Small ERGs were recorded to blue and green flashes. The stimulus was a Ganzfeld which employed light emitting diodes. ERGs were obtained in both the dark-adapted eye and after light adaptation to intense orange light (peak wavelength 610 nm). The change in sensitivity with light adaptation and the relative spectral sensitivity was determined from the voltage/log light intensity functions, using a 10 microV criterion. RESULTS: (1) peak times and changes in sensitivity did not help distinguish light-adapted rod from possible S-cone responses; (2) analysis of the change in the ratio of blue:green sensitivity from darkness to 4.4 log Td. 610 nm background suggests that in seven normal subjects, 90% or more of the ERG evoked by 440 nm flashes is generated by S-cones; (3) three tritanopes have insignificantly reduced S-cone responses. CONCLUSIONS: (1) clinical techniques used to isolate S-cone ERGs are appropriate; (2) there are at least two types of tritanope and in those we investigated, functional S-cones are probably displaced into the retinal periphery.

Adaptation, Ocular↗
PubMed1999

Effects of refractive blur on the multifocal electroretinogram.

A significant difference in the response density of the MF-ERG response has been suggested for every 2 diopter change of refraction. The influence of refractive blur on the MF-ERG was studied in 8 healthy volunteers using either the VERISTM system (Group A: n=5) or Retiscan(TM) (Group B: n=3). For each eye recordings were obtained with a corrective lens of -3 dpt, 0 dpt, +3 dpt and +6 dpt placed in front of the contact lens electrode. The viewing distance was adjusted to compensate for the induced changes in the retinal image size. When the changes in retinal image size due to the refractive lens were compensated for, no influence due to refraction was observed in either latencies or amplitudes of (KI (P > 0.05). This held true for the central response average (four degrees) as well as for the outer 6-25 degrees. In KII.1 only the peripheral amplitudes of Group B showed an influence due to refraction (P < or = 0.05). This may be due to adaptation as the recordings of group B were obtained in succession. As expected, significant differences were observed when the recordings obtained with the different systems were compared (P < or = 0.05).

Accommodation, Ocular↗
PubMed1999

[Color vision in relation to age: a study of normal values].

BACKGROUND: It is difficult to quantify thresholds in most colour vision tests, and this is especially the case for tritan hues, where a strong age-related increase of threshold has been reported. With the development of computer-graphic methods it is possible to remove brightness clues caused by lens absorption. This study attempts to give normative values for colour contrast thresholds and assess the age related changes therein. PATIENTS AND METHODS: 115 patients aged between 6 & 71 years were tested for central and peripheral colour contrast sensitivity. No patient had any systemic or eye disease. As a preliminary, heterochromatic flicker balance between the luminosities of the R and G and B and G phosphors was established, so that all colours subsequently generated were isoluminant for the person tested. Then, using a modified binary search technique, colour contrast thresholds were established using both 2 degree optotypes, for central vision, and a ring, 12.5 degrees in radius for peripheral vision. In the latter case, the observer had to name the position of the missing quadrant in the ring. Stimuli were presented for 200 msec at 1 Hz. Colours were modulated on protan, deutan or tritan colour axis. RESULTS: No correlation between age and central colour vision thresholds was observed. By contrast a significant but only minor increase of peripheral colour vision threshold was observed for the peripheral protan and tritan axis. DISCUSSION: The present system removes luminance clues from colour vision tests and permits both central and peripheral retina to be tested. The results are simple in that the influence of age can be neglected. The variability of threshold results is small, and it is easy to detect the relatively large changes associated with disease. Since high-quality monitors are standardised and calibrated, providing the stimulus parameters described are adhered to, the results given here for upper limits of normal may be used for other similar systems.

Adolescent↗
PubMed1994

HIV-related ocular microangiopathic syndrome and color contrast sensitivity.

PURPOSE: Color vision deficits in patients with acquired immunodeficiency syndrome (AIDS) or human immunodeficiency virus (HIV) disease were reported, and a retinal pathogenic mechanism was proposed. The purpose of this study was to evaluate the association of color vision deficits with HIV-related retinal microangiopathy. METHODS: A computer graphics system was used to measure protan, deutan, and tritan color contrast sensitivity (CCS) thresholds in 60 HIV-infected patients. Retinal microangiopathy was measured by counting the number of cotton-wool spots, and conjunctival blood-flow sludging was determined. Additional predictors were CD4+ count, age, time on aerosolized pentamidine, time on zidovudine, and Walter Reed staging. The relative influence of each predictor was calculated by stepwise multiple regression analysis (inclusion criterion; incremental P value = < 0.05) using data for the right eyes (RE). The results were validated by using data for the left eyes (LE) and both eyes (BE). RESULTS: The only included predictors in multiple regression analyses for the RE were number of cotton-wool spots (tritan: R = .70; deutan: R = .46; and protan: R = .58; P < .0001 for all axes) and age (tritan: increment of R [Ri] = .05, P = .002; deutan: Ri = .10, P = .004; and protan: Ri = .05, P = .002). The predictors time on zidovudine (Ri = .05, P = .002) and Walter Reed staging (Ri = .03, P = .01) were additionally included in multiple regression analysis for tritan LE. The results for deutan LE were comparable to those for the RE. In the analysis for protan LE, the only included predictor was number of cotton-wool spots. In the analyses for BE, no further predictors were included. The predictors Walter Reed staging and CD4+ count showed a significant association with all three criteria in univariate analysis. Additionally, tritan CCS was significantly associated with conjunctival blood-flow sludging. CONCLUSION: CCS deficits in patients with HIV disease are primarily associated with the number of cotton-wool spots. Results of this study are in accordance with the hypothesis that CCS deficits are in a relevant part caused by neuroretinal damage secondary to HIV-related microangiopathy.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Impairment of colour contrast sensitivity and neuroretinal dysfunction in patients with symptomatic HIV infection or AIDS.

Ophthalmic and neurological complications are frequent findings in patients with AIDS. Little is known about neuroretinal dysfunction in patients with HIV infection. The purpose of this study was to measure and evaluate colour vision in patients with HIV infection or AIDS. Colour contrast sensitivity tests were performed on 75 patients (150 eyes) in different stages of HIV infection. A highly sensitive computer graphics system was used to measure tritan, deutan, and protan colour contrast thresholds. Patients were classified into three clinical groups: (a) asymptomatic HIV infection, (b) lymphadenopathy syndrome or AIDS-related complex, and (c) AIDS. Overall, tritan (p < 0.0001), deutan (p = 0.003), and protan (p = 0.009) colour contrast sensitivities were significantly impaired in patients with HIV infection compared with normal controls. Colour thresholds in patients with asymptomatic HIV infection (mean tritan threshold: 4.33; deutan: 4.41; protan: 3.97) were not impaired compared with normal controls. Colour vision was slightly impaired in patients with lymphadenopathy syndrome or AIDS-related complex (tritan: 6.25 (p < 0.0001); deutan: 4.99 (p = 0.02); protan: 4.45 (p = 0.05)). In patients with AIDS the impairment was even more marked (tritan: 7.66 (p < 0.0001); deutan: 5.15 (p < 0.0009); protan: 4.63 (p = 0.004)). Analysis of covariance controlling for age demonstrated a close association between impairment of tritan colour contrast sensitivity and progression of HIV disease (p < 0.0001). Following Köllner's rule, our study suggests that neuroretinal dysfunction occurs in patients with symptomatic HIV infection or AIDS. This is emphasised by the finding that the relative impairment in tritan vision compared with deutan/protan vision might reflect the difference in the number of cones or receptive fields. Measurement of tritan colour contrast sensitivity appears to be an appropriate and easily applicable method to detect early neuroretinal dysfunction in patients with HIV disease.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Leber's hereditary optic neuroretinopathy and the X-chromosomal susceptibility factor: no linkage to DXs7.

Leber's hereditary optic neuroretinopathy (LHON) was the first human disease for which mitochondrial inheritance was demonstrated. Analysis of genealogies, however, suggests the existence of an interacting X-linked factor, and linkage to DXS7 was recently described. We tested this location in four LHON families, with DXS7 and two flanking markers, OTC and DXS426. We found recombinations with DXS7 in two families and with DXS426 in one. The two point lod scores to DXS7 were negative with all the allele frequencies for the X-linked factor tested (q = 0.5; 0.35; 0.05).

Female↗
PubMed1991

A survey of color discrimination in German ophthalmologists. Changes associated with the use of lasers and operating microscopes.

Color vision tests were performed on 211 German ophthalmologists during their annual meeting at Essen. The subjects also answered detailed questionnaires about their use of lasers and operating microscopes, and their ocular and general health. It was found that 33% of doctors who use lasers or operating microscopes have decreased color discrimination for colors in a tritan color-confusion axis (greater than 2 standard deviations above normal). There is a relationship between number of patients treated and the degree of threshold elevation. Thirty hours of using the operating microscope produces an increase in tritan threshold equivalent to one panretinal photocoagulation.

Adult↗
PubMed1989

Sorsby's fundus dystrophy. A clinical study.

A survey was undertaken of a family known to have Sorsby's fundus dystrophy. Fifty members were reviewed, and 14 were found to be affected. Many of Sorsby's original conclusions were confirmed, including the pattern of inheritance and age of visual loss. Yellow material was present at the level of Bruch's membrane early in the course of the disease. However, the earliest phenotypic marker was delayed filling of the choriocapillaris. Abnormalities of choroidal perfusion became more profound and extended centrifugally with time. The loss of central vision was commonly due to atrophy of the outer retina and choroid. Subretinal neovascularization was a rare occurrence. The homology between this dystrophy and age-related macular disease underlines the importance of the clinical findings in this family.

Adult↗
PubMed1985

Spatial tuning of the pattern ERG across temporal frequency.

The spatial response function of the electroretinogram (ERG) to contrast checkerboard pattern reversal at several check sizes was determined at a fixed contrast. The influence of the rate of modulation on the spatial response function was assessed. Reversing square wave patterns were presented at eight temporal frequencies ranging from 1 to 25 reversals per sec. The waveform consisted of an initial positive and a subsequent negative deflection. Irrespective of the temporal frequency, the spatial response function of the positive component did not show a spatial tuning. The amplitude of the negative component exhibited a pronounced attenuation of the response at check sizes larger than optimal. Mean maximal amplitude was found at an optimal check size between 25 and 50 min of arc. A distinction between a positive or negative component was not made for temporal frequencies higher than 10 reversals per sec, since the waveform at these modulation rates consisted merely of a sinusoidal steady-state response. The spatial response function obtained at 14 reversals per sec, resembling that of the negative component, exhibited a prominent spatial tuning. The results demonstrate that the pattern ERG has at least two components: a positive component which is not specific to changes in retinal distribution of contrast, followed by a negative wave showing spatial tuning across temporal frequency.

Electroretinography↗
PubMed1985

Luminance and contrast responses recorded in man and cat.

The major goal of this investigation was to describe and characterize response components of graded retinal responses in man and cat as a function of check size of the spatial stimulus. The arterially perfused cat eye enabled us to record the pattern reversal electroretinogram (PERG) and simultaneously summed activity of retinal ganglion cells by recording a compound action potential of the optic nerve (ONR). Checkerboard pattern reversal stimuli were presented at a low temporal frequency (recording 2 reversals in each trace), while a number of parameters such as check size, modulation depth and field size have been varied in order to elucidate similarities in response characteristics between the PERG and ONR. The striking similarity area dependence of the PERG and ONR points to ganglion cell activity as well as summation within the latter's receptive field center, reflected in the PERG. A fractionation was obtained of the PERG into two separate components generated by specific changes in spatial contrast and by luminance, respectively. The spatial response component of the PERG recorded in man from the enucleated cat eye closely resembled and consisted of a negative deflection. This component is preceded by a positive deflection sensitive to luminance changes and prominent upon peripheral retinal stimulation. It is anticipated that mild to moderate abnormalities of the ganglion cell activity will be first reflected in the negative contrast component upon central retinal stimulation.

Action Potentials↗
PubMed1984

Pattern reversal responses in man and cat: a comparison.

In 42 enucleated and arterially perfused cat eyes, graded potentials were recorded from the retina (ERG) and from the optic nerve ( ONR ) in response to checker-board stimuli, reversing at a low temporal frequency in a square wave mode. The ERG and ONR responses show an almost perfect duplication of the response to each reversal of the pattern and exhibit, in contrast to luminance responses, striking similarities in response characteristics such as amplitude, wave shape and time course. Furthermore, the amplitude versus check size plots coincide in both responses. In cat, pattern reversal responses can be recorded from 74 to 9 min of arc, correlating to the cat's visual resolution. In man, almost identical responses can be recorded for the pattern ERG. However, in accordance with the difference in visual resolution in man and cat, a parallel shift for the human pattern reversal ERG response to higher spatial frequencies is observed.

Animals↗
PubMed1984

[Computer tomographic follow-up in radiotherapy of brain tumors].

33 patients with primary and secondary brain tumours received radiotherapy. The therapeutic success was computer tomographically controlled. Only a temporary reduction in the size of the tumour could be observed during the radiotherapy. In connection with the reduction of the pathological findings in the CT, an improvement in the neurological findings was determined. A change in the tumour absorption may occur under the radiotherapy. An important indicator for tumour growth or regression is the change in the tumour absorption in computed tomography with the contrast medium. If the enhancement remains inspite of the radiotherapy, it can prognostically be considered as a detrimental factor. In the case of 10 of the 33 patients undergoing radiotherapy the tumour became isodense. No more enhancement was detectable. Isodensity may not be seen as a complete normalization of the brain tissue as could be established by histological investigations. On the other hand if again hypodense areas are revealed, it does not necessarily mean recurrence of tumour. Such an hypodense region then implies a radiogenic tumour-necrosis. Only the renewed enhancement after administering of the contrast medium in the area of the tumour must be considered as recurrence.

Aged↗