Biomedical subjects

Tom H Margrain

Publications and source records attributed to Tom H Margrain.

6 recordsLinked to original sources

PubMed2006

Development of a technique for recording the focal rod ERG.

The scotopic ERG recorded in response to a focal stimulus has a double b-wave. The first wave results from direct focal stimulation of the retina, and the second originates in the peripheral retina in response to scattered light. The aim of this study was to assess two possible protocols for the isolation of the focal rod response, namely 'Subtraction' and 'Background Adaptation' techniques. The Subtraction technique involved the recording of a full-field response, which matched the b-wave elicited by intraocular light scatter, and the subtraction of this full-field response from the initial trace to isolate the focal component. In the Background Adaptation technique an adapting surround was used to suppress the response from the peripheral retina. Focal rod responses were isolated with both techniques. However, the Background Adaptation technique was found to more reliably elicit a focal response with a measurable a-wave, and was also considerably less time consuming than the Subtraction technique.

Adaptation, Ocular↗

PubMed2005

Evaluation of retinal function using the Dynamic Focal Cone ERG.

The development of effective means of assessing visual function in retinal disease holds the key to improved understanding of pathogenesis, and better monitoring of treatment outcomes. In diseases such as age-related macular degeneration, in which the primary locus of dysfunction is the outer retina, tests which provide a direct measure of the functional integrity of the photoreceptor/retinal pigment epithelium (RPE) complex are of great importance. Recovery of retinal function following adaptation to a bright light requires the healthy function of photoreceptors, RPE, Bruch's membrane and choroidal circulation, making an assessment of this recovery a potentially useful clinical tool. However, current techniques are either subjective in nature, or are influenced by post-retinal processing of visual information. This report describes a novel technique, the 'Dynamic Focal Cone Electro-retinogram (ERG)', which allows direct, objective assessment of the recovery of macular function following photopigment bleach. A series of 41 Hz ERGs was recorded, and ERG amplitude was plotted as a function of time following cessation of the bleach. Normative data was collected from 10 healthy subjects. For all subjects, there was no measurable ERG immediately after the bleach, but the amplitude had returned to a pre-bleach level within 4 min. The amplitude recovery data were adequately described both by an exponential recovery function and by a model based on a rate-limited recovery process. We conclude that this technique provides a clinically applicable, objective measure of outer retinal recovery.

Adaptation, Ocular↗

PubMed2005

Anisometropia is independently associated with both spherical and cylindrical ametropia.

PURPOSE: To explore the associations between anisometropia and spherical ametropia, astigmatism, age, and sex. METHOD: Associations between the prevalence and magnitude of anisometropia with age, sex, spherical power, and cylindrical power, were assessed in a group of 90,884 subjects attending optometry practices in the United Kingdom. Logistic regression models were used to assess the independent contribution of each explanatory variable. RESULTS: Logistic regression analyses that included all subjects or just those aged 20 to 40 years showed that spherical ametropia and astigmatism were independently associated with anisometropia (myopes, P < 1.0E-61; hyperopes, P < 1.0E-11). Anisometropia was relatively stable between the ages of 20 and 40 years, but then became more common with age, in myopes from the age of 40 years onward (P < 0.003) and in hyperopes from the age of 70 years onward (P < 1.0E-6). Sex was not associated with anisometropia to a clinically significant extent. CONCLUSIONS: This is the first study to show an independent association between anisometropia and both spherical ametropia and astigmatism. The results also suggest that the previously noted increased prevalence of anisometropia with age occurs later in hyperopes than in myopes, once other covariates have been controlled for. However, it could not be ruled out that this latter effect was due to clinical selection bias in our sample. The findings suggest that research projects involving the recruitment of highly ametropic subjects, such as those investigating the genetics of refractive error, may benefit by avoiding the use of stringent inclusion criteria for anisometropia, because otherwise a large proportion of the relevant population will be excluded.

Adolescent↗

PubMed2003

Evaluating anxiety in patients attending optometric practice.

Although anxiety is a well-established obstacle to the delivery of effective health care, there have been no attempts to measure it in the optometric consulting room. In this paper, we introduce physiological and psychological techniques that may be used to evaluate anxiety and arousal in the consulting room and present data from a small group of patients attending for a routine eye examination. Specifically, arousal was assessed before, during, and after the examination by measuring skin conductance in five patients. Anxiety was evaluated using the State-Trait Anxiety Inventory. Our data confirm the ability of these techniques to quantify arousal and anxiety in the optometric consulting room and reveal a previously unknown but important facet of the eye examination. We conclude that these techniques are suitable for use in further experimental work and may be used to identify factors capable of reducing anxiety in the optometric consulting room.

Adult↗

PubMed2002

Sources of variability in the clinical photostress test.

The photostress test is a simple clinical technique that can differentiate between retinal and postretinal disease. Unfortunately a wide range of normal results have been reported in the literature and it is perhaps for this reason that the test has been little used by clinicians. The purpose of this investigation was to evaluate the effect of photostress technique, age, ametropia, pupil size and acuity on photostress recovery time (PSRT) in normal subjects. Photostress recovery time was measured in 50 healthy subjects whose ages ranged from 21 to 69 using three clinically applicable techniques and a reference technique designed to bleach a consistent amount of photopigment. The agreement between each clinical technique and the reference technique was determined. Mean photostress recovery time differed for each of the techniques studied. Analysis of the data obtained with the reference and the best clinical technique showed that age was the only factor that had a significant effect on PSRT. The best clinical technique involves exposing the eye to the light from the direct ophthalmoscope for 30 s and measuring the time taken for acuity to return to within one line of pre-bleach acuity. Photostress recovery time increases with age but is independent of pupil size, ametropia and visual acuity.

Adaptation, Physiological↗

PubMed2002

Head-centred motion perception in the ageing visual system.

Stationary objects appear to move in the opposite direction to a pursuit eye movement (Filehne illusion) and moving objects appear slower when pursued (Aubert-Fleischl phenomenon). Both illusions imply that extra-retinal, eye-velocity signals lead to lower estimates of speed than corresponding retinal motion signals. Intriguingly, the velocity (i.e. speed and direction) of the Filehne illusion depends on the age of the observer, especially for brief display durations (Wertheim and Bekkering, 1992). This suggests relative signal size changes as the visual system matures. To test the signal-size hypothesis, we compared the Filehne illusion and Aubert-Fleischl phenomenon in young and old observers using short and long display durations. The trends in the Filehne data were similar to those reported by Wertheim and Bekkering. However, we found no evidence for an effect of age or duration in the Aubert-Fleischl phenomenon. The differences between the two illusions could not be reconciled on the basis of actual eye movements made. The findings suggest a more complicated explanation of the combined influence of age and duration on head-centred motion perception than that described by the signal-size hypothesis.

Adult↗