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V Greenstein

Publications and source records attributed to V Greenstein.

10 recordsLinked to original sources

Identifying inner retinal contributions to the human multifocal ERG.

Contributions to the multifocal electroretinogram (ERG) from the inner retina (i.e. ganglion and amacrine cells) were identified by recording from monkeys before and after intravitreal injections of n-methyl DL aspartate (NMDLA) and/or tetrodotoxin (TTX). Components similar in waveform to those removed by the drugs were identified in the human multifocal ERG if the stimulus contrast was set at 50% rather than the typically employed 100% contrast. These components were found to be missing or diminished in the records from some patients with glaucoma and diabetes, diseases which affect the inner retina.

Adult↗

Assessment of local retinal function in patients with retinitis pigmentosa using the multi-focal ERG technique.

To assess local retinal function in patients with retinitis pigmentosa (RP), multi-focal ERGs and local thresholds (static visual fields) were obtained on eight RP patients with visual acuities of 20/25 or better. All eight patients showed multi-focal responses with normal timing within the central 5 deg. However, there were few responses with normal timing in the areas outside the central 7.5 deg, except in the case of the only patient with a 30 Hz full-field response with normal timing. Since full-field ERGs are dominated by responses from the periphery, this finding supplies a foundation for the commonly observed delays in the full-field cone ERGs of patients with RP. With respect to amplitude, only two patients showed multi-focal responses with near normal amplitudes anywhere in the field. The loss of amplitude at any point was not a good predictor of visual sensitivity in the Humphrey visual field. On the other hand, all areas with normal timing had near normal sensitivity. Timing changes appear to be an early indication of local retinal damage to the cone system. Nearly all areas with sensitivity losses greater than 0.5 log unit, and some areas with near normal sensitivity, showed significantly delayed multi-focal ERGs. Finally areas with extreme sensitivity loss show multi-focal responses with a wide range of amplitudes and implicit times across patients, suggesting different mechanisms of disease action in different patients.

Adult↗

Relative effects of aging and age-related macular degeneration on peripheral visual function.

The purpose of this study was to determine the extent of peripheral visual deficits in patients with early age-related macular degeneration (ARMD) using electrophysiological and psychophysical techniques. Dark-adaptation curves, electro-oculograms (EOGs), and electroretinograms (ERGs) were obtained from patients with early ARMD and from normally sighted control subjects. The control subjects' data were used to calculate age-dependent 95% confidence intervals for each measure of visual function. For the control subjects, performance on all our measures of visual function decreased with age. For the patients with early ARMD, the cone system absolute thresholds, EOG ratios, and cone-dominated ERG amplitudes and implicit times were within the range of normal age-related changes. Rod system absolute thresholds, cone-rod break times, and rod-dominated electroretinographic measures were abnormal in some patients. These results suggest that when the effects of aging are taken into account, some patients classified as early ARMD may not show significant changes in peripheral retinal function with standard clinical tests.

Aged↗

Rates of change differ among measures of visual function in patients with retinitis pigmentosa.

PURPOSE: To assess changes in measures of visual function in patients with retinitis pigmentosa (RP) over time. METHODS: Patients with RP and visual acuity of 20/40 or better and central visual fields of 10 degrees or larger were enrolled in a 9-year prospective study. The following measures of visual function were obtained annually over the follow-up period: visual acuity, Goldmann visual fields (V4e target), focal electroretinograms, and hue discrimination. RESULTS: Over the follow-up period, the averaged group data showed changes in all measures of visual function. The smallest amount of change occurred for visual acuity and hue discrimination, and the greatest amount of change occurred for visual field area. Examination of individual patient data over the follow-up period indicated that the rates of change varied among patients and that losses in function for one measure did not correlate well with losses on other measures. CONCLUSIONS: These results stress that although visual function deteriorated over time for this group of patients with RP, there were differences among our measures of visual function. Measures that primarily assess central retinal function change relatively slowly compared with measures that assess more peripheral retinal function.

Adult↗

Temporal frequency dependent adaptation at the level of the outer retina in humans.

The focal electroretinogram (FERG) was used to examine temporal frequency tuning at the outer retinal level in humans by measuring temporal modulation thresholds. Changes in FERG thresholds as a function of ambient light level were compared to temporal modulation thresholds obtained psychophysically using the same stimuli. At lower temporal frequencies, both FERG and psychophysical thresholds changed sensitivity proportional to the mean illuminance level. At higher illuminance levels, both threshold measures were relatively independent of illuminance. The comparison of the FERG to the behavioral data suggest that most of the adaptation-dependent changes in temporal sensitivity in humans occur at the level of the photoreceptor complex.

Adaptation, Ocular↗

Models of the normal and abnormal rod system.

A framework is presented for using threshold data to test hypotheses about the action of a disease, a chemical agent, or a developmental process. A model of the normal rod system, based on models from the physiological and psychophysical literature, is presented. Hypotheses about the alteration of the rod system are specified in this model. The approach is illustrated with a class of hypotheses that places the decrease in sensitivity with retinal disease at the rod receptors and with data from patients with retinitis pigmentosa and congenital stationary night blindness. The implications for models of the normal rod system are considered.

Adaptation, Ocular↗

Hue discrimination and S cone pathway sensitivity in early diabetic retinopathy.

Measures of hue discrimination and M (green) and S (blue) cone pathway sensitivities were compared in a group of 24 diabetics with either early background retinopathy or no retinopathy. The Farnsworth-Munsell 100-hue test was used to measure hue discrimination, and a two-color increment threshold technique was used to measure S and M cone pathway sensitivities. The results were compared to the level of diabetic retinopathy, to the degree of macular edema, and to the duration of the disease. No significant correlation was found between the Farnsworth-Munsell 100-hue error scores and the level of retinopathy; S cone pathway sensitivity loss, however, correlated significantly with both the level of retinopathy and the degree of macular edema. Our results indicate that measurements of S cone pathway sensitivity using an increment threshold technique provide a more sensitive method than hue discrimination for detecting color vision deficits in early diabetic retinopathy.

Adult↗

Losses of temporal modulation sensitivity in retinal degenerations.

Sensitivity losses in patients with retinitis pigmentosa (RP) have been attributed to a decrease in photopigment density, to a reduction in the number of photoreceptors, and also to a change in temporal response properties of the receptors. The sensitivity losses in patients with macular degeneration have also been attributed to a loss of photoreceptors. To test these explanations for sensitivity loss we obtained electrophysiological and psychophysical temporal modulation transfer functions (MTFs) on normal subjects in response to varying stimulus luminances and retinal loci. These stimulus manipulations did not duplicate the changes observed in the temporal MTFs of patients. The temporal response properties of the receptors were tested electrophysiologically by manipulating stimulus presentation interval. The results provided evidence for sensitivity losses in RP patients being due to alterations in the temporal response properties of the receptors.

Aged↗

Changes in the focal electroretinogram with retinal eccentricity.

Flicker sensitivity increases in the peripheral retina when relatively large targets are used. This enhancement of cone system-mediated temporal sensitivity persists even when corrections are made for cortical magnification factors. It has been suggested that the differences in temporal frequency response characteristics across the retina are based on differences in receptor morphology between the peripheral and central cones. We have examined a possible retinal origin of this phenomenon by obtaining psychophysical and electroretinographic data at a variety of locations on the temporal retina. Psychophysical results show an increased sensitivity for high temporal frequency stimuli (above 30 Hz) with retinal eccentricity whether or not the stimulus size was scaled. Focal electroretinograms recorded with a constant size stimulus did not show an increase in amplitude with eccentricity. However, when an equal number of receptors were stimulated by scaling the target size, focal amplitudes were larger in the periphery. The electrophysiological findings are consistent with a possible retinal origin for this flicker enhancement phenomenon.

Contrast Sensitivity↗

A comparison of the components of the multifocal and full-field ERGs.

The multi-input technique of Sutter and Tran (1992) yields multiple focal ERGs. The purpose here was to compare the components of this multifocal ERG to the components of the standard, full-field ERG. To record multifocal ERGs, an array of 103 hexagons was displayed on a monitor. Full-field (Ganzfeld) ERGs were elicited by flashes presented upon steady background fields. The latencies of two prominent subcomponents of the full-field ERG were altered by varying the intensity of the incremental flash or the intensity of the background field. By showing that similar manipulations of the multi-input parameters produce similar changes in latency, we were able to relate the components of the multifocal ERG to the components of the full-field ERG. The biphasic responses of the multifocal ERG appear to be generated by the same cells generating the a-wave and positive peaks of the full-field cone ERG.

Adult↗