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Biomedical subjects

W H Seiple

Publications and source records attributed to W H Seiple.

12 recordsLinked to original sources

Maculopathy caused by intra-arterially administered cisplatin and intravenously administered carmustine.

Eight patients with malignant gliomas were monitored with clinical examinations to study the effects of the combination of intravenous administration of carmustine and infraophthalmic intra-arterial administration of cisplatin on retinal and optic nerve function. Three patients developed a severe macular retinal pigment abnormality in the eye ipsilateral to the intra-arterial infusion. Electrophysiologic studies disclosed no evidence of a generalized disturbance in the photoreceptors, middle retinal layers, or retinal pigment epithelium. In contrast to previous studies involving patients whose visual loss was caused by vaso-occlusive lesions in the retina and optic nerve, our study involved patients with clinically significant maculopathy, that was not vascular in origin and that developed after treatment with carmustine and cisplatin. We suggest that the deficit may result from a localized retinal pigment disturbance in the macula.

Adult

The clinical utility of visual-evoked potential acuity testing.

We assessed the clinical utility of objectively measured acuity using visual-evoked potentials. The technique was first standardized in normal emmetropic subjects and then applied to uncorrected myopic subjects. We found that visual-evoked potential acuity could accurately indicate Snellen acuity in emmetropia and corrected myopia; however, the two measures were highly correlated only in those uncorrected myopic subjects with visual acuities of 20/100 or better. In subjects with poorer than 20/200 uncorrected visual acuity caused by myopia, estimates of visual-evoked potential acuity could not be obtained. The correlation between these two measures of visual acuity was also lower in patients with decreased Snellen acuity attributable to retinal or ocular disease. We found that patients with unexplainable claims of decreased visual acuity could be diagnosed as having functional visual loss based on objective visual-evoked potential acuities.

Adolescent

Cone function in congenital nyctalopia.

A patient with congenital stationary night blindness (CSNB) (Schubert-Bornschein type) transmitted as an autosomal recessive trait was studied with several tests of electrical function as well as a variety of psychophysical procedures. Comparison of the patient's present findings with those obtained 23 years earlier showed that while rod thresholds have remained the same, cone sensitivity has decreased. Subjective flicker thresholds obtained following a bleach were unchanged during the course of dark adaptation. The absence of rod-cone interaction, together with an absent scotopic b-wave, implies that the defect is in the mid-retinal layers. Further, the absence of oscillatory potentials in the photopic electroretinogram (ERG) suggests that the interplexiform cell may be implicated in some manner. The focal ERG of the CSNB patient showed normal amplitude and normal phase delays, supporting the idea that the focal ERG samples primarily cone photoreceptor activity.

Adult

Pattern electroretinogram threshold does not show contrast adaptation.

Pattern electroretinogram (PERG) thresholds were examined using a swept contrast stimulus method. Stimulus contrast was either continuously changed (swept) from high to low (descending sweep), or from low to high (ascending sweep). Visual evoked potential (VEP) contrast threshold was higher when measured using descending sweeps than when using ascending sweeps. This VEP threshold difference has been attributed to cortical adaptation. Although previous work has reported changes in the PERG amplitude as a function of pre-exposure, we have found no analogous effect on the PERG threshold.

Adaptation, Physiological

Contrast sensitivity of the human pattern electroretinogram.

Contrast thresholds for the pattern electroretinogram (PERG) were measured using lock-in amplifier retrieval of the retinal signal and a swept contrast display. Contrast sensitivity functions (CSF) developed from these PERG contrast thresholds were compared with those established psychophysically under identical stimulus conditions. Whereas the PERG CSF showed a band-pass characteristic across temporal frequency, the psychophysical CSF (and a temporal CSF developed from visual evoked potential contrast thresholds) had a low-pass pattern. Across spatial frequency, the PERG and psychophysical CSFs had similar shapes, although the PERG CSF peaked at a lower spatial frequency than the psychophysical CSF.

Adult

Objective assessment of temporal modulation transfer functions using the focal ERG.

Temporal modulation transfer functions (MTF's) were recorded from the macula of nine normal subjects using focal electroretinography (FERG). An array of light emitting diodes (LED's) was used to experimentally manipulate stimulus temporal frequency, modulation depth, and mean luminance values. Two techniques were used to derive FERG modulation thresholds at several temporal frequencies: conventional averaging with extrapolation to a criterion amplitude, and a swept stimulus lock-in retrieval method. These two methods produced comparable results. The electrophysiologically derived MTF's were similar in shape to those obtained psychophysically. Six patients with retinal disease were also examined; all patients showed sensitivity losses which were most marked at the higher frequencies. Such losses tended to be greater in patients with poorer visual acuity.

Adult

Evaluating macular function using the focal ERG.

A stimulus consisting of 96 red LEDs mounted in the rear of a ganzfeld bowl was used to elicit focal electroretinograms (FERG) from the central 9 degrees of the retina in human subjects. The luminance of the stimulus was driven sinusoidally at frequencies from 10-60 Hz. The temporal responsiveness and response phase lags of normal subjects and patients with retinal disease were measured. Normal subjects produced maximum amplitude FERG responses to stimuli between 30-40 Hz. Patients with retinitis pigmentosa showed a low-pass pattern of amplitude loss, with an additional frequency independent loss in sensitivity in those with poorer visual acuity. Patients with macular degeneration showed general amplitude loss associated with a relative sparing of the mid-temporal frequencies. The response phase lags in both patient groups were not significantly different from the normals. These findings point to a loss in temporal responsiveness accompanied by a secondary loss of sensitivity in these heredoretinal degenerations.

Adolescent

Human VEP contrast modulation sensitivity: separation of magno- and parvocellular components.

Human cortical visual evoked potentials (VEPs) were retrieved in real time (without averaging). The stimuli were sinusoidal gratings whose contrast was temporally modulated about some mean value. Electrophysiologically determined contrast modulation thresholds were measured at standing contrast over the range from 2.5% to 50%, defining an increment threshold function. Increment threshold functions were obtained under two different spatio-temporal stimulus conditions identified as "sustained" (4 c/deg grating modulated at 1.5 Hz) and "transient" (1 c/deg grating modulated at 20 Hz). Under each of these conditions, threshold responses were retrieved at both the fundamental and second harmonic of the contrast modulation frequency. Under "sustained" conditions log increment threshold responses and the fundamental the second harmonic of the modulation frequency were similar to those at the fundamental except for a saturation effect (i.e., above a mean contrast of 25% there was little further reduction in modulation sensitivity). There was no contrast gain control under "transient" stimulus conditions. In other words, the same absolute amount of contrast change produced threshold responses for all mean levels up to 25%. This was true at both the fundamental and second harmonic of the modulation frequency. Stimulus differences produce striking differences in the electrophysiologically inferred increment threshold function for grating contrast, but fundamental and second harmonic evoked responses reflect processes with similar increment threshold behavior.

Contrast Sensitivity