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Biomedical subjects

G B Arden

Publications and source records attributed to G B Arden.

At least 73 records · Page 4Linked to original sources

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↗

[Color vision disturbance in laser operators and patients: comparison of argon and dye lasers].

Color contrast sensitivity was measured in laser operators before and after laser sessions. The tritan threshold was elevated after the sessions in all laser operators who had used argon (blue-green) lasers. No change was observed when lasers with longer wave-lengths were used. Elevation of the tritan threshold to above-normal levels was observed even before laser sessions. The thresholds remained increased even when the laser operator did not use a laser for 3 weeks. Thus, it appears that the damage caused by the argon blue-green laser is cumulative. Elevated tritan thresholds were also observed in patients with peripheral retinal breaks who were treated with an argon (blue-green) laser.

Adolescent↗

Peripheral contrast sensitivity in glaucoma and ocular hypertension.

Contrast sensitivity has been measured in patients with glaucoma and ocular hypertension, the latter graded into high, medium, and low risk clinical groups. Measurements were made centrally and peripherally at 10 degrees, 15 degrees, 20 degrees, and 25 degrees off-axis at each of the four meridians 45 degrees, 135 degrees, 225 degrees, and 315 degrees. A sine wave grating of 1.9 cycles/degree, reversing at 1 Hz was used. It was displayed on a 100-Hz refresh rate monitor. Normal values were established to compare those from 41 eyes from patients with either primary open angle glaucoma (POAG) with minimal field loss detectable on a Humphrey perimeter, or raised IOP and/or disc changes but no field loss (OH). Those with POAG had normal central contrast sensitivity, but at 20 degrees and 25 degrees eccentricity the values were greater than 2 standard deviations above the normal mean. This was also the case for high risk OH, but not for low risk patients. All the high risk patients except one who had abnormal peripheral contrast sensitivity had possible field defects (threshold elevation at one or more points more than 5 but less than 10 dB above normal mean). Only one of those with normal peripheral contrast sensitivity had such 'suspect points'. The results are assessed in terms of screening of glaucoma suspects.

Contrast Sensitivity↗

Using argon laser blue light reduces ophthalmologists' color contrast sensitivity. Argon blue and surgeons' vision.

Color contrast sensitivity was measured in laser operators before and after laser use. After argon blue-green laser treatment sessions, sensitivity was reduced for colors lying along a tritan color-confusion line for several hours. This acute effect is due to specular "flash-backs" from the aiming beam off the surface of the contact lens. It is caused only by argon 488-nm light, when the aiming beam intensity is high. In addition, a correlation has been demonstrated between the number of years of laser experience and a chronic reduction in tritan color contrast sensitivity. It is suggested that repeated acute changes caused by the argon lasers may cause cumulative effects and produce a chronic threshold elevation. A simple method of eliminating the acute effect is documented.

Adult↗

Changes in colour contrast sensitivity associated with operating argon lasers.

A new test of colour vision using computer graphics has been used to obtain quantitative estimates of colour contrast sensitivity in ophthalmologists before and after they have treated patients by argon laser retinal photocoagulation. The colour vision of all subjects is normal when tested with the 100-hue test and HRR (Hardy, Rittler, Rand) plates, but colour contrast sensitivity measured along a tritan colour confusion line is selectively impaired after a treatment session. No such change occurs after a medical session spent examining patients with a fundus camera. In younger ophthalmologists the sensitivity recovers several hours after the treatment session ends, but in some persons there is a prolonged and possibly permanent elevation of threshold.

Adult↗

Separable evoked retinal and cortical potentials from each major visual pathway: preliminary results.

Single cell experiments in primates show that there are two major parallel pathways named after the lamination in the lateral geniculate nucleus. Each of these systems can be preferentially excited by appropriate stimuli. Here we report that in man the polarity of the evoked potentials both in retina and in cortex depends on which of these pathways is stimulated. The identification of the resulting waveforms is thereby simplified--a matter of practical importance. The fact that at retina and cortex there are characteristic potentials may reflect the different cell biology of the two pathways.

Color Perception↗

Retinal sensitivity in hereditary retinal degeneration in Abyssinian cats: electrophysiological similarities between man and cat.

The functional and electrophysiological similarities in the changes in the electroretinogram (ERG) of man and cat affected by hereditary retinal degenerative disease were studied. The results of a series of log intensity-amplitude studies in a group of young affected Abyssinian cats were fitted to the Naka-Rushton relationship by means of a mathematical package on the University of London mainframe. The analysis showed that the amplitude of the maximum dark-adapted b-wave was significantly reduced by the end of the period studied but that the value of k, a variable inversely equivalent to retinal sensitivity, was only slightly reduced by the retinal degenerative process. The electrophysiological findings thus are similar to those found in cases of human diffuse dominantly inherited retinitis pigmentosa.

Animals↗

Monitoring of patients taking canthaxanthin and carotene: an electroretinographic and ophthalmological survey.

1. Patients who have taken canthaxanthin and beta-carotene to avert phototoxicity have been monitored by electroretinographic testing. 2. Patients took the compounds only during the summer months, but were monitored for more than 1 year to determine if seasonal changes in the ERG were visible. 3. The characteristic refractile retinal crystals reduced during the winter. 4. The scotopic b-wave amplitude increased during the winter, whether evoked by red or blue flashes. 5. No other ERG parameter altered. 6. Changes noted in 3 and 4 above are reversible. 7. A dose/ERG-amplitude response relationship was established, but no correlation between blood level or total cumulative dose and b-wave amplitude could be found. 8. It is suggested that the Müller cells concentrate canthaxanthin and this is the mechanism which affects the ERG.

Aged↗

Leber's hereditary optic atrophy.

Leber described a particular type of hereditary optic atrophy in 1871. The clinical features of all cases since reported are reviewed. There is characteristically acute visual loss, circumpapillary teleangiectatic micropathy, tortuosity of the retinal vessels and oedema in the retinal nerve fibres. 85% of those affected are male, but affected fathers do not transmit the condition to their children. The exact mode of inheritance is still obscure but it is suggested that inheritance may be mitochondrial; enlarged subsarcolemmal mitochondria in LOA patients have been described. Colour vision defects are observed not only in patients, but also in presumed carriers. Electrophysiological investigations demonstrate optic nerve damage, but are not indicative of any particular pathology. It has been reported that in many cases of LOA the severity of the disease is related to tobacco smoking. Increased cyanocobalamin blood levels in patients and increased cyanide blood levels support this hypothesis.

Electroretinography↗

Electrophysiological discrimination between retinal and optic nerve disorders.

In this study we show how the Pattern ERG (PERG) can be used to distinguish between optic nerve and retinal disease. Records from eyes with RBN and delayed visual evoked responses are compared with those recorded from the normal fellow eyes. In optic nerve disease there is a selective reduction of the later negative component of the response. PERG's were also recorded from patients with mild diabetic retinopathy. These were divided into three groups on the basis of the delay in their Visual Evoked Potential (VEP). The amplitude of both positive and negative components fall with increasing severity of the disease thus showing that the abnormally long delau in VEP found in some cases is due to retinal disease rather than optic nerve disease.

Adolescent↗

Transretinal mass receptor potentials recorded from the canine retina in vitro.

A transretinal method for recording the summed potentials generated by photoreceptors of the isolated canine retina in vitro is reported. Pieces from 10 retinas of 5 clinically and visually normal dogs were maintained in a recording chamber and superperfused with a modified cell culture medium. Sodium glutamate added to the medium eliminated electrical responses from retinal glia and allowed the summed receptor potentials to be recorded. The response to flashes of light consisted of a negative potential, which increased in amplitude in a graded manner and in complexity with increased stimulus intensity. The response was similar in waveform to that reported in other vertebrate species, using intracellular and extracellular techniques. This method of recording the mass transretinal receptor potentials in vitro will be of value for investigating abnormal photoreceptor functions in dogs in the early stages of inherited retinal degeneration.

Action Potentials↗

Detection of the carrier state of X-linked retinoschisis.

We determined the extent of suppressive rod-cone interaction in 11 obligate carriers and eight potential carriers of X-linked retinoschisis from eight families. Despite otherwise normal ophthalmoscopic and functional testing, all of the obligate heterozygous carriers demonstrated a complete absence of normal rod-cone interaction. Of the potential heterozygous carriers, three had normal rod-cone interactions, two had no detectable interaction, and two yielded technically unsatisfactory results. This lack of rod-cone interactions allows heterozygous individuals to be identified clinically and has implications concerning the origin of this inherited disorder.

Flicker Fusion↗

The pattern electroretinogram (PERG) in ocular hypertension and glaucoma.

Studies of normal subjects and of patients with optic nerve disorders suggest that one of the components of the pattern electroretinogram (PERG), the second negative wave, is related to optic nerve function and appears to be diminished even when the condition is relatively mild, with little alteration of visual acuity. It is known that significant loss of nerve fibers may occur prior to the development of visual field loss. We have investigated the PERGs of a group of subjects with early glaucoma and ocular hypertension, comparing them with normal subjects, and have found a selective reduction in the second negative wave in patients with evidence of optic nerve dysfunction. The PERG may prove helpful in discriminating those patients with ocular hypertension who are destined to develop visual field loss unless medical or surgical therapy were to be employed.

Adolescent↗

Color vision defects in ocular hypertension and glaucoma. Quantification with a computer-driven color television system.

In order to detect early defects of color vision caused by increased intraocular pressure, a computer graphics device and color monitor system were used to measure color contrast sensitivity. The system determines the threshold chrominance of a colored grating in which there is no change in luminance. The study included 13 control subjects aged 10 to 57 years and 19 patients with ocular hypertension or glaucoma aged 20 to 58 years. In the 13 eyes with visual field loss, color contrast sensitivity was profoundly reduced when the grating colors fell on a tritan color confusion line. In the eyes without visual field loss, tritan color contrast sensitivity was reduced to an average level considerably below the extreme limits of the control group. These results were compared with those of other color vision tests and diagnostic criteria for glaucoma. The findings suggest that among the tests used, color contrast sensitivity testing was able to discriminate most effectively between patients who had retinal damage and the normal population.

Color Perception Tests↗

The pattern electroretinogram.

Physiological experiments and the exploitation of clinical conditions have provided compelling evidence that retinal ganglion cells and other inner retinal structures generate the pattern ERG (PERG). As an increasing number of clinical reports have been published some contradictory findings have been reported. These may be ascribed to variation in recording and measuring techniques. The PERG consists of two major portions, the early positive and the following negative component which can be investigated separately if the stimulus conditions allow isolated (or "transient") responses to be recorded. Care has to be taken in positioning the reference electrode, maintaining accurate refraction, and the influence of pupil size must be considered. Furthermore the PERG is contaminated by a luminance component which may be generated in the outer retina. The size of this increases with low spatial frequency (large check-sizes) and high mean luminance. The PERG permits the examination of an additional level of the retina and helps the understanding of pathophysiology of various eye diseases, and is of clinical importance in routine diagnosis and assessment. In glaucoma the PERG amplitude is often reduced before it is possible to detect a scotoma and it is therefore an important prognostic indicator in patients with ocular hypertension. In diabetic retinopathy, retinal ischaemia sufficient to lead to the pre-proliferative state can be demonstrated. The PERG also has a major clinical role in examining localised retinal pathology. If combined with VECP recording, it greatly extends the interpretations possible, since not only can damage to the optic nerve be detected by both tests, but the normal PERG in the presence of an abnormal PVECP implies that the losses are confined to the central pathway.

Amblyopia↗

Effect of pattern luminance profile on the pattern ERG in man and pigeon.

Pattern electroretinograms (PERGs) have been recorded in man and pigeon using phase reversing patterns. Studies were made in both species of the effect of grating spatial frequency, grating profile (sine or square) or the size of the squares of a checkerboard on the amplitude of the responses. The results obtained in the two species were similar. In general, the ratio of the amplitudes of the sine wave:square wave responses is that predicted by the Fourier fundamentals of the pattern, and is thus not determined by changes in local luminance or contrast as it is normally defined. Checks however gave larger responses than sine or square wave profile bars matched to the Fourier fundamental on the diagonal. The results are not explicable in terms of any single stimulus parameter and suggest that the PERG generator has a degree of center/surround organisation similar to retinal ganglion cells. It is however argued that, because of the known physiological properties, generators cannot be unequivocally localised by varying the stimulus or comparing retinal, cortical and perceptual response dynamics.

Animals↗

Rod-cone interactions in night-blinding disease.

When rods are dark-adapted they reduce cone flicker sensitivity as though a low-pass filter had been inserted in the visual pathway. This process is exaggerated in certain individuals and accounts for their complaint of night blindness, though ordinary clinical testing shows no abnormality. This rod-cone interaction occurs in the ERG and is absent in disease of the outer retina, which argues that the pathway involved is via the horizontal cell feedback onto the cones. Various anomalies of rod-cone interaction can be seen in retinitis pigmentosa. These suggest that it is the rod dark current which is responsible for inhibiting cones. The implications for the pathophysiology of retinitis pigmentosa are discussed.

Dark Adaptation↗