Search PubMed⌕ Search

Biomedical subjects

Günter Niemeyer

Publications and source records attributed to Günter Niemeyer.

10 recordsLinked to original sources

ERG components of negative polarity from the inner retina and the optic nerve response.

ERG components of negative polarity in the light-adapted and in the dark-adapted inner retina are reviewed from a clinical perspective and include consideration of experimental research. Field potentials are inherently complex including summating contributions from specialized neurons as well as from glial elements. This property applies to the PERG, PhNR and to the STR. Experimental research can contribute to identifying the sites/cells of origins i.e. by determining depth profiles and by pharmacological manipulation. Intraretinal microelectrode-studies and pharmacological dissection of light-evoked responses have elucidated the origin of field potentials from the retinal pigment epithelium to the retinal ganglion cells. Thresholds for dark-adapted response components have been compared. Attenuation of the STR by anesthesia was found in cats in vivo when compared to threshold intensities used in isolated eye preparations in vitro, suggestive of depression of inner retinal activity by anesthetics. Evidence has been presented for antidromically elicited retinal responses of negative polarity that resemble the STR and summate with the light-evoked retinal response. This observation supports the notion that negative field potentials and components as recorded in the vitreous and at the cornea receive contributions from retinal ganglion cells. The weight of this contribution appears to vary among species, at least concerning the STR. The ocular negative responses from the inner retina are compared to cortical excitatory mechanisms generating negativity in the baseline of the EEG.

Animals↗

Quantitative analysis of OCT characteristics in patients with achromatopsia and blue-cone monochromatism.

PURPOSE: To quantify optical coherence tomography (OCT) images of the central retina in patients with blue-cone monochromatism (BCM) and achromatopsia (ACH) compared with healthy control individuals. METHODS: The study included 15 patients with ACH, 6 with BCM, and 20 control subjects. Diagnosis of BCM and ACH was established by visual acuity testing, morphologic examination, color vision testing, and Ganzfeld ERG recording. OCT images were acquired with the Stratus OCT 3 (Carl Zeiss Meditec AG, Oberkochen, Germany). Foveal OCT images were analyzed by calculating longitudinal reflectivity profiles (LRPs) from scan lines. Profiles were analyzed quantitatively to determine foveal thickness and distances between reflectivity layers. RESULTS: Patients with ACH and BCM had a mean visual acuity of 20/200 and 20/60, respectively. Color vision testing results were characteristic of the diseases. The LRPs of control subjects yielded four peaks (P1-P4), presumably representing the RPE (P1), the ovoid region of the photoreceptors (P2), the external limiting membrane (ELM) (P3), and the internal limiting membrane (P4). In patients with ACH, P2 was absent, but foveal thickness (P1-P4) did not differ significantly from that in the control subjects (187 +/- 20 vs. 192 +/- 14 microm, respectively). The distance from P1 to P3 did not differ significantly (78 +/- 10 vs. 82 +/- 5 microm) between ACH and controls subjects. In patients with BCM, P3 was lacking, and P2 advanced toward P1 compared with the control subjects (32 +/- 6 vs. 48 +/- 4 microm). Foveal thickness (153 +/- 16 microm) was significantly reduced compared with that in control subjects and patients with ACH. CONCLUSIONS: Quantitative OCT image analysis reveals distinct patterns for controls subjects and patients with ACH and BCM, respectively. Quantitative analysis of OCT imaging can be useful in differentiating retinal diseases affecting photoreceptors. Foveal thickness is similar in both normal subjects and patients with ACH but is decreased in patients with BCM.

Adult↗

THUMP: an immersive haptic console for surgical simulation and training.

Telerobotic systems are revolutionizing minimally invasive surgery (MIS), giving the surgeon complete control over precise dexterous movements of tiny robotic instruments. Such 'surgery-by-wire' approaches also create unique opportunities for simulation and training, as the surgeon operates at a computer-mediated haptic console. Possible extensions include offline training in simulated environments and advanced guidance and mentoring during actual operations. To explore these options and further improve telerobotic interfaces, we have constructed a two-handed, fully articulating haptic console that provides force and torque feedback as well as a stereoscopic display.

Computer Simulation↗

Multiple effects of adenosine in the arterially perfused mammalian eye. Possible mechanisms for the neuroprotective function of adenosine in the retina.

It has been postulated that the major physiological role of adenosine is protection of the central nervous system in conditions such as ischemia, hypoxia, or prolonged neuronal excitation. Under these conditions adenosine is released, and exerts multiple effects, including vasodilation, inhibition of neuronal activity, and enhancement of glycogenolysis, resulting in neuroprotection. In this article, published as well as unpublished data on the multiple effects of exogenous adenosine and application of adenosine-related agents, performed using the arterially perfused cat eye, will be reviewed and discussed within the framework of the neuroprotective role of adenosine. The isolated, arterially perfused eye preparation has the advantage of combining integrity of the eye structure, exact control of arterial concentration and timing of applied pharmacological agents, and access to electrophysiological parameters of both retina and optic nerve, as well as the ability to control and monitor perfusate flow. The absence of red blood cells in the perfusate prevents adenosine from being metabolized prior to reaching the eye.

Adenosine↗

Multifocal electroretinogram (mfERG) in a family with occult macular dystrophy (OMD).

BACKGROUND: Localized macular dysfunction, in Stargardt macular dystrophy for example, is frequently not detected by Ganzfeld electroretinography (ERG) but it may be detected by methods such as focal macular electroretinogram and pattern electroretinogram at the posterior pole of the eye or indirectly by recording of the visual evoked cortical potentials (VEP). The multifocal electroretinogram (mfERG) is a new diagnostic tool allowing analysis of local bioelectrical signals of circumscript areas across the macular region. Miyake recently described a type of macular dystrophy, which he termed "Occult Macular Dystrophy" (OMD) because of a normal fundus aspect and functional deficit even in aged patients. This is a case report about a family with a presumed OMD where mfERG demonstrated a central depression in the affected family members. PATIENTS AND METHODS: Three members of a family with a suspected autosomal dominant trait complained of a reduced visual acuity since early childhood. The fundus of all patients appeared normal without signs of a maculopathy. The first order mfERG (ROLAND system) was recorded using 61 hexagons. RESULTS: The signals arising from the macular region of the 6 eyes (3 affected family members) were selectively depressed while the signals from the paracentral area were much less impaired. Statistical analysis of the mfERG signals (concentric hexagon rings) confirmed the central depression with a better performance of the peripheral rings. CONCLUSIONS: A new family with OMD is added to preceeding reports. A reduced visual acuity without visible fundus abnormalities may be misdiagnosed as amblyopia, optic nerve disease or nonorganic visual disorder. The mfERG offers the diagnostic tool to detect a circumscript retinal/macular dysfunction by a single procedure.

Adolescent↗

Cross-sectional study of visual acuity and electroretinogram in two types of dominant drusen.

PURPOSE: To compare the changes with increasing age of ERG parameters in relation to clinical data in two distinct phenotypes of genetically determined, dominantly inherited macular drusen: malattia leventinese (ML) and Zermatt macular dystrophy (ZMD). METHODS: Ganzfeld rod- and cone-electroretinograms (ERGs) from 15 patients affected with ML and 14 patients with ZMD and clinical data were analyzed retrospectively. The patients' ages ranged from 20 to 77 years in the ML group and from 9 to 74 years in the ZMD group. RESULTS: Both inherited macular degenerations caused a marked decrease in visual acuity, the latest after age 65. Most patients with ML retained good visual function (0.8-1.0) until the fifth decade, followed by a rapid decrease in the fifth or sixth decade. ZMD is characterized by a relatively continuous decrease in visual acuity with increasing age. Morphologically, in the juvenile stages in both entities, drusen were observed at the posterior pole. Rod-driven and cone-driven ERG b-wave amplitudes decreased nearly linearly in ML and ZMD in accord with the normal loss of amplitude with increasing age. Implicit times of cone b-waves for ML increased markedly with age, whereas in ZMD the values were always prolonged beyond the normal range with a slight increase with age. CONCLUSIONS: In terms of visual acuity, the progression of both dominantly inherited macular dystrophies is quite different. This is not reflected in the amplitudes of the b-waves in the Ganzfeld ERGs, which decrease normally for both entities. Implicit times of the cone-b waves were more markedly prolonged in ML compared with ZMD. In-depth longitudinal documentation of the natural course of those dominantly inherited macular diseases should facilitate patient counseling.

Adolescent↗

[Ganzfeld and multifocal electroretinography in Malattia Leventinese and Zermatt Macular Dystrophy].

BACKGROUND: To show the value of Ganzfeld electroretinography (ERG) in Malattia Leventinese (ML, or Hereditary Dominant Drusen) and Zermatt Macular Dystrophy (ZMD) and to illustrate multifocal electroretinography (mfERG) in 2 cases of ML. PATIENTS AND METHODS: In 15 patients with ML and 14 with ZMD we recorded Ganzfeld ERGs along with clinical examinations. In two patients with ML, and an we also performed a mfERG and an automated and Goldmann perimetry. All patients had a genotypic confirmation of the respective disease. For ERG measurements, the UTAS-3000 system was used, the mfERG was recorded using the RetiScan system. RESULTS: In ML, the visual acuity remained at 0.8 or higher until the 5 (th) or 6 (th) decade of life, followed by a rapid drop. In ZMD, the decrease in acuity began already in the 3 (rd) decade and followed a more continuous time course. The time course of the decrease of the ERG b-wave amplitudes was nearly identical for either disease. The mfERG showed in one case of ML a marked reduction in the macular response density but, in the second case, a normal density response pattern despite large degenerative changes at the posterior pole. In both of these patients, we found no visual field defects. CONCLUSIONS: Patient history and clinical testing raised the suspicion of a hereditary macular dystrophy. By means of Ganzfeld and multifocal electroretinography the course of the disease could be observed. However, definite diagnosis could only be established by genetic identification.

Adult↗

[Normal fundus and abnormal electroretinogram: differential diagnosis].

PURPOSE: To assess retinal dysfunction when ophthalmoscopy reveals normal features. METHODS: Ganzfeld electroretinography of the rod and of the cone systems was used to detect congenital or acquired retinal dysfunction. In infants under 5 years of age ERG was performed using inhalational anaesthesia. In addition, multifocal ERG techniques detect discrete local retinal dysfunctions. The ERG results are evaluated in comparison to normative data and to ophthalmoscopic as well as perimetric results. Patient data were selected to demonstrate typical ERG changes and the corresponding differential diagnosis. RESULTS: Abnormalities in ERG results and normal ophthalmoscopic features are shown in 8 typical examples. They were observed in the following conditions: (1) stationary congenital dysfunctions, (2) early stages of the hereditary tapetoretinal degenerations, and (3) toxic or cancer-associated retinopathies. In these disorders the ERG complemented visual field testing by detecting isolated dysfunction of the rod- and cone-systems. CONCLUSION: In the context of making crucial diagnostic decisions ERG complements ophthalmoscopy and psychophysical testing of the retinal function. This diagnostic test facilitates differential diagnosis, helps to establish prognosis, and provides a basis for genetic counselling.

Anesthesia, Inhalation↗

Absolute sensitivity of the electroretinogram and of the optic nerve action potential in the perfused feline eye.

PURPOSE: To assess and characterize the electroretinogram (ERG) and the optic nerve response (ONR) at threshold stimulus intensity in the isolated perfused cat eye. METHODS: Eyes were enucleated from deeply anesthetized adult cats and arterially perfused with oxygenated serum-enriched tissue culture medium. Light stimuli of 20- to 400- msec duration from a xenon arc source, attenuated down to threshold intensities by neutral density filters, were delivered via a modified fundus camera in full dark adaptation. Vitreal ERGs and ONRs were amplified, digitized, averaged and analyzed using LabVIEW for Windows software. RESULTS: The threshold intensities in log scot q/deg(2) per second for the negative scotopic threshold response (STR), for the ERG b-wave, and for the ONR were at 2.87+/-0.35, 3.53+/-0.35 and 1.78+/-0.48, respectively. CONCLUSION: The in vitro perfused mammalian eye preparation exhibits remarkably low thresholds for the ERG and particularly for the ONR near the intensity required for the human psychophysical threshold.

Action Potentials↗

Improving contact realism through event-based haptic feedback.

Tapping on surfaces in a typical virtual environment feels like contact with soft foam rather than a hard object. The realism of such interactions can be dramatically improved by superimposing event-based, high-frequency transient forces over traditional position-based feedback. When scaled by impact velocity, hand-tuned pulses and decaying sinusoids produce haptic cues that resemble those experienced during real impacts. Our new method for generating appropriate transients inverts a dynamic model of the haptic device to determine the motor forces required to create prerecorded acceleration profiles at the user's fingertips. After development, the event-based haptic paradigm and the method of acceleration matching were evaluated in a carefully controlled user study. Sixteen individuals blindly tapped on nine virtual and three real samples, rating the degree to which each felt like real wood. Event-based feedback achieved significantly higher realism ratings than the traditional rendering method. The display of transient signals made virtual objects feel similar to a real sample of wood on a foam substrate, while position feedback alone received ratings similar to those of foam. This work provides an important new avenue for increasing the realism of contact in haptic interactions.

Computer Graphics↗