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Biomedical subjects

Herbert Jägle

Publications and source records attributed to Herbert Jägle.

At least 19 recordsLinked to original sources

L:M-cone ratio estimates of the outer and inner retina and its impact on sex differences in ERG amplitudes.

The relative number of L- and M-cones varies greatly between individuals. Differences in the relative number of L- and M-cones may also contribute to the sex difference in the ERG response amplitude reported several times. We therefore investigated the relative number of L- and M-cones and its impact on sex differences in ERG amplitudes. Multifocal ERG (mfERG) and multifocal oscillatory potentials (mfOP) combined with a cone silent substitution technique were used to investigate outer and inner retinal signals recorded from 7 female and 7 male trichromats. L:M ratios were estimated from peak amplitude as well as from area under curve (AUC) analysis. For mfERGs the L:M ratios estimates were independent of the method of analysis, while for mfOPs, differences were found which are possibly due to an artefact in the calculation of ratios for small responses. There was a tendency for lower L:M ratios in female than in male subjects for both analysis of mfERG and mfOP responses. The (L+M)-response amplitudes at both sites were slightly higher and the L:M ratios were lower for female than for male observers. Because the magnitude of the ERG amplitude differences is larger than could be explained by L:M-ratio and axial length differences, we conclude that it may be due to a direct effect of sex hormones on ion channel function.

Adaptation, Ocular↗

Advantages and disadvantages of human dichromacy.

We compared the visual detection thresholds for cone-isolating stimuli of trichromats (those with normal color vision) with those of X-linked dichromats, who lack either the long-wavelength-sensitive (L) cones (protanopes) or middle-wavelength-sensitive (M) cones (deuteranopes). At low (1 Hz) temporal frequencies, dichromats have significantly higher (twofold) thresholds for all colored stimuli than trichromats; whereas at high (16 Hz) temporal frequencies, they perform as well or better than trichromats. The advantages of dichromats in detecting high temporally modulated targets can be related to an increased number, through replacement, of the remaining L- or M-cone type. However, their disadvantages in detecting low temporally modulated targets, even in directions of color space where their increased number of cone photoreceptors might be expected to be beneficial, are best explained in terms of the loss of L-M cone opponency and the inability of the visual pathways to reorganize to allow the detection of low-frequency luminance modulation.

Case-Control Studies↗

A luminous efficiency function, V*(lambda), for daylight adaptation.

We propose a new luminosity function, V*(lambda), that improves upon the original CIE 1924 V(lambda) function and its modification by D. B. Judd (1951) and J. J. Vos (1978), while being consistent with a linear combination of the A. Stockman & L. T. Sharpe (2000) long-wavelength-sensitive (L) and middle-wavelength-sensitive (M) cone fundamentals. It is based on experimentally determined 25 Hz, 2 degrees diameter, heterochromatic (minimum) flicker photometric data obtained from 40 observers (35 males, 5 females) of known genotype, 22 with the serine variant L(ser180), 16 with the alanine L(ala180) variant, and 2 with both variants of the L-cone photopigment. The matches, from 425 to 675 nm in 5-nm steps, were made on a 3 log troland xenon white (correlated color temperature of 5586 K but tritanopically metameric with CIE D65 standard daylight for the Stockman and Sharpe L- and M-cone fundamentals in quantal units) adapting field of 16 degrees angular subtense, relative to a 560-nm standard. Both the reference standard and test lights were kept near flicker threshold so that, in the region of the targets, the total retinal illuminance averaged 3.19 log trolands. The advantages of the new function are as follows: it forms a consistent set with the new proposed CIE cone fundamentals (which are the Stockman & Sharpe 2000 cone fundamentals); it is based solely on flicker photometry, which is the standard method for defining luminance; it corresponds to a central 2 degrees viewing field, for which the basic laws of brightness matching are valid for flicker photometry; its composition of the serine/alanine L-cone pigment polymorphism (58:42) closely matches the reported incidence in the normal population (56:44; Stockman & Sharpe, 1999); and it specifies luminance for a reproducible, standard daylight condition. V*(lambda) is defined as 1.55L(lambda) + M(lambda), where L(lambda) and M(lambda) are the Stockman & Sharpe L- & M-cone (quantal) fundamentals. It is extrapolated to wavelengths shorter than 425 nm and longer than 675 nm using the Stockman & Sharpe cone fundamentals.

Adaptation, Physiological↗

Visual acuity and X-linked color blindness.

PURPOSE: Optimal sampling for visual acuity requires a fine array of cones with identical sensitivity. Thus, dichromats, whose inner fovea is made up of cones having the same spectral sensitivity, may have better than normal visual acuity. We investigated this by comparing the visual acuities of trichromats and X-linked dichromats, while taking into account the different molecular genetics underlying the disorder. METHODS: Our subjects were age- and refraction-matched groups of normals (n=8) and X-linked dichromats (n=13). The dichromats (four protanopes and nine deuteranopes) were genotyped and classified according to whether they carried a single (n=6) or multiple (n=7) visual pigment genes on their X-chromosome. Visual acuity was measured in both eyes with the Freiburger Visual Acuity Test. RESULTS: Normal trichromats and ungenotyped dichromats do not significantly differ in visual acuity, nor do ungenotyped protanopes and deuteranopes. However, multi-gene dichromats, who possess more than one photopigment gene in the array, all of which encode for the same long- or middle-wavelength sensitive photopigment, have significantly higher visual acuity than either normal trichromats or dichromats who have only a single-gene. CONCLUSIONS: Multi-gene dichromats may benefit from a reduction in chromatic aberration and chromatic noise in the high acuity channel, normally a consequence of combining signals from different cone photoreceptor types and of cone-specific patterns of retinal image defocus and blur. Single-gene dichromats may not share in the advantage because of other molecular differences that influence the development of the retinal mosaic and/or its visual pathways.

Adult↗

Progressive cone dystrophy with deutan genotype and phenotype.

PURPOSE: To study the electroretinographic signals originating in the long-wavelength-sensitive (L) and middle-wavelength-sensitive (M) cone pathways by means of large-field and multifocal cone type-specific electroretinograms (ERGs) in a patient with progressive cone dystrophy. METHODS: A 65-year-old male patient with colour vision disturbances (age at onset 10 years), loss of visual acuity (14 years), and central visual field defects (40 years) was investigated. Large-field flicker-ERG responses to stimuli that exclusively modulated the L-cones or the M-cones, or the two simultaneously (both in-phase and in counter-phase), were measured. Short-wavelength-sensitive (S) cones were not modulated. Multifocal ERGs (mfERGs) were also recorded, with a pattern-reversing display that modulated only the L- or the M-cones at equal cone contrasts and average quantal catches. Genetic analysis of L- and M-pigment genes was performed on genomic DNA isolated from peripheral venous blood. RESULTS: The patient showed a normal rod-driven ERG but reduced cone-driven electroretinographic amplitudes with normal implicit times in the International Society for Clinical Electrophysiology of Vision (ISCEV) standard ERG. The large-field flicker-ERG responses to pure L-cone modulation were significantly above noise level but were substantially reduced in comparison with both normal trichromatic subjects and (otherwise normal) deuteranopes. The L-cone driven electroretinographic implicit times and phases were within normal limits. The M-cone driven electroretinographic responses were not detectable. A model fit of all the L- and M-cone driven flicker-ERG data revealed that the responses were exclusively driven by the L-cones. Consistently, the cone type-specific mfERGs showed severely reduced but detectable responses to L-cone-isolating stimuli. The M-cone driven multifocal-ERG responses were undistinguishable from noise. The L- and M-pigment gene array consisted of only a single L-pigment gene. The complete coding sequence of this gene was determined and showed no abnormality. CONCLUSIONS: This patient exhibits a coincidence of progressive cone dystrophy and deuteranopia. The molecular genetic data of the L/M-pigment gene array is consistent with the deutan phenotype. It cannot be excluded that the rearrangement of the X-chromosome pigment gene array is responsible for the cone dystrophy in this patient. It is, however, suggested that the dichromacy and the cone dystrophy have different and independent genetic origins.

Aged↗

CNGB3 mutations account for 50% of all cases with autosomal recessive achromatopsia.

Achromatopsia is a congenital, autosomal recessively inherited disorder characterized by a lack of color discrimination, low visual acuity (<0.2), photophobia, and nystagmus. Mutations in the genes for CNGA3, CNGB3, and GNAT2 have been associated with this disorder. Here, we analyzed the spectrum and prevalence of CNGB3 gene mutations in a cohort of 341 independent patients with achromatopsia. In 163 patients, CNGB3 mutations could be identified. A total of 105 achromats carried apparent homozygous mutations, 44 were compound (double) heterozygotes, and 14 patients had only a single mutant allele. The derived CNGB3 mutation spectrum comprises 28 different mutations including 12 nonsense mutations, eight insertions and/or deletions, five putative splice site mutations, and three missense mutations. Thus, the majority of mutations in the CNGB3 gene result in significantly altered and/or truncated polypeptides. Several mutations were found recurrently, in particular a 1 bp deletion, c.1148delC, which accounts for over 70% of all CNGB3 mutant alleles. In conclusion, mutations in the CNGB3 gene are responsible for approximately 50% of all patients with achromatopsia. This indicates that the CNGB3/ACHM3 locus on chromosome 8q21 is the major locus for achromatopsia in patients of European origin or descent.

Alleles↗

Glare sensitivity and professional drivers' safety: a case of rod-cone dystrophy with negative electroretinogram.

BACKGROUND: To obtain a driver's licence certain requirements for visual acuity and visual field have to be fulfilled. Mesopic contrast and glare sensitivity are not regularly tested and are not crucial to passing the driving test. CASE REPORT: We report a case of a 39-year-old professional bus driver whose only complaint was increased glare sensitivity. After he had been involved in four traffic accidents, ophthalmological investigations revealed binocular annular scotomata and night blindness, leading to the diagnosis of rod-cone dystrophy. DISCUSSION: Enhanced glare sensitivity is a common complaint in elderly people or people with the beginnings of cataract but may also represent an initial symptom of a retinal disorder. It is therefore advisable for traffic safety if drivers with such complaints undergo a complete ophthalmological investigation including visual field testing.

Accidents, Traffic↗

The Nagel anomaloscope: its calibration and recommendations for diagnosis and research.

BACKGROUND: The Nagel anomaloscope Model I is the definitive clinical instrument for classifying phenotypic variations in X-linked color-vision disorders. Its system of classification is based on the Rayleigh equation: the relative amounts of red and green primary lights required to match a yellow primary. Our aim was to characterize how changes in mains voltage and ambient temperature influence the wavelength and intensity of each primary and alter the Rayleigh matches of normal and anomalous trichromats. METHODS: A Nagel Model I anomaloscope was calibrated in wavelength and intensity while varying the temperature of its prism housing and the mains voltage. Three normal, three protanomalous and three deuteranomalous trichromats made Rayleigh matches at various temperatures and voltages. RESULTS: The intensities of the green and red primaries show an exponential growth with mains voltage. Additionally, the wavelengths and intensities of all three primaries change with prism housing temperature. As a result, the R-G match midpoints of normal and anomalous trichromats shift with increasing mains voltage, and more markedly with increasing prism housing temperature, to higher R-G settings. CONCLUSIONS: Rayleigh matches obtained with the Nagel I anomaloscope are sensitive to changes in voltage supply and prism housing temperature, arising largely from thermal effects of the internal light sources. However, the instrument may still be safely used for diagnostic and research purposes provided that: (1) a stable voltage supply is used; (2) it is kept at a constant temperature; and (3) the match midpoint of the reference population has been established under identical conditions.

Biomedical Research↗

Molecular basis of an inherited form of incomplete achromatopsia.

Mutations in the genes encoding the CNGA3 and CNGB3 subunits of the cyclic nucleotide-gated (CNG) channel of cone photoreceptors have been associated with autosomal recessive achromatopsia. Here we analyze the molecular basis of achromatopsia in two siblings with residual cone function. Psychophysical and electroretinographic analyses show that the light sensitivity of the cone system is lowered, and the signal transfer from cones to secondary neurons is perturbed. Both siblings carry two mutant CNGA3 alleles that give rise to channel subunits with different single-amino acid substitutions. Heterologous expression revealed that only one mutant forms functional channels, albeit with grossly altered properties, including changes in Ca2+ blockage and permeation. Surprisingly, coexpression of this mutant subunit with CNGB3 rescues the channel phenotype, except for the Ca2+ interaction. We argue that these alterations are responsible for the perturbations in light sensitivity and synaptic transmission.

Adolescent↗

Visual short-term effects of Viagra: double-blind study in healthy young subjects.

PURPOSE: To investigate short-term visual effects of a single 100-mg dose of Viagra (sildenafil citrate) in healthy men. DESIGN: Randomized, double-blind, placebo-controlled clinical trial of drug effects on normal volunteers conducted by a single center. METHODS: Twenty men, aged 20 to 40 years, were treated with either a placebo or 100 mg sildenafil. Visual function tests included electroretinogram (ERG) recordings, on-/off- and 3.3 Hz-flicker-ERG recordings, anomaloscope matches, and measurements of cone contrast sensitivities and transient tritanopia. RESULTS: Most visual tests did not differ between the sildenafil and placebo groups. However, statistically significant increases in sensitivity during transient tritanopia were observed as well as significant prolongations in the implicit times of scotopic a-wave, photopic b-wave, and 3.3 Hz-flicker a-wave and b-wave ERG recordings. The magnitude of the differences correlated with peak sidenafil plasma concentration. Although rod amplitudes of the ERG recordings tended to be higher and cone amplitudes lower in the sildenafil group after drug ingestion, the differences were nonsignificant. There were no reports of visual side effects, and all electrophysiologic and psychophysical measurements returned to the normal range within 24 hours. CONCLUSIONS: A single oral dose of 100-mg sildenafil given to healthy young men led to small but statistically significant transient changes of outer and inner retinal function, as detected by ERG and psychophysical methods. Although the acute effects were fully reversible within 24 hours, it would be worthwhile to compare them with those induced by other PDE5 and PDE6 inhibitors.

3',5'-Cyclic-GMP Phosphodiesterases↗

Inherited multifocal RPE-diseases: mechanisms for local dysfunction in global retinoid cycle gene defects.

Alterations of retinoid cycle genes are known to cause retinal diseases characterized by focal white dot fundus lesions. Fundus appearances reveal circumscribed RPE-changes, although generalized metabolic defects and global functional abnormalities are present. As a possible explanation, topographic inhomogeneities of the human photoreceptor mosaic and the role of a cone specific visual cycle will be discussed. Due to particular characteristics of photoreceptor subtypes as well as different pathways for photopigment regeneration the metabolic demand of individual RPE cells might differ. In "flecked retina diseases" heterogeneity of metabolic demand in individual RPE cells could therefore be responsible for their multifocal appearance.

Fundus Oculi↗

Detecting color vision in a malingerer.

A patient describing himself as totally color blind was ordered by the judicial system to have his color vision investigated in order to establish his suitability for military service. Basic clinical (Farnsworth Panel D-15, Moreland and Rayleigh anomaloscope equations), electroretinographic (ERG) and psychophysical techniques (spectral sensitivities) were applied to determine the extent of his color discrimination performance and cone function. These standard procedures were complemented by a test for cone interaction (transient tritanopia) and by newly developed cone-isolating flicker large-field ERG recordings. The patient's data consistently indicate the function as well as the functional interaction of the middle-wavelength-sensitive (M-) and the short-wavelength-sensitive (S-) cones. But the function of the long-wavelength-sensitive (L-) cones was completely absent. Hence the patient was correctly demonstrated to be a protanope. This study establishes that standard classical procedures, in combination with newly developed and easy to apply psychophysical and ERG ones, which can be reliably used to assess true color discrimination performance, in difficult cases of malingering.

Adult↗

The molecular basis of dichromatic color vision in males with multiple red and green visual pigment genes.

We investigated the genotypic variation in 50 red-green color vision deficient males (27 deuteranopes and 23 protanopes) of middle European ancestry who possess multiple genes in the X-linked photopigment gene array. We have previously shown that only the first two genes of the array are expressed and contribute to the color vision phenotype. Therefore, the hypothesis is that the first two genes possessed by multigene-dichromats encode pigments of identical or nearly identical spectral sensitivity: one gene normal (R or G) and the other a hybrid (G/R or R/G). The spectral sensitivities of the encoded pigments were inferred from published in vitro and in vivo data. The color vision phenotype was assessed by standard anomaloscopy. Most genotypes (92%) included hybrid genes whose sequence and position and whose encoded pigment correlated exactly with the phenotype. However, one and possibly two of the protanopes had gene arrays consistent with protanomaly rather than protanopia, since two spectrally different pigments may be encoded by their arrays. Two of the deuteranopes had only R- and G-photopigment genes, without any detectable G/R-hybrid genes or any as-of-yet identified point mutation or coding/promoter sequence deletions. Further, an unexpectedly high number of multigene-deuteranopes (11%) had the C203R mutation in their most upstream G-pigment gene, suggesting a founder effect of middle European origin for this mutation. About half of the protanopes possessed an upstream R/G-hybrid gene with different exon 2 coding sequences than their downstream G-pigment gene(s), which is inconsistent with published data implying that a single amino acid substitution in exon 2 can confer red-green color discrimination capacity on multigene-protans by altering the optical density of the cones.

Color Perception↗

Reorganization of human cortical maps caused by inherited photoreceptor abnormalities.

We describe a compelling demonstration of large-scale developmental reorganization in the human visual pathways. The developmental reorganization was observed in rod monochromats, a rare group of congenitally colorblind individuals who virtually lack cone photoreceptor function. Normal controls had a cortical region, spanning several square centimeters, that responded to signals initiated in the all-cone foveola but was inactive under rod viewing conditions; in rod monochromats this cortical region responded powerfully to rod-initiated signals. The measurements trace a causal pathway that begins with a genetic anomaly that directly influences sensory cells and ultimately results in a substantial central reorganization.

Adult↗

The multifocal visual evoked potential and cone-isolating stimuli: implications for L- to M-cone ratios and normalization.

Multifocal visual evoked potentials (mfVEP) were recorded with a pattern-reversing display that modulated only the long wavelength-sensitive (L) cones or only the middle wavelength-sensitive (M) cones. Outside the central 5.8 degrees (radius), the ratio of the amplitudes of the mfVEP responses to L- and M-cone modulation varied across the six subjects, ranging from 1.1 to 1.7. The responses from the central 1 degrees (radius) showed a substantially lower ratio, ranging from 0.8 to 1.1 (average of 0.9). The variation among individuals outside the central fovea is probably due to differences in the ratio of the L/M cone input to both magno- and parvocellular pathways. The substantially lower ratios for the central responses is consistent with an L/M cone ratio closer to 1.0 in the central 1 degrees and/or an adjustment in the gain of the L- versus M-cone contributions to the central parvocellular pathways. Taking into consideration evidence from other techniques, we believe it is unlikely that most individuals have a L/M cone ratio of 1.0 in the fovea. Instead, it appears that there is a change in gain before the mfVEP is generated in area 17.

Adolescent↗

The multifocal electroretinogram (mfERG) and cone isolating stimuli: variation in L- and M-cone driven signals across the retina.

Multifocal electroretinograms (mfERG) were recorded from 38 normal trichromats with a pattern-reversing display that modulated only their long-wavelength sensitive (L) or only their middle-wavelength sensitive (M) cones at equal cone contrasts and average quantal catches. The display consisted of scaled, 103 hexagonal elements, subtending 84 degrees x 75 degrees of visual angle. Typically, the amplitude of the L-cone driven signal was greater than that for the M-cone driven one at all retinal eccentricities, but large differences were found among observers. These values correlated with L- to M-cone ratios obtained psychophysically in the same observers using 2 degrees (dia.) heterochromatic flicker photometry. Interestingly, the L- to M-cone driven amplitude ratios differed between the central and peripheral retina. For the central fovea (5 degrees dia.), the mean ratio was 1.4 +/- 0.6 (for the N1P1 component), whereas for the annular ring centered at 40 degrees in the periphery, it was 2.3 +/- 2.0. The mean P1 latency of the summed M-cone driven mfERG (28.0 +/- 2.6 ms) was significantly advanced relative to the L-cone driven signal (29.0 +/- 1.9 ms), but the mean N1 latencies were similar (15.6 +/- 1.7 ms and 16.2 +/- 1.3 ms, respectively). The P1 latency difference between the L- and M-cone driven waveforms was not found in the central 5 degrees (dia.) of the retina. However, it increased with retinal eccentricity. The regional differences in the amplitudes and latencies of the L- and M-cone driven mfERG signals can be related to variations in the L- to M-cone ratios and/or the receptor to bipolar gain factors that depend on eccentricity.

Adult↗

Dose-dependency and time-course of electrophysiologic short-term effects of VIAGRA: a case study.

The dose-dependency and time-course of the short-term visual effects of sildenafil citrate (VIAGRA) were tested in two subjects. Blood pressure was measured and samples of blood taken at 30 min intervals before and after drug administration. In the first experiment, prolongations of the implicit times of the scotopic maximum a-wave, cone a- and b-wave, 33 Hz flicker, ON-response a- and b-wave and 3.3 Hz a- and b-wave electroretinogram (ERG) recordings and of the oscillatory potentials OP1, OP2, and OP3 were observed for both eyes of both subjects, following 100 or 200 mg dosings. Interestingly, no prolongation was found for OP4, to which the OFF-bipolar cell pathway significantly contributes. In the second experiment, in which visual function was repeatedly assessed following a 200 mg dose, similar prolongations were found in both eyes of one subject for the implicit times of the oscillatory potential OP2, the cone b-wave response and the 3.3 Hz a-wave. Moreover, the steady-state (A0) and immediate extinction (B0) blue target thresholds of transient tritanopia were raised relative to the pre-drug administration baseline effects. While the maximum lowering of both systolic and diastolic blood pressure approximately correlated with the peak plasma concentration of sildenafil (c. 30-60 min after administration), the peak magnitudes of most visual effects were found at c. 110 min, consistent with a second compartment kinetic.

3',5'-Cyclic-GMP Phosphodiesterases↗

Multifocal electroretinogram in trichromat and dichromat observers under cone isolating conditions.

The aim of this study was to obtain information about single cone class driven activity in the inner and outer retina in humans. We examined outer retinal activity with the multifocal electroretinogram (mfERG) and inner retinal activity using multifocal oscillatory potentials (mfOPs). A standard (black-white) stimulus was used, as well as stimuli aimed at isolating a single photoreceptor class. The results of 10 trichromats were compared to those of 2 protanopes and 2 deuteranopes. At both retinal layers we find that trichromats show cone isolating response amplitudes that reflect the expected number of cones and that single- gene dichromats have a similar total number of functioning cones as trichromats. The ratio of the responses of the L- and M-cones is slightly smaller for the mfOPs than for the mfERGs. The results indicate that there are major changes in the gain of retinal signals after the inner plexiform layer.

Adult↗