Biomedical subjects

Vittorio Porciatti

Publications and source records attributed to Vittorio Porciatti.

13 recordsLinked to original sources

PubMed2006

Pattern electroretinogram in glaucoma.

PURPOSE OF REVIEW: Several studies have shown that the pattern electroretinogram, a direct, objective method of measuring retinal ganglion cell function, is altered early in ocular hypertension and glaucoma. Renewed interest in the pattern electroretinogram for early detection of pre-perimetric glaucoma has been sparked by noninvasive and reproducible methods of recording using skin electrodes. RECENT FINDINGS: With the noninvasive pattern electroretinogram, response abnormalities have been detected in up to 50% of glaucoma suspects with normal standard perimetry. In early glaucoma (with either normal or high intraocular pressure), a reduction of intraocular pressure has sometimes yielded improvement in pattern electroretinogram amplitude. A prolonged steady-state stimulus presentation reduces the pattern electroretinogram amplitude and increases optic nerve blood flow in normal subjects, suggesting that sustained activity of retinal ganglion cells is physiologically associated with autoregulatory changes of the neural-vascular system. It is unknown whether this autoregulation is altered in glaucoma. The multifocal pattern electroretinogram does not seem to have an advantage over the pattern electroretinogram in the early detection of glaucoma. The photopic negative response of the diffuse flash electroretinogram has shown changes in glaucoma, but may not be able to detect retinal dysfunction in normal tension glaucoma. SUMMARY: The pattern electroretinogram is a noninvasive, direct, objective method that may be useful to clinicians in detecting early retinal ganglion cell dysfunction in glaucoma suspects. The pattern electroretinogram may also optimize treatment strategies based on improvement of retinal ganglion cell function.

Electroretinography↗

PubMed2006

Visual-evoked potentials to onset of chromatic red-green and blue-yellow gratings in Parkinson's disease never treated with L-dopa.

The differential dysfunction of chromatic and achromatic visual pathways in early Parkinson's disease (PD) was evaluated by means of visual-evoked potentials (VEPs) recorded in 12 patients (mean age 60.1 +/- 8.3 years; range 46 to 74 years) in the early stages of PD and not yet undergoing treatment with L-dopa, and in 12 age-matched controls. Visual stimuli were full-field (14 deg) equiluminant red-green (R-G), blue-yellow (B-Y), and black-white (B-W) sinusoidal gratings of two cycles per degree, presented in onset (300 milliseconds)--offset (700 milliseconds) mode, at two contrast (K) levels (90% and 25%). The VEP mean latencies were significantly more delayed in PD patients than in controls for chromatic than for luminance stimuli, in particular for B-Y stimuli of low contrast (K90%: B-W = 6.6 milliseconds, R-G = 3.34 milliseconds, B-Y = 15.48 milliseconds; K25%: B-W = 7.8 milliseconds, R-G = 14.8 milliseconds, B-Y = 28.9). Latencies of chromatic VEPs were more variable that achromatic VEP latencies in both normal subjects and PD patients. Therefore, the frequency of latency abnormalities (within 30%) was not significantly different for the three visual stimuli. Our results show that, in addition to achromatic VEPs, chromatic VEPs are impaired in early PD patients not yet undergoing L-dopa therapy, indicating an acquired color deficiency in these patients. The greater delay for the B-Y VEPs suggests a higher vulnerability of visual blue-cone pathway in the early stages of the disease. However, the overall sensitivity of chromatic VEPs in detecting early visual impairment in PD is comparable with that of achromatic VEPs.

Aged↗

PubMed2006

The relationship between retinal ganglion cell function and retinal nerve fiber thickness in early glaucoma.

PURPOSE: To compare relative reduction of retinal ganglion cell (RGC) function and retinal nerve fiber layer (RNFL) thickness in early glaucoma by means of steady-state pattern electroretinogram (PERG) and optical coherence tomography (OCT), respectively. METHODS: Eighty-four persons with suspected glaucoma due to disc abnormalities (GS: mean age 56.6 +/- 13.8 years, standard automated perimetry [SAP] mean deviation [MD] -0.58 +/- 1.34 dB) and 34 patients with early manifest glaucoma (EMG, mean age 65.9 +/- 10.7 years, SAP MD -2.7 +/- 4.5 dB) were tested with PERG and OCT. Both GS and EMG patients had small refractive errors, corrected visual acuity > or =20/25, and no systemic or retinal disease other than glaucoma. RESULTS: MDs from age-predicted normal values were larger for PERG amplitude (GS: -1.113 dB; EMG: -2.352 dB) compared with the PERG-matched RNFL thickness (GS: -0.217 dB; EMG: -0.725 dB). Deviations exceeding the lower 95% tolerance intervals of the normal population were more frequent for PERG amplitude (GS: 26%; EMG: 56%) than PERG-matched RNFL thickness (GS: 6%; EMG: 29%). CONCLUSIONS: In early glaucoma, reduction in RGC electrical activity exceeds the proportion expected from lost RGC axons, suggesting that a population of viable RGCs in the central retina is dysfunctional. By combining PERG and OCT it is, in principle, possible to obtain unique information on reduced responsiveness of viable RGCs.

Aged↗

PubMed2005

Pattern electroretinogram abnormality and glaucoma.

PURPOSE: To determine the existence of retinal ganglion cell dysfunction and associated risk factors in glaucoma suspects with increased optic disc cupping and normal visual field. DESIGN: Cross-sectional, observational study. PARTICIPANTS: Two hundred glaucoma suspect (GS) patients were identified based on optic disc abnormalities (vertical cup-to-disc ratios [C/D]>0.5; vertical C/D asymmetry >or= 0.2; disc hemorrhages; notching) in association with known glaucoma risk factors (positive family history, African American descent, increased intraocular pressure [IOP]), but normal visual fields. Forty-two patients had early manifest glaucoma (EMG). Sixteen normal black subjects were added to update previous pattern electroretinogram (PERG) normative data and to establish a normal control (NC) group with a racial breakdown comparable with that of the study groups. METHODS: Pattern electroretinograms were recorded simultaneously from both eyes using skin electrodes and automated analysis; visual fields were monitored with standard white-on-white automated perimetry (SAP) central 24-2 program; vertical C/D was evaluated by an independent reader from stereo disc photographs; and univariate and multivariate statistical analysis between PERG and other outcome measures was evaluated. MAIN OUTCOME MEASURES: Pattern electroretinogram amplitude (microV), phase (pi rad), and interocular asymmetry in amplitude and phase (%); and SAP mean deviation (MD; decibels), vertical C/D, age (years), IOP (mmHg), and race (black vs. nonblack). RESULTS: The PERG results were abnormal in at least 1 of the outcome measures in 52% of GS patients and 69% of EMG patients. The PERG amplitude was correlated weakly with both MD (P<0.01) and vertical C/D (P = 0.05). The correlation between PERG amplitude and MD and C/D was stronger (P<0.001) for interocular differences rather than absolute measures. Interocular PERG amplitude asymmetry increased with severity of disease (EMG>GS>NC; P<0.01). The PERG amplitude decline with age was steeper in patients with a more negative MD (P<0.01) and in patients with a more negative MD and a larger vertical C/D (P = 0.06). Black race (but not family history) was associated with lower PERG amplitude (P = 0.005) in GS and EMG patients, but not in normal controls (P = 0.44). CONCLUSIONS: The correlation between PERG abnormality and known risk factors for glaucoma indicates that PERG has a predictive potential for the development or progression of the disease, or both.

Adult↗

PubMed2005

Restoration of retinal ganglion cell function in early glaucoma after intraocular pressure reduction: a pilot study.

PURPOSE: To investigate the changes of pattern electroretinogram (PERG) after intraocular pressure lowering in glaucoma patients and normal controls. DESIGN: Interventional retrospective cross-sectional study. PARTICIPANTS: Twenty-five patients (49 eyes) with ocular hypertension or glaucoma undergoing topical treatment to lower IOP served as a study group; 22 patients (44 eyes) with ocular hypertension or glaucoma observed without treatment served as a control group for treated glaucoma patients; 9 normal subjects (18 eyes) receiving a 250-mg acetazolamide tablet served as a second study group; and 17 normal subjects (34 eyes) from a previous study served as a second control group for treated normal subjects. METHOD: Pattern electroretinograms were recorded simultaneously from both eyes using skin electrodes and automated analysis. Visual field (VF) analyses were performed with white-on-white standard automated perimetry (SAP). Intraocular pressure was measured with Goldmann applanation tonometry; central corneal thickness was measured with pachymetry. MAIN OUTCOME MEASURES: Pattern electroretinogram amplitude (microvolts), phase (pi rads), and test-retest variability (test 2-to-test 1 ratio, in decibels), SAP mean deviation (decibels), and IOP (millimeters of mercury). RESULTS: In 56% of right eyes and 21% of left eyes of the treated glaucoma subgroup, the PERG amplitude and/or phase improved beyond the 95% confidence intervals of the test-retest variability of the untreated glaucoma control group. Pattern electroretinogram improvement with IOP lowering occurred in both high- and low-tension glaucoma eyes. Eyes with severely impaired VFs showed little improvement in PERG; however, eyes of normal subjects treated with acetazolamide did not show significant PERG changes relative to the test-retest variability of normal controls. CONCLUSIONS: Retinal ganglion cell function can be at least partially restored after IOP reduction in glaucomatous eyes with early VF impairment.

Adult↗

PubMed2005

Habituation of retinal ganglion cell activity in response to steady state pattern visual stimuli in normal subjects.

PURPOSE: To evaluate autoregulatory changes of retinal ganglion cell (RGC) activity, as measured by the pattern electroretinogram (PERG), when the eye is exposed to a steady state presentation of stimuli that maximize PERG amplitude and blood flow. METHODS: The PERG was recorded from both eyes of 14 normal subjects in response to steady state presentation (4 minutes) of contrast-reversing (16.28/s) gratings (1.6 cyc/deg) with different contrast (12%-99%) and mean luminance (40-1.3 cd/m(2)). One temporal period of the stimulus (122.8 ms) was sampled and averaged in packets of 50 sweeps ( approximately 15 seconds each). PERG amplitude and phase were evaluated by Discrete Fourier Transform and displayed as a function of time. Data were fitted with an exponential decay function to evaluate PERG changes with time. RESULTS: For patterns of 99% contrast, the PERG amplitude progressively decreased with time until reaching a plateau approximately 30% lower than the initial amplitude after approximately 2 minutes (habituation). The ratio between initial and plateau amplitude did not change by reducing the stimulus luminance by 1 log unit. However, reducing contrast decreased amplitude habituation. The habituation was abolished at 25% contrast. CONCLUSIONS: Decrease of PERG amplitude with time is consistent with a slow adaptive change of RGC activity in response to high-contrast, steady state stimuli. The authors propose that the initial amplitude represents an index of RGC activity, and the plateau amplitude represents a dynamic equilibrium between RGC activity and the available energy supply. These results are relevant for a better understanding of glaucomatous optic neuropathy.

Adult↗

PubMed2004

Normative data for a user-friendly paradigm for pattern electroretinogram recording.

PURPOSE: To provide normative data for a user-friendly paradigm for the pattern electroretinogram (PERG) optimized for glaucoma screening (PERGLA). DESIGN: Prospective nonrandomized case series. PARTICIPANTS: Ninety-three normal subjects ranging in age between 22 and 85 years. METHODS: A circular black-white grating of 25 degrees visual angle, reversing 16.28 times per second, was presented on a television monitor placed inside a Ganzfeld bowl. The PERG was recorded simultaneously from both eyes with undilated pupils by means of skin cup electrodes taped over the lower eyelids. Reference electrodes were taped on the ipsilateral temples. Electrophysiologic signals were conventionally amplified, filtered, and digitized. Six hundred artifact-free repetitions were averaged. The response component at the reversal frequency was isolated automatically by digital Fourier transforms and was expressed as a deviation from the age-corrected average. The procedure took approximately 4 minutes. MAIN OUTCOME MEASURES: Pattern electroretinogram amplitude ( micro V) and phase (pi rad); response variability (coefficient of variation [CV] = standard deviation [SD] / mean x 100) of amplitude and phase of 2 partial averages that build up the PERG waveform; amplitude ( micro V) of background noise waveform, obtained by multiplying alternate sweeps by +1 and -1; and interocular asymmetry (CV of amplitude and phase of the PERG of the 2 eyes). RESULTS: On average, the PERG has a signal-to-noise ratio of more than 13:1. The CVs of intrasession and intersession variabilities in amplitude and phase are lower than 10% and 2%, respectively, and do not depend on the operator. The CV of interocular asymmetries in amplitude and phase are 9.8+/-8.8% and 1.5+/-1.4%, respectively. The PERG amplitude and phase decrease with age. Residuals of linear regression lines have normal distribution, with an SD of 0.1 log units for amplitude and 0.019 log units for phase. Age-corrected confidence limits (P<0.05) are defined as +/-2 SD of residuals. CONCLUSIONS: The PERGLA paradigm yields responses as reliable as the best previously reported using standard protocols. The ease of execution and interpretation of results of PERGLA indicate a potential value for objective screening and follow-up of glaucoma.

Adult↗

PubMed2004

Physiology of human photosensitivity.

Human epileptic photosensitivity has been studied in several ways. (a) Visual stimulation that resembles the stimulation normally responsible for seizures, such as that from televisions or videogames, both of which typically use cathode ray tubes in which the display is created in a flickering pattern. Such stimulation is often rendered yet more epileptogenic by programmes with content that also involves flashing or patterned material. (b) Elementary visual stimuli that enable inferences to be drawn concerning the physiological trigger mechanisms. The topographic distribution of epileptiform EEG activity in response to such stimuli has complemented this approach, leading to the inference that the trigger is cortical and requires sychronised mass action of neurons. (c) Stimuli that avoid paroxysmal EEG activity and permit an investigation of the subepileptic response to visual stimuli, using the evoked potential. This has revealed abnormalities in the cortical mechanisms that control the response to strong visual stimulation.

Epilepsy, Reflex↗

PubMed2003

Remodeling of second-order neurons in the retina of rd/rd mutant mice.

This is a brief review of data obtained by analyzing the morphology and the physiology of the retinas in rd/rd and normal, wt mice, aged 10-90 days. Second-order neurons of the rd/rd show abnormalities that start with the anomalous development of rod bipolar cells around P10 and culminate with the atrophy of dendrites in cone bipolar cells, mostly evident at P90. Horizontal cells remodel considerably. Cone-mediated ERGs, (recorded between 13 and 16 days of age) have reduced a-wave and b-wave amplitudes and longer b-wave latency and duration. B-wave abnormalities indicate specific postreceptoral dysfunction. Morphological and ERG changes in rd/rd retinas are consistent with substantial inner retinal remodeling associated to photoreceptor degeneration.

Animals↗

PubMed2002

Heterozygous knock-out mice for brain-derived neurotrophic factor show a pathway-specific impairment of long-term potentiation but normal critical period for monocular deprivation.

Genetic deletion of a single allele of the BDNF gene affects hippocampal LTP and causes several behavioral phenotypes, including deficits in spatial learning. In the developing visual cortex, overexpression of BDNF accelerates the time course of the critical period for monocular deprivation (MD), and exogenous administration of BDNF alters the outcome of MD. We asked whether reduced levels of BDNF could affect visual cortex plasticity by studying long-term potentiation (LTP) induction and the effects of MD in heterozygous BDNF knock-out mice. We found that theta burst stimulation that induced LTP in the layer IV-III pathway of wild-type (wt) mice caused only a transient potentiation in BDNF+/- mice, and that this potentiation vanished in 25 min. In contrast, LTP elicited by stimulation of the white matter (WM), a form of LTP that can be induced only during the critical period, occurred normally in wt and BDNF+/- mice. The effects of MD during the critical period were similar in wt and BDNF+/- mice, indicating that layer IV-evoked, layer III LTP is not required for ocular dominance plasticity. We then asked whether reduction of cortical BDNF levels could prolong the critical period for MD and for the WM-evoked, layer III LTP induction. We found that in adult BDNF+/- mice, WM-evoked, layer III LTP was not inducible, and that the critical period for MD terminated normally. We conclude that deletion of one copy of the BDNF gene selectively impairs LTP of the layer IV-III pathway but does not alter ocular dominance plasticity.

Animals↗

PubMed2002

Morphological and functional abnormalities in the inner retina of the rd/rd mouse.

We investigated the effects of photoreceptor degeneration on the anatomy and physiology of inner retinal neurons in a mouse model of retinitis pigmentosa, the retinal degeneration (rd) mutant mouse. Although there is a general assumption that the inner retinal cells do not suffer from photoreceptor death, we confirmed major changes both accompanying and after this process. Changes include sprouting of horizontal cells, lack of development of dendrites of rod bipolar cells, and progressive atrophy of dendrites in cone bipolar cells. Electrophysiological recordings demonstrate a selective impairment of second-order neurons that is not predictable on the basis of a pure photoreceptor dysfunction. Our data point out the necessity to prove integrity of the inner retina before attempting restoring visual function through photoreceptor intervention. This is even more important when considering that although intervention can be performed before the onset of any symptoms in animals carrying inherited retinopathies, this is obviously not true for human subjects.

Animals↗

PubMed2002

Electrophysiology of the postreceptoral visual pathway in mice.

Pattern VEPs have been recorded locally from the binocular portion of the primary visual cortex of wild type- and different transgenic mice by means of microelectrodes. Local pattern VEPs have been used on the one hand to obtain information on basic cortical layout (topography, laminar analysis) and ocularity (relative contribution of the contralateral and ipsilateral eye), and on the other hand to evaluate several aspects of visual physiology that have a counterpart in visual behavior (visual acuity, contrast sensitivity, motion sensitivity, response latency). As compared to visual behavior, pattern VEPs offer the advantage that several aspects of vision can be evaluated in the same animals, including those with poor behavior due to motor- or cognitive deficits, even during the postnatal development. Pattern VEPs provide a means for characterizing the visual phenotype of mutant mice and for the evaluation of the effects induced by experimental manipulation.

Animals↗

PubMedDate not supplied

Changes in pattern electroretinograms to equiluminant red-green and blue-yellow gratings in patients with early Parkinson's disease.

In Parkinson's disease (PD), the luminance pattern electroretinogram (PERG) is reported to be abnormal, indicating dysfunction of retinal ganglion cells (RGCs). To determine the vulnerability of different subpopulations of RGCs in PD patients, the authors recorded the PERG to stimuli of chromatic (red-green [R-G] and blue-yellow [B-Y]) and achromatic (yellow-black [Y-Bk]) contrast, known to emphasize the contribution of parvocellular, koniocellular, and magnocellular RGCs, respectively. Subjects were early PD patients (n = 12; mean age, 60.1 +/- 8.3 years; range, 46 to 74 years) not undergoing treatment with levodopa and age-sex-matched controls (n = 12). Pattern electroretinograms were recorded monocularly in response to equiluminant R-G, B-Y, and Y-Bk horizontal gratings of 0.3 c/deg and 90% contrast, reversed at 1Hz, and presented at a viewing distance of 24 cm (59.2 x 59 degree field). In PD patients, the PERG amplitude was significantly reduced (by 40 to 50% on average) for both chromatic and luminance stimuli. Pattern electroretinogram latency was significantly delayed (by about 15 ms) for B-Y stimuli only. Data indicate that, in addition to achromatic PERGs, chromatic PERGs are altered in PD before levodopa therapy. Overall, chromatic PERGs to B-Y equiluminant stimuli exhibited the largest changes. Data are consistent with previous findings in PD, showing that visual evoked potentials (VEP) to B-Y chromatic stimuli are more delayed than VEPs to R-G and achromatic stimuli. The results suggest that the koniocellular subpopulation of RGCs may be particularly vulnerable in early stages of Parkinson's disease.

Aged↗