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At least 235 records · Page 13Linked to original sources

The effect of dark adaptation on the responses of cat retinal ganglion cells to eyeball deformation.

Eyeball deformation in total darkness leads to an activation of on-center ganglion cells and an inhibition of off-center ganglion cells. After "deformation off" most on-center ganglion cell activity decreased slowly to the normal spontaneous dark level, while in off-center ganglion cells some returned according to an exponential function to normal dark activity, while others had a transient postinhibitory activation period. In general, the response type of latency class I and latency class II neurons was the same. Dark adaptation of 30-45 min duration only changed this neuronal response pattern slightly, if at all. A detailed statistical analysis is provided for the four classes of retinal ganglion cells recorded: latency class I on-center and off-center neurons and latency class II on-center and off-center neurons. The missing effects of dark adaptation on neuronal responses evoked by eyeball deformation are explained by three possible models. The more plausible one assumes that horizontal cells are depolarized by retinal stretch. Their interaction with cone on-bipolars or cone off-bipolars is fairly independent of photoreceptor adaptation or transmitter release at the cone pedicles and is still effective when all molecular receptor sites at cone/bipolar cell synapses are occupied during scotopic states of dark adaptation. In psychophysical experiments (two subjects), as in the neuronal responses, we also could not find any indication that the "pressure phosphenes" evoked by lateral eyeball indentation are altered during dark adaptation.

Action Potentials↗

Mobility performance with a pixelized vision system.

A visual prosthesis, based on electrical stimulation of the visual cortex, has been suggested as a means for partially restoring functional vision in the blind. The prosthesis would create a pixelized visual sense consisting of punctate spots of light (phosphenes). The present study investigated the feasibility of achieving visually-guided mobility with such a visual sense. Psychophysical experiments were conducted on normally sighted human subjects, who were required to walk through a maze which included a series of obstacles, while their visual input was restricted to information from a pixelized vision simulator. Walking speed and number of body contacts with obstacles and walls were measured as a function of pixel number, pixel spacing, object minification, and field of view. The results indicate that a 25 x 25 array of pixels distributed within the foveal visual area could provide useful visually guided mobility in environments not requiring a high degree of pattern recognition.

Blindness↗

Gaze-evoked amaurosis from vitreopapillary traction.

PURPOSE: We report four patients with gaze-evoked amaurosis attributable to incomplete posterior vitreous detachment and ensuing vitreopapillary traction. We present these cases to illustrate and extend the spectrum of vitreopapillary syndromes and to draw attention to vitreopapillary traction and its expected manifestations in both optic disk appearance and optic nerve and retinal function. DESIGN: This is a retrospective observational case series culled from tertiary neuro-ophthalmology practice. METHODS: Patients were evaluated with direct and indirect ophthalmoscopy, Hruby (precorneal) lens, three-mirror Goldmann contact lens, macular contact lens, formal perimetry, fundus photography, fluorescein angiography, and orbital ultrasound. RESULTS: Four patients with gaze-evoked amaurosis had disk edema associated with a partial posterior vitreous separation. These patients were young and had atypical posterior vitreous detachments characterized by persisting vitreopapillary attachments. CONCLUSIONS: Gaze-evoked amaurosis is a rare visual obscuration precipitated by changes in volitional gaze, usually associated with an underlying orbital mass. We extend its etiologies to implicate the vitreous through traction expressed at the optic disk. In our cases, vitreopapillary traction elevated the nerve head and eye movements precipitated transient visual phosphenes followed by gaze-evoked amaurosis caused by traction transmitted from the vitreous to superficial nerve fibers of the retina and disk.

Adult↗

A model for intracortical visual prosthesis research.

In the field of visual prosthesis research, it has generally been held that animal models are limited to testing the safety of implantable hardware due to the inability of the animal to provide a linguistic report of perceptions. In contrast, vision scientists make extensive use of trained animal models to investigate the links between visual stimuli, neural activities, and perception. We describe an animal model for cortical visual prosthesis research in which novel animal psychophysical testing has been employed to compensate for the lack of a linguistic report. One hundred and fifty-two intracortical microelectrodes were chronically implanted in area V1 of a male macaque. Receptive field mapping was combined with eye-tracking to develop a reward-based training procedure. The animal was trained to use electrically induced point-flash percepts, called phosphenes, in performing a memory saccade task. It is our long-term goal to use this animal model to investigate stimulation strategies in developing a multichannel sensory cortical interface.

Animals↗

[Photopsia: an often unrecognized symptom and sensitivity of electroretinography].

BACKGROUND: Photopsias are unformed luminous spontaneous visual hallucinations, often described as flickering or wiggling lights, sometimes like a glare. Phosphenes are more intense and of shorter duration whereas migraine fortifications have a specific time course and succession of events. Recognition of this symptom is often poor, hence patients are wrongly investigated. PURPOSE: To describe the clinical presentation and electroretinographic characteristics of patients with photopsias. METHODS: 4 patients were worked-up with clinical, psychophysical, angiographic and electroretinographic examinations. RESULTS: Despite normal fundus and angiographic examinations, full-field electroretinogram was diagnostic in all cases. Retinal dysfunction involved either inner or outer retina. Paraneoplastic, and probable autoimmune/inflammatory retinopathies were found in our cases. CONCLUSION: Photopsias are often secondary to sick retinal cells. In the presence of photopsias, investigations should be directed towards the retina and electroretinography is the gold standard. Recognition of the symptom should prevent useless and potentially harmful investigations for the patient.

Diagnosis, Differential↗

Rapporteur report: weak field interactions in the central nervous system.

Experimental evidence was presented of the interaction of extremely low frequency (ELF) physiologically weak electric fields (that is, internal fields of around 1-1000 mV m(-1)) with tissues of the central nervous system and the consequences of this for visual and cognitive function. These internal fields are higher than those induced in the body by exposure to environmental EMFs, but are small compared to nerve excitation thresholds. Two papers considered the effect of weak electric fields directly applied to hippocampal tissue in vitro on neuronal excitability assessed from evoked responses and on the modulation of neural network activity involving large numbers of individual neurons. A review was presented of the effects on electrical measures of perceptual and cognitive processes and on the performance of various behavioural tasks in volunteers exposed to electromagnetic fields. Finally, two papers addressed the visual perception of flickering light--phosphenes--in volunteers exposed to ELF magnetic fields. The first examined possible physiological origins of this phenomenon and the second assessed the induced electric fields and currents in the retina, using complex dosimetric modelling. These papers were discussed in several plenary sessions and in one breakout group, all of which are briefly summarised in this report.

Animals↗

Pulse configuration-dependent effects of repetitive transcranial magnetic stimulation on visual perception.

Transcranial magnetic stimulation (TMS) is a noninvasive technique for direct stimulation of the neocortex. In the last two decades it is successfully applied in the study of motor and sensory physiology. TMS uses the indirect induction of electrical fields in the brain generated by intense changes of magnetic fields applied to the scalp. It encompasses two widely used waveform configurations: mono-phasic magnetic pulses induce a single current in the brain while biphasic pulses induce at least two currents of inverse direction. As has been shown for the motor cortex, efficacy of repetitive transcranial magnetic stimulation (rTMS) may depend on pulse configuration. In order to clarify this question with regard to visual perception, static contrast sensitivities (sCS) were evaluated before, during, immediately after and 10 minutes after monophasic and biphasic low frequency (1 Hz) rTMS applied to the occipital cortex of 15 healthy subjects. The intensity of stimulation was the phosphene threshold of each individual subject. Using 4 c/d spatial frequency, significant sCS loss was found during and immediately after 10 min of monophasic stimulation, while biphasic stimulation resulted in no significant effect. Ten minutes after the end of stimulation, the sCS values were at baseline level again. However, reversed current flow direction resulted in an increased efficacy of biphasic and decreased efficacy of monophasic stimulation. Our results are in agreement with previous findings showing that primary visual functions, such as contrast detection, can be transiently altered by low frequency transcranial magnetic stimulation. However the effect of modulation significantly depends on the current waveform and direction.

Adult↗

Transcranial magnetic stimulation in study of the visual pathway.

The authors critically reviewed experiments in which transcranial magnetic stimulation (TMS) and repetitive TMS (rTMS) of the higher visual pathway were used. Topics include basic mechanisms of neural excitation by TMS and their relevance to the visual pathway (excitatory and inhibitory effects), TMS and rTMS of calcarine cortex (suppression, unmasking, and phosphenes), TMS of V5 (suppression), TMS and rTMS of higher level temporoparietooccipital areas (perceptual errors, unmasking, and inattention), the role of frontal lobe output in visual perception, and vocalization of perceived visual stimuli (role of consciousness of linguistic symbols).

Attention↗

Contribution to the theory of prosthetic vision.

By way of extracellular, electrical stimulation of the visual pathway, the various approaches to vision prosthesis aim to provide crude, patterned vision to individuals with profound blindness. Common to all approaches is the implantable electrode array and the rendering of phosphenes-the actuated percepts occupying the visual field of the implantee. Thus prosthetic vision may be simulated, and underlying theories as to how to render it efficacious developed. We review the field of simulated prosthetic vision. Furthermore, with retinal prosthesis in mind, we suggest a revised approach-an approach with regard to sampling theory, the vertebrate central visual pathway, and eye movements. The parallel development of prosthetic vision theory, explored via simulation and bioengineering issues surrounding neurostimulator design and implantation has bearing on the success of clinical trials by numerous groups in coming years.

Biomedical Engineering↗

Sites of neuronal excitation by epiretinal electrical stimulation.

Action potentials arising from retinal ganglion cells ultimately create visual percepts. In persons blind from retinitis pigmentosa and age-related macular degeneration, viable retinal ganglion cells remain, and the retina can be stimulated electrically to restore partial sight. However, it is unclear what neuronal elements in the retina are activated by epiretinal electrical stimulation. This study investigated the effects of cellular geometry, electrode to neuron distance, stimulus duration, and stimulus polarity on excitation of a retinal ganglion cell with an epiretinal electrode. Computer-based compartmental models representing simplified retinal ganglion cell morphology provided evidence that the threshold for excitation was lower when an electrode was located in proximity to the characteristic 90 degrees bend in the axon of the retinal ganglion cell than when it was located over a passing axon of the nerve fiber layer. This electrode-position-dependent difference in threshold occurred with both cathodic and anodic monophasic stimuli, with point source and disk electrodes, at multiple electrode-to-neuron distances, and was robust to changes in the electrical properties of the model. This finding reveals that the physical geometry of the retinal ganglion cells produces stimulation thresholds that depend strongly on electrode position. The low excitation thresholds near the bend in the axon will result in activation of cells local to the electrode at lower currents than required to excite passing axons. This pattern of activation provides a potential explanation of how epiretinal electrical stimulation results in the production of punctuate, rather than diffuse or streaky phosphenes.

Action Potentials↗

The Proview Eye Pressure Monitor: influence of clinical factors on accuracy and agreement with the Goldmann tonometer.

PURPOSE: To investigate (i) the effect of probe position on the lid when using the Proview Eye Pressure Monitor (Proview) and (ii) the accuracy of the Proview and its agreement with the Goldmann applanation tonometer (GAT) in a normal population. METHODS: Intraocular pressure (IOP) measurements were performed on 107 control subjects (mean 25 years) using the Proview and the GAT. The Proview probe was applied to two locations on the eyelid (superior nasal and superior temporal). The IOPs measured with both instruments were compared. RESULTS: A total of 4.6% of young normal eyes could not perceive the phosphene. The mean Proview reading using the recommended nasal lid position was significantly higher (+2.5 mmHg) than that measured using the GAT. The position of the probe application was significant, with temporal lid application giving statistically significantly higher IOP readings than the recommended nasal lid application. The repeatability of Proview measurements was lower than the GAT (coefficients of repeatability of GAT and Proview nasal were 0.96 and 4.21 mmHg respectively). The limit of agreement between the GAT and the Proview nasal was low at +/-7.95 mmHg. CONCLUSION: This study shows that the position of probe application can influence the measurements taken using the Proview. Application of the probe to the nasal superior lid (as recommended) gives the more repeatable and accurate results. Overall however the data indicate that the Proview is neither sufficiently accurate nor repeatable to be used in the detection and management of glaucoma. More work is needed in developing this interesting product.

Adolescent↗

Cortical inhibition is reduced in chronic and episodic migraine and demonstrates a spectrum of illness.

BACKGROUND: The pathophysiological relationship between episodic migraine and chronic migraine is not fully understood. We aimed to examine transcranial magnetic stimulation (TMS) indices of cortical excitability in patients with episodic migraine (EM) and probable chronic migraine (PCM), and matched controls. METHODS: Cortical excitability was assessed at baseline with two well-established methods: phosphene thresholds (PT) and magnetic suppression of perceptual accuracy (MSPA) profiles. Five EM patients, five PCM patients, and five normal controls participated in the main study. In addition, two patients were reassessed after 30 days of treatment with topiramate. RESULTS: Both PT and MPSA measures were consistent in indicating a continuum of excitability across the three groups: PCM patients had the highest excitability, followed by EM, then controls. In the two treated patients MPSA profiles appeared to normalize at a 100 mg dosage. CONCLUSIONS: Patients with PCM appear to be characterized by very high cortical excitability. This may contribute to their greatly increased attack frequency. TMS-based methods will be important for future research examining the evolution of chronic migraine from episodic migraine over time.

Cerebral Cortex↗

Reduction of human visual cortex excitability using 1-Hz transcranial magnetic stimulation.

The effects of low-frequency (1-Hz) repetitive transcranial magnetic stimulation on visual cortex excitability were investigated by measuring phosphene thresholds (PTs) and stimulus-response curves. Stimulation over the visual cortex led to significantly decreased visual cortex excitability, expressed as an increase in PT. The motor threshold of the hand muscles did not change, indicating the topographic specificity of this effect. This intervention may be useful in situations associated with a hyperexcitable visual cortex.

Adult↗

Optic neuritis with residual tunnel vision in perchloroethylene toxicity.

CASE REPORT: In a 57-year-old female owner of a dry-cleaning shop, we describe the association of severe bilateral optic neuritis with unexpectedly high concentrations of perchloroethylene/metabolites in the blood and of chloroform in urine. Visual disturbances consisted of complete blindness for 9 days in the left eye, for 11 days in the right eye, with bright phosphenes and pain on eye rotation. Only central (2-3 degrees radius) vision recovered in the following months. CONCLUSION: Although environmental concentrations of perchloroethylene were within normal limits, we measured five-fold increases in vapors emitted when ironing freshly dry-cleaned fabrics, and suggest that inhalation of perchloroethylene vapors was the cause of this case of ocular nerve toxicity, recapitulating a previous report of major perchloroethylene toxicity.

Blindness↗

[Functional signs indicating retinal detachment].

PURPOSE: Retinal detachment is a rare but potentially blinding disease. Incidence of retinal detachment is stable in France, in spite of argon laser prophylaxis. METHOD: We have performed a prospective study on 100 patients with reghmatogenous, idiopathic retinal detachment. RESULTS: Functional signs were carefully recorded in 89% of cases. Vitreous signs were frequent (85%) mostly black points (67% of cases) myodesopia (32% of cases) floating images (14% of cases) black stains and filaments (11% of cases). Phosphens were recorded in 45% of cases and described as flashes of lightning in 30% of cases. Macular detachment was significantly more frequent among patients consulting after retinal signs appeared. CONCLUSION: Our study shows the frequency of functional signs in retinal detachment disease for rapid take over of these patients.

Adult↗

[Circumstances of choroid and ciliary body melanoma detection].

PURPOSE: To report and analyze the circumstances of uveal melanoma detection. METHODS: The records of 143 consecutive patients diagnosed in the Ophthalmology Department of Gustave Roussy Institute between September 1994 and September 2001 were analyzed. The study included 66 females and 77 males, aged from 21 to 91 years (mean, 62.75 years). RESULTS: The first symptom was decreased visual acuity in 37% of cases. In 34.9%, there was no functional sign and a systematic fundus exam provided the diagnosis. Of the 143 patients, 18.8% presented alteration of the visual field or scotoma, 9.9% complained of phosphenes, 9% complained of metamorphopsia, and 6.5% complained of floaters. In 5.5% of cases, there was documented tumor growth. In 2%, the presence of extrascleral exteriorization was the first sign. At the time of diagnosis, anterior tumors tended to be significantly larger than posterior tumors (p<0.007). Smaller lesions were significantly associated with a systematic detection of the tumor (p<0.005). Liver metastasis occurred more frequently with ciliary body melanomas (p<0.001), which were more frequently the largest lesions. CONCLUSION: These results emphasize the importance of early detection of uveal melanoma. We recommended frequent fundus examination after pupil dilatation.

Adult↗

Outer retinal degeneration: an electronic retinal prosthesis as a treatment strategy.

OBJECTIVE: To review progress toward an electronic retinal prosthesis for outer retinal degeneration. METHOD: Literature review. RESULTS: Retinal degenerations such as retinitis pigmentosa result in a loss of photoreceptors. There is a secondary loss of inner retinal cells, but significant numbers of bipolar and ganglion cells remain for many years. Electrical stimulation can produce phosphenes in the eyes of individuals who are blind as a result of retinitis pigmentosa. Several research groups are trying to exploit this phenomenon to produce artificial vision with electronic retinal prostheses. Two groups, with private company sponsorship, have recently implanted first-generation devices in subjects with advanced retinitis pigmentosa. They have reported limited preliminary results. This article seeks to put these results in a broader context and review potential obstacles to successful prosthesis development. These include inner retinal cell viability, high thresholds, signal encoding, power requirements, biocompatibility, and device encapsulation. CONCLUSION: There has been substantial progress toward an electronic retinal prosthesis, but fully functional, long-lasting devices are not on the immediate horizon.

Biocompatible Materials↗

Afterimages: a tool for defining the neural correlate of visual consciousness.

Our visual system not only mediates information about the visual environment but is capable of generating pictures of nonexistent worlds: afterimages, illusions, phosphenes, etc. We are "aware" of these pictures just as we are aware of the images of natural, physical objects. This raises the question: is the neural correlate of consciousness (NCC) of such images the same as that of images of physical objects? Images of natural objects have some properties in common with afterimages (e.g., stability of verticality) but there are also obvious differences (e.g., images maintain size constancy, whereas afterimages follow Emmert's Law: when seen while screens at different distances are observed, an afterimage looks larger, the greater the distance of the screen). The differences can be explained by differences in the retinal extent of images and afterimages, which favors the view that both have the same NCC. It seems reasonable to assume that before neural activity can produce awareness, all the computations necessary for a veridical representation of, e.g., an object, must be completed within the neural substrate and that information characteristic of a particular object must be available within the NCC. Given these assumptions, it can be shown that no retinotopic (in a strict sense) cortical areas can serve as the NCC, although some type of topographic representation is necessary. It seems also to be unlikely that neurons classified as cardinal cells alone can serve as NCC.

Afterimage↗