Aims-To determine whether the short wavelength sensitive (S) cone electroretinogram (ERG) is selectively altered in diabetic patients with and without retinopathy. Methods-Ganzfeld spectral flashes in the presence of bright white background illumination were used to elicit S cone ERGs in 15 non-retinopathic diabetics, 16 The intensities of the flashes were changed by neutral density filters. The flash duration was 10 microseconds and the stimulus frequency was 5 Hz. Responses were averaged with use of the Neuropack 2 averager (Nihon Kohden, Tokyo, Japan). To determine the difference in relative light intensity required to match the long wavelength sensitive (L) and middle wavelength sensitive (M) cone b-wave produced by the blue (450 nm) flash and that produced by the red (633 nm) flash, we determined the relation between L, M cone b-wave amplitude and light intensity that produced an equal amplitude L, M cone b-wave for the blue (450 nm) flash. To compare the lens yellowing, we obtained the L, M cone balance-namely, the log density units of the neutral density filter required to produce the L, M cone b-wave elicited with red stimuli, which is identical to that with blue stimuli. The lens yellowing reduces short wavelength transmissivity and reduces the L, M cone b-wave amplitude as well as the S cone amplitude. Thus, the L, M cone balance increases with the lens yellowing because long wavelength transmissivity is not greatly affected.9 We obtained permanent recordings using the maximum flash intensity available at 450 nm and dimming the other stimuli with neutral density filters to produce approximately equal long wavelength sensitive (L) and middle wavelength sensitive (M) cone ERGs, because all longer wavelength stimuli had more effective energy for the L and M cones. To obtain action spectra based on equal 973 on 10 May 2018 by guest. Protected by copyright.

No abstract

The cone electroretinograms (ERGs) to different chromatic stimuli were recorded in myopic subjects. Ganzfeld color flashes under bright white background illumination were used to elicit short-wavelength-sensitive (S-), and mixed long-(L-) and middle-(M-) wavelength-sensitive cone ERGs. Nineteen subjects with mild myopia (between -3.0 and -6.0 D), 12 subjects with high myopia (greater than -6.25 D) but without chorioretinal atrophy or posterior staphyloma, and 22 age-matched normal controls were compared. The S-cone and L,M-cone b-wave amplitudes decreased progressively with increasing myopia. The amplitudes of the S-cone and the L,M-cone b-wave were significantly lower in highly myopic subjects, as compared with controls. The implicit times of both b-waves were normal in most myopic subjects. The S-cone and the L,M-cone ERGs were almost equally affected in myopic eyes. The selective reduction of the S-cone pathway in high myopia, reported previously, may not originate from the other retina.

A 7-year-old girl with foul-smelling, bloody vaginal discharge for more than 2 years was initially suspected of suffering from vaginal foreign bodies. Although plain radiography revealed no abnormal findings in the pelvis, magnetic resonance imaging (MRI) showed multiple low intensity objects and an intact vaginal wall. Four plastic toys were removed with forceps under general anesthesia. MRI is supposed to be the best technique for evaluating vaginal foreign bodies in young girls.

The short wavelength-sensitive (S-) cone electroretinogram (ERG) is selectively reduced in diabetic patients both with and without retinopathy, but the exact mechanism of the vulnerability of the S-cone system is still unclear. This study examined relationships of the S-cone ERG to systemic factors in diabetes. Cone ERGs to different color flash stimuli were examined in the presence of bright white background illumination in 17 diabetic patients without retinopathy and in 17 diabetics with background retinopathy. Relationships of the amplitude and implicit time of the S-cone ERG to the following systemic factors were statistically analyzed: patients' age, hemoglobin A1 level, method of diabetic control, presence of retinopathy, and presence of nephropathy. The amplitude of the S-cone ERG b-wave was significantly reduced in diabetics treated with insulin and in those associated with nephropathy. No significant correlation was found between the S-cone ERG and patient's age, hemoglobin A1 level and presence or absence of retinopathy. A selective reduction of the S-cone ERG is observed in patients whose metabolic control has been poor for a longer period, suggesting that microvascular changes may play a role in the S-cone ERG impairment.

Torasemide can be safely used, and appears to be effective for treatment of HF in children. Future clinical trials are warranted to verify the present results.

We examined cone and rod electroretinograms to ganzfeld stimuli in a patient with crystalline retinopathy. The 54-year-old man complained of night blindness, blurred vision, and metamorphopsia in both eyes. His visual acuity was 10/200 in the right eye and 10/20 in the left eye; his subjective dark-adaptation threshold was elevated 1 log unit, and he made one tritan error on the Farnsworth Panel D-15. Specular microscopic examinations revealed tiny crystalline deposits in the limbal cornea bilaterally. Ophthalmoscopically, crystalline deposits were found in the posterior fundi. His light-adapted cone electroretinograms to white stimuli were diminished (about 30% of those of normal controls), with normal implicit times. His dark-adapted rod electroretinogram amplitudes were 10% of those of normal controls. The S-cone electroretinogram was not detectable to different spectral stimuli with strong white background, while the L-M-cone responses appeared normal in waveforms with reduced amplitude. These ERG results indicated that the patient's S-cone system is more highly impaired than the L-M-cone system, supporting the psychophysical evidence that the S-cone system is more vulnerable than other cone systems in retinal diseases.

In congenital cases, ocular toxoplasmosis often presents as a focal whitish fluffy lesion in the retina adjacent to an inactive chorioretinal scar. We examined a girl who has visible floaters in the right eye. The patient had focal active retinitis in the right fundus, a focal chorioretinal scar in the left fundus, a positive enzyme-linked immunosorbent assay (ELISA) for IgG anti-Toxoplasma antibodies and a negative ELISA for IgM antibodies. We believe that active focal retinitis in one eye and a focal chorioretinal scar in the fellow eye in congenital toxoplasmosis, as demonstrated in our patient, may be rare.