Retinal function in high refractive error assessed electroretinographically.

Perlman, Ido; Meyer, Ewy; Haim, T.; Zonis, S

doi:10.1136/bjo.68.2.79

Cited by 57 publications

(39 citation statements)

References 5 publications

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“…2,8,9,18,19 Researchers have suggested that the reduced ERG amplitude could result from an increase in the subretinal space, 20 reduced image size, decreased retinal illumination, and the reduced retinal cell density 9,21 in the elongated eyeball. However, none of these factors could explain the findings in children.…”

Section: Discussionmentioning

confidence: 99%

Subclinical Decrease in Central Inner Retinal Activity Is Associated With Myopia Development in Children

Choi

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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Citation: Li SZ-C, Yu W-Y, Choi K-Y, et al. Subclinical decrease in central inner retinal activity is associated with myopia development in children. Invest Ophthalmol Vis Sci. 2017;58:4399-4406. DOI:10.1167/ iovs.16-21279 PURPOSE. To investigate the characteristics of retinal electrophysiological activity in relation to early myopia development in children.METHODS. Fifty-six children aged 6 to 9 years with emmetropic refractive error (defined as ‡ À0.5 diopter [D] and þ0.5 D) were recruited. Cycloplegic refraction, axial length, and global flash multifocal electroretinogram (MOFO mfERG) at 49% and 96% contrast levels were recorded in all children at their first visit. The refraction and axial length measurements were repeated after 1 year. The amplitudes and implicit times of the direct component (DC) and the induced component (IC) of the MOFO mfERG obtained at the initial visit were analyzed. Correlations between the MOFO mfERG parameters and changes in refractive error and axial length were investigated. RESULTS.The mean spherical equivalent refractive error and axial length of the eyes of the children at the first visit were þ0.19 6 0.33 D and 23.14 6 0.6 mm, respectively. After 1 year, the mean refractive error increased by À0.55 6 0.53 D, whereas axial length increased by 0.37 6 0.22 mm. The changes in refractive error and axial length were significantly correlated with the central IC amplitudes at 49% contrast level measured at the initial visit (q ¼ 0.46, P < 0.001 and q ¼ À0.34, P ¼ 0.01, respectively).CONCLUSIONS. The prospective changes we have shown are believed to derive from central inner retina. These changes appear to precede myopia and could be a potential reference for juvenile myopia development.Keywords: myopia development, multifocal electroretinogram, children vision, inner retina E xcessive eyeball elongation causes myopia. In severe cases, it may result in retinal stretching, thinning, and changes in retinal cell morphology and pathology. Application of the ERG technique has provided ample evidence to confirm that myopia results in impaired retinal function. It has been reported that myopia in adults was associated with decreased nonlinear components of ERG responses, 1 multifocal ERG (mfERG) responses, 2,3 retinal adaptation response, 4 and inner retinal function. [5][6][7] Axial length was shown to be linearly related to ERG amplitudes, 8 first-order kernel, and the first slice of second-order kernel of mfERG responses. 9 The reduction in mfERG responses in myopic adults is believed to be due to the deterioration in retinal function associated with long-standing myopia. However, this explanation cannot be applied to myopic children, and discrepancies of ERG characteristics have been noted between myopic adults and children.2,7 Luu and his colleagues 2 conducted a cross-sectional study of mfERG measurement in 104 children and 31 adults with a range of refractive errors. They found a significant correlation between refractive error and mfERG response in adults, but this correlation ...

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Section: Discussionmentioning

confidence: 99%

Subclinical Decrease in Central Inner Retinal Activity Is Associated With Myopia Development in Children

Choi

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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“…Decreased amplitudes may indicate retinal dysfunction or degeneration. However, a marked reduction in a-and b-wave amplitudes, as observed in the PTHS-patient, is also associated with high myopia (Perlman et al 1984;Yoshii et al 2002;Flitcroft et al 2005). Moreover, the implicit times measured in the ERG recordings, which are more reliable parameters in very long eyes, were within the normal range in our patient, again rather negating presence of a panretinal degenerative or dystrophic disease.…”

Section: Discussionmentioning

confidence: 54%

Neurologic and ocular phenotype in Pitt–Hopkins syndrome and a zebrafish model

et al. 2011

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In this study, we performed an in-depth analysis of the neurologic and ophthalmologic phenotype in a patient with Pitt-Hopkins syndrome (PTHS), a disorder characterized by severe mental and motor retardation, carrying a uniallelic TCF4 deletion, and studied a zebrafish model. The PTHS-patient was characterized by high-resolution magnetic resonance imaging (MRI) with diffusion tensor imaging to analyze the brain structurally, spectral-domain optical coherence tomography to visualize the retinal layers, and electroretinography to evaluate retinal function. A zebrafish model was generated by knockdown of tcf4-function by injection of morpholino antisense oligos into zebrafish embryos and the morphant phenotype was characterized for expression of neural differentiation genes neurog1, ascl1b, pax6a, zic1, atoh1a, atoh2b. Data from PTHS-patient and zebrafish morphants were compared. While a cerebral MRI-scan showed markedly delayed myelination and ventriculomegaly in the 1-year-old PTHS-patient, no structural cerebral anomalies including no white matter tract alterations were detected at 9 years of age. Structural ocular examinations showed highly myopic eyes and an increase in ocular length, while retinal layers were normal. Knockdown of tcf4-function in zebrafish embryos resulted in a developmental delay or defects in terminal differentiation of brain and eyes, small eyes with a relative increase in ocular length and an enlargement of the hindbrain ventricle. In summary, tcf4-knockdown in zebrafish embryos does not seem to affect early neural patterning and regionalization of the forebrain, but may be involved in later aspects of neurogenesis and differentiation. We provide evidence for a role of TCF4/E2-2 in ocular growth control in PTHS-patients and the zebrafish model.

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“…It has previously been seen that high myopia results in subnormal amplitudes of the maximal response, the rod and cone response, the light adapted oscillatory potentials and the flicker response [25], while the relationships between the a-and b-wave amplitudes remain normal [23]. The amplitudes of the S-cone and L, M-cone b-wave have also been shown to be affected in highly myopic subjects [24].…”

Section: Discussionmentioning

confidence: 92%

“…Therefore, in complete CSNB, according to an assumed dysfunction of the ON-pathway, at least slight alteration of the a-and d-waves can be expected beside severe b-wave abnormalities. At the same time, complete CSNB is usually associated with myopia, which has been shown to influence the electroretinogram (ERG) [23][24][25], although its effects on photopic ON-and OFF-responses have not been studied yet. The aim was thus to explore the ON-and OFF-responses in complete CSNB through increasing stimulus intensities, to differentiate the effects of ONpathway dysfunction from the effects of myopia.…”

Section: Introductionmentioning

confidence: 99%

Photopic ON- and OFF-responses in complete type of congenital stationary night blindness in relation to stimulus intensity

et al. 2007

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The complete type of congenital stationary night blindness (complete CSNB) is a retinal disorder where the ON-response b-wave of the photopic electroretinogram is reduced, while the ON-response a-wave and OFF-response d-wave are preserved. These findings are related to ON-bipolar cell dysfunction, whereas the effects of myopia, which is usually associated with complete CSNB, have not been studied yet. The aim was to investigate ON-bipolar cell dysfunction in complete CSNB with variable-intensity stimuli, while excluding effects of myopia. ON- and OFF-responses were recorded from six complete CSNB patients, 10 control subjects (no refractive error; emmetropic control group) and 14 myopic subjects with similar refractive error and axial length as those with complete CSNB (myopic control group). Responses were elicited with stimulus intensities from 0.4 to 2.1 log cd s/m2 on a 20 cd/m2 background. Stimulus/response (S/R) functions were fitted to the Naka-Rushton equation and statistically evaluated. In complete CSNB, the S/R function of the a-wave measured at the time corresponding to the controls showed a lower Vmax than for the emmetropic controls, while all parameters were similar to the myopic control group. The b- and d-wave S/R functions of the complete CSNB group were similarly different to both control groups--for the b-wave, the Vmax and n were significantly lower, and for the d-wave, the sigma was significantly higher. These findings suggest that in complete CSNB, dysfunction of ON-bipolar cells influences the dynamics of the ON-response b-wave and OFF-response d-wave, independently of the effects of myopia.

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Retinal function in high refractive error assessed electroretinographically.

Cited by 57 publications

References 5 publications

Subclinical Decrease in Central Inner Retinal Activity Is Associated With Myopia Development in Children

Subclinical Decrease in Central Inner Retinal Activity Is Associated With Myopia Development in Children

Neurologic and ocular phenotype in Pitt–Hopkins syndrome and a zebrafish model

Photopic ON- and OFF-responses in complete type of congenital stationary night blindness in relation to stimulus intensity

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