Faculty Bibliography

PURPOSE. To examine the sites of cone sensitivity loss in patients with retinitis pigmentosa by comparing focal electroretinographic and psychophysical modulation thresholds. METHODS. Both psychophysical and electrophysiologic increment threshold curves were obtained in retinitis pigmentosa patients and a group of age-matched, normally-sighted adults. RESULTS. The majority of the retinitis pigmentosa data could be accounted for by a vertical displacement of the normal curve. The retinitis pigmentosa patients showed similar patterns of cone sensitivity losses using both techniques. CONCLUSIONS. The combined electrophysiologic and psychophysical results provide support for an outer retina locus for these cone sensitivity losses. The data suggest that these deficits may be caused by a spatially independent loss of cone photoreceptors with normal adaptation properties in the remaining photoreceptors

Previous studies have shown that S-cone pathway sensitivity is selectively decreased in the early stages of diabetic retinopathy. In the present study, rod system sensitivity was evaluated in a group of diabetic patients using psychophysical techniques. The course of dark adaptation was first determined, then absolute thresholds were measured in the horizontal and vertical meridians. For all patients, although the recovery of the initial portions of rod dark adaptation were normal, absolute thresholds were increased in both the horizontal and vertical meridians. The findings provide evidence that patients with early diabetic retinopathy show a generalized dysfunction of the rod system

PURPOSE. To study the effects of acetazolamide on central and peripheral visual function in patients with retinitis pigmentosa (RP) who showed no evidence of macular edema. METHODS. Thirteen patients with retinitis pigmentosa participated in a preliminary study. Measures of central and peripheral visual function were obtained before and after an 8 wk period on acetazolamide. An additional 10 patients participated in a cross-over study. They were placed on a placebo for an 8 wk period, then on acetazolamide for a second 8 wk period. RESULTS. None of the patients in the preliminary study showed significant changes in visual acuity, color vision, foveal cone pathway sensitivities, focal electroretinogram (ERG) amplitudes, or in any ERG parameter. Three patients, however, showed significant changes in visual field area and in dark-adapted thresholds. None of the patients in the cross-over study showed significant increases in visual field area. CONCLUSIONS. Given the results and the reports of side-effects, it is difficult to justify using acetazolamide to improve retinal function in RP patients who show no evidence of cystoid macular edema

The focal electroretinogram (FERG) was used to examine temporal frequency tuning at the outer retinal level in humans by measuring temporal modulation thresholds. Changes in FERG thresholds as a function of ambient light level were compared to temporal modulation thresholds obtained psychophysically using the same stimuli. At lower temporal frequencies, both FERG and psychophysical thresholds changed sensitivity proportional to the mean illuminance level. At higher illuminance levels, both threshold measures were relatively independent of illuminance. The comparison of the FERG to the behavioral data suggest that most of the adaptation-dependent changes in temporal sensitivity in humans occur at the level of the photoreceptor complex

Although numerous reports show that the sensitivity of the S cone system is decreased in diabetic patients, few studies have been directed toward identifying the possible sites of the sensitivity loss. In this study, a psychophysical technique was used to test hypotheses about sites of S cone system sensitivity loss in a group of patients with early diabetic retinopathy. A model of the S cone system was assumed and the experimental conditions were chosen to distinguish between explanations for S cone sensitivity loss at the receptor level from explanations for loss at a post-receptoral level. Within the context of the model, the data were consistent with S cone system sensitivity loss occurring at a post-receptoral level