Documenta Ophthalmologica最新文献

{"title":"Macular retinal function after autologous retinal transplantation in patients with refractory macular holes.","authors":"Rei Arasaki, Tatsuya Inoue, Hiroko Terasaki, Shinji Ueno, Kazushige Tsunoda, Jun Takeuchi, Shohei Kitahata, Yasuo Yanagi, Maiko Maruyama-Inoue, Kazuaki Kadonosono","doi":"10.1007/s10633-025-10024-3","DOIUrl":"https://doi.org/10.1007/s10633-025-10024-3","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate subjective and objective macular retinal function and morphology in eyes after autologous retinal transplantation (ART).</p><p><strong>Methods: </strong>We conducted the study in three patients with large macular holes (MHs) who underwent ART. The examination modalities included optical coherence tomography (OCT), microperimetry (MP-3), and focal macular electroretinography (FMERG) with 10-degree and 5-degree stimulus spots under infrared camera monitoring centered on the treated MHs after ART.</p><p><strong>Results: </strong>All three patients showed improved visual acuity after the ART; MP-3 showed relatively good sensitivity around the fixation point with a dense scotoma at the center of the graft. All MHs were closed with autologous grafts and the size of MHs was decreased. OCT revealed clearly visible ellipsoid zones of the host retina around the grafted retina, however one transplanted eye showed disorganized outer layer of the host retina near the border of graft-host retina. FMERGs with the 10-degree stimulus were recorded successfully in all three treated eyes with more than half of a- and b-wave amplitudes of the fellow eyes. FMERGs with the 5-degree stimulus were recorded successfully in two of the treated and their fellow eyes.</p><p><strong>Conclusions: </strong>The FMERGs showed well-maintained macular retinal function after ART. The electrophysiologic and anatomic outcomes suggested that the host retina around the transplanted retina may play an important role in the postoperative macular retinal function with the mechanical support by the graft.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of visual function and morphological changes in patients with adrenoleukodystrophy using SS-OCT and PVEP.","authors":"Yongqiu Yu, Lujie Zhang, Shuiqian Wen, Chongyi Li, Liang Tan, Xian Wu, Yangcheng Zou, Ting Liu","doi":"10.1007/s10633-025-10021-6","DOIUrl":"https://doi.org/10.1007/s10633-025-10021-6","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to evaluate visual function and morphological changes in patients with adrenoleukodystrophy (ALD) through sweep-source optical coherence tomography (SS-OCT) and patterned visual evoked potentials (PVEP), with the goal of providing more accurate and comprehensive data for the diagnosis, monitoring, and assessment of treatment efficacy in patients with ALD.</p><p><strong>Methods: </strong>This study included 46 ALD patients and 44 healthy controls. The thickness of the retinal nerve fiber layer (RNFL) around the optic disc, as well as the macular RNFL and ganglion cell-inner plexiform layer (GCIPL) thickness, was assessed using SS-OCT. The peak time and amplitude of the P100 wave were also measured using PVEP. Factors that were statistically significant in the univariate analysis were subjected to stepwise binary logistic regression analysis for further investigation. Predictive performance was evaluated by constructing receiver operating characteristic (ROC) curves and compared using DeLong's test.</p><p><strong>Results: </strong>Compared with the control patients, ALD patients presented a significant increase in the peak time of the P100 wave (P < 0.05); however, no notable difference in amplitude was observed (P > 0.05). Additionally, substantial decreases in the RNFL and GCIPL thicknesses were observed within the parafoveal ring, especially in the superior and nasal quadrants (P < 0.05). The area under the curve for the binary logistic stepwise regression model was 0.883, with a sensitivity of 0.95, which surpassed the performance of the individual parameters.</p><p><strong>Conclusion: </strong>ALD patients present with abnormal retinal structures and a PVEP peak time delay. Combining these two parameters could increase the accuracy of an early ALD diagnosis.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The diagnostic value of multichannel VEPs for children without nystagmus.","authors":"Siân E Handley, Joanne Cowe, Lisa Tucker, Oliver R Marmoy, Dorothy A Thompson","doi":"10.1007/s10633-025-10020-7","DOIUrl":"https://doi.org/10.1007/s10633-025-10020-7","url":null,"abstract":"<p><strong>Purpose: </strong>This study explored the clinical value of routine multichannel pattern reversal visual evoked potential (prVEP) recordings in children without nystagmus.</p><p><strong>Methods: </strong>A single centre, retrospective case note review was carried out of children without nystagmus who had multichannel prVEP recordings from midline, O1 and O2 electrodes referred to Fz to an ISCEV large check (50' check width), reversing 3/s in a full 30° field and right and left 0-15° half fields, during 2020. Full-field (FF) prVEPs were classified as abnormal if midline P100 amplitude and peak time fell outside reference limits. Trans-occipital distribution asymmetry was defined as differences ≥ 20% amplitude between FF-prVEP the O₁ and O₂ at the peak time of the midline P100. Half field (HF) prVEPs acted as the gold standard discriminator of abnormality. The trans-occipital distribution and amplitude of the HF-prVEP ipsilateral positive peak (iP100) were compared for each eye.</p><p><strong>Results: </strong>FF-prVEP and HF-prVEP data from 63 children were classified. Group 1, 7/63 (11%), had abnormal midline FF-prVEP evidence of visual pathway dysfunction, whilst Group 2, 56/63 (89%), had normal midline FF-prVEPs. Group 2 was subdivided further according to the trans-occipital distribution of FF-prVEPs followed by HF-prVEPs. Group2A, 14/56 (25%), had symmetrical FF-prVEP distribution and normal HF-prVEPs. Group2B, 31/56 (55.4%), had asymmetrical FF-prVEP distribution, but lateralised HF-prVEPs that explained the FF-prVEP asymmetric distribution. Group2C, 11/56 (19.6%), had HF-prVEP evidence of pathway dysfunction with symmetric (n = 2) or asymmetric (n = 9) FF-prVEP distributions. Common referral reasons in all groups were reduced vision, glioma, craniopharyngioma, epilepsy presurgical evaluation, craniosynostosis, papilloedema/disc drusen, with various other specific conditions.</p><p><strong>Conclusions: </strong>Multichannel prVEPs add value to investigations of reduced or unexplained vision in children without nystagmus. Visual pathway abnormalities would not have been identified without a multichannel FF- or HF-prVEP in 11/56 (19.6%) of children in this study who had normal midline FF-prVEPs.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synthetic electroretinogram signal generation using a conditional generative adversarial network.","authors":"Mikhail Kulyabin, Aleksei Zhdanov, Irene O Lee, David H Skuse, Dorothy A Thompson, Andreas Maier, Paul A Constable","doi":"10.1007/s10633-025-10019-0","DOIUrl":"https://doi.org/10.1007/s10633-025-10019-0","url":null,"abstract":"<p><strong>Purpose: </strong>The electroretinogram (ERG) records the functional response of the retina. In some neurological conditions, the ERG waveform may be altered and could support biomarker discovery. In heterogeneous or rare populations, where either large data sets or the availability of data may be a challenge, synthetic signals with Artificial Intelligence (AI) may help to mitigate against these factors to support classification models.</p><p><strong>Methods: </strong>This approach was tested using a publicly available dataset of real ERGs, n = 560 (ASD) and n = 498 (Control) recorded at 9 different flash strengths from n = 18 ASD (mean age 12.2 ± 2.7 years) and n = 31 Controls (mean age 11.8 ± 3.3 years) that were augmented with synthetic waveforms, generated through a Conditional Generative Adversarial Network. Two deep learning models were used to classify the groups using either the real only or combined real and synthetic ERGs. One was a Time Series Transformer (with waveforms in their original form) and the second was a Visual Transformer model utilizing images of the wavelets derived from a Continuous Wavelet Transform of the ERGs. Model performance at classifying the groups was evaluated with Balanced Accuracy (BA) as the main outcome measure.</p><p><strong>Results: </strong>The BA improved from 0.756 to 0.879 when synthetic ERGs were included across all recordings for the training of the Time Series Transformer. This model also achieved the best performance with a BA of 0.89 using real and synthetic waveforms from a single flash strength of 0.95 log cd s m^-2.</p><p><strong>Conclusions: </strong>The improved performance of the deep learning models with synthetic waveforms supports the application of AI to improve group classification with ERG recordings.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel mutation in CNNM4 is associated with a case of Jalili syndrome in Egypt.","authors":"Caroline Atef Tawfik, Haneen Sabry Aly, Menna Kabeel, Iman Yousri, Sara Abdallah Mohamed","doi":"10.1007/s10633-025-10018-1","DOIUrl":"https://doi.org/10.1007/s10633-025-10018-1","url":null,"abstract":"<p><strong>Purpose: </strong>To report a novel homozygous mutation in CNNM4 gene associated with Jalili syndrome (JS) which is a rare, recessively inherited oculo-dental syndrome which encompasses cone-rod dystrophy (CORD) and amelogenesis imperfecta (AI).</p><p><strong>Methods: </strong>A 4-year-old male patient of consanguineous Egyptian parents, who presented with progressive visual impairment and tooth decay underwent complete ophthalmological examination, dental, and systemic examination. Additionally, color fundus photography, fundus autofluorescence (FAF), spectral domain optical coherence tomography (SD-OCT) of the macula, full field electroretinogram (ffERG) were obtained. Orthopantomogram (OPG) were also obtained. NGS-based gene panel testing was done in a commercial laboratory from a peripheral blood sample.</p><p><strong>Results: </strong>Fundus examination demonstrated typical features of CORD in the form of loss of foveal reflexes with macular retinal pigment epithelial mottling and atrophy reminiscent of bull's eye maculopathy. Dental assessment revealed evidence of AI. NGS-based gene panel identified a novel mutation in CNMM4 gene c.1423 G>A consistent with a diagnosis JS, thereby confirming the rare diagnosis.</p><p><strong>Conclusion: </strong>To the best of our knowledge, this is the first report of Jalili syndrome in Egypt. We are reporting a novel mutation in CNMM4 gene. We are also expanding the clinical spectrum of dental manifestation by reporting early eruption of the first permanent molars and suggesting that hyperopia could be a rather constant feature of JS. This case emphasizes the importance of comprehensive multidisciplinary assessment beyond visual complaints in IRD patients in order to reach an accurate diagnosis.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The ERGtools2 package: a toolset for processing and analysing visual electrophysiology data.","authors":"Moritz Lindner","doi":"10.1007/s10633-025-10017-2","DOIUrl":"https://doi.org/10.1007/s10633-025-10017-2","url":null,"abstract":"<p><strong>Purpose: </strong>To introduce ERGtools2, an open-source R package for processing, analysing and long-term storing visual electrophysiology data.</p><p><strong>Methods: </strong>A dataset comprising Electroretinogram (ERG) recordings of C57Bl/6J mice, subjected to standard ISCEV stimuli, was used to present the functionality of ERGtools2. ERGtools2 stores and organizes all recordings, metadata, and measurement information from an individual examination in a single object, maintaining raw data throughout the analysis process.</p><p><strong>Results: </strong>A standard workflow is presented exemplifying how ERGtools2 can be used to efficiently import, pre-process and analyse ERG data. Following this workflow, basic ERG measurements and visualisation of a single exam as well as group statistics are obtained. Moreover, special use cases are described, including for the handling of noisy data and the storage of data in the HDF5 format to ensure long-term preservation and accessibility.</p><p><strong>Conclusions: </strong>ERGtools2 provides a comprehensive, flexible, and device-independent solution for visual electrophysiology data analysis. Its emphasis on maintaining raw data integrity, combined with advanced processing and analysis capabilities, makes it a useful tool for preclinical and clinical research applications. The open-source nature and the use of open data formats promote reproducibility and data sharing in visual neurosciences.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DTL versus skin electrodes in recording of multifocal pattern electroretinogram and multifocal photopic negative response.","authors":"Henrike Marie Nowitzki, Michael B Hoffmann, Khaldoon O Al-Nosairy","doi":"10.1007/s10633-025-10014-5","DOIUrl":"https://doi.org/10.1007/s10633-025-10014-5","url":null,"abstract":"<p><strong>Objective: </strong>To compare the photopic negative response of the multifocal ERG (mfERG_PhNR) and the multifocal pattern electroretinogram (mfPERG) using DTL electrode (E_DTL) vs skin electrode (E_SKIN) in healthy young and old adults.</p><p><strong>Methods: </strong>Ten \"Young\" [20-27 years] and eight \"Old\" [60-72 years] participants took part in this study. The electrophysiological responses were recorded binocularly using E_DTL and E_SKIN. 5-way ANOVAs were applied to investigate the following factors on mfERG_PhNR: i) ELECTRODE, ii) DILATATION, iii) AGE, iv) EYE, and v) ECCENTRICITY. For mfPERG, the same factors, except dilatation, were investigated applying 4-way ANOVAs. These were conducted for amplitude and peak time of different components as well as signal-to-noise-ratio (SNR).</p><p><strong>Results: </strong>Amplitudes of mfERG_PhNR [mfPERG]-based E_SKIN recording were reduced to 32-38% [37-38%] compared to E_DTL, <math><mrow><mi>p</mi> <mo><</mo> <mn>0.001</mn></mrow> </math> . This corresponded to SNR reduction to 80% [60%], <math><mrow><mi>p</mi> <mo><</mo> <mn>0.001</mn></mrow> </math> . E_SKIN based responses had shorter peak times, by 0.2-0.5 ms for N1 and P1, <math><mrow><mi>p</mi> <mo><</mo> <mn>0.05</mn></mrow> </math> , [P1: 1.5 ms, <math><mrow><mi>p</mi> <mo><</mo> <mn>0.001</mn></mrow> </math> ]. Both age groups had comparable amplitudes and SNRs, but Young had shorter peak times, by 1.5-2.2 ms for N1 and P1, <math><mrow><mi>p</mi> <mo><</mo> <mn>0.05</mn></mrow> </math> [3.7-4.2 ms for N1, P1, N2, <math><mrow><mi>p</mi> <mo><</mo> <mn>0.05</mn></mrow> </math> ]. Compared to dilated recordings, undilated mfERG_PhNR amplitudes were reduced to 47-87%, <math><mrow><mi>p</mi> <mo><</mo> <mn>0.01</mn></mrow> </math> , and peak times were delayed by 2.0-11.8 ms, <math><mrow><mi>p</mi> <mo><</mo> <mn>0.001</mn></mrow> </math> .</p><p><strong>Conclusions: </strong>mfPERG & mfERG_PhNR traces were similar for E_DTL and E_SKIN. However, for skin electrodes, amplitudes and SNRs were lower and peak times shorter. E_SKIN thus seem to be a viable alternative in patients in whom the use of corneal electrodes is precluded, e.g., children and disabled patients, but at the expense of SNR and with reference to E_SKIN normative data.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phenotypic spectrum and theoretical prime editing analysis of WDR19-mediated retinal degeneration.","authors":"Jorge Pincay, Bruna Lopes da Costa, Peter M J Quinn, Marilyn Rodriguez, Ashley Zhou, Maximilian D Kong, Janet R Sparrow, Stephen H Tsang","doi":"10.1007/s10633-025-10016-3","DOIUrl":"https://doi.org/10.1007/s10633-025-10016-3","url":null,"abstract":"<p><strong>Purpose: </strong>The ciliopathies are a broad category of pleiotropic disease with numerous genes involved in pathogenesis. One of the genes implicated in the ciliopathies is WDR19, which can lead to several syndromic diseases that may manifest with a form of retinal degeneration. There is a lack of reporting on the WDR19-mediated retinal phenotype, and therefore warrants more clinical investigation. With retinal degeneration being the most prevalent symptom among the ciliopathies, phenotypic reporting is needed to enhance understanding of pathogenesis.</p><p><strong>Methods: </strong>Clinical, imaging, and diagnostic records of patients with two variants in the WDR19 gene and a form of retinal degeneration were retrospectively reviewed. Two different individuals analyzed the variants in the studied patients using SnapGene (Version 4.3.11), employing both the canonical NGG PAM and the NGA PAM prime editors.</p><p><strong>Results: </strong>Four patients from three families each carrying biallelic variants the WDR19 gene were reviewed. Two of the six unique variants identified among the patients were novel. Two identical twin patients presented with a recessive Stargardt (STGD)-like phenotype while the other two patients presented with a clinical picture more characteristic of retinitis pigmentosa (RP). Three of four patients had thickened external limiting membrane (ELM) on spectral-domain optical coherence tomography (SD-OCT). Full-field electroretinograms (ffERG) performed on two patients with the STGD-like phenotype showed a cone-rod pattern of degeneration. Quantitative short-wave fundus autofluorescence (qAF) performed on the two STGD-like patients was within the 95th percentile of normal eyes.</p><p><strong>Conclusions: </strong>WDR19-mediated retinal degeneration is heterogenous in presentation, and in some cases can phenocopy STGD. The foveal sparing phenotype was apparent in three of four patients with relatively preserved visual acuity, which may serve as a retinal prognostic factor in patients with pathogenic variants in WDR19. All six variants evaluated are correctable by prime editing, establishing a foundation for future research in therapeutic development.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between fasted insulin levels and mfERG implicit times in patients with type 2 diabetes and prediabetes.","authors":"Jennyffer D Smith, Rachel Redfern, Liam Burhans, Theodore W Zderic, Marc T Hamilton, Wendy W Harrison","doi":"10.1007/s10633-025-10004-7","DOIUrl":"10.1007/s10633-025-10004-7","url":null,"abstract":"<p><strong>Purpose: </strong>It is established that the mfERG is altered in type 2 diabetes (T2DM). The P1 implicit time (IT) becomes delayed even before retinopathy is present. This has been associated with the duration of damage to retinal cells from hyperglycemia. However, patients withT2DM and prediabetes also have changes in insulin values. The impact of elevated or reduced blood insulin on retinal function using mfERG has not been explored. Here we evaluate the the relationship between blood insulin levels and mfERG parameters in patients with and without T2DM and prediabetes.</p><p><strong>Methods: </strong>66 subjects (age 50.4 ± 10.5) were included in this cross-sectional study. Subjects were asked if fasted upon presentation. HbA1c was taken and used to categorize subjects into groups as controls (< 5.7%), prediabetes (5.7-6.4%) or T2DM (> 6.4% or previously diagnosed). Insulin was collected from finger stick and was analyzed via ELISA. A mfERG (103 hexagons) was performed (VERIS 6.3) with 4-min m-sequence at near 100% contrast. Data was evaluated for ring hexagons, as well as averaged together for P1 IT. No subjects had retinopathy or were taking exogenous insulin. Data were evaluated through ANOVA for comparisons of groups and as well as with multivariate regression analysis.</p><p><strong>Results: </strong>There was a strong positive correlation between fasting blood glucose and mfERG IT (P < 0.002) in all subjects. There was also a negative relationship between averaged mfERG IT and fasted blood insulin concentration (P = 0.035) after age, T2DM duration and blood glucose were controlled for in a multivariate regression. There was a significant difference in mfERG IT between the groups (p = 0.008) with T2DM exhibiting the longest IT, but no difference between controls and prediabetes. There was no difference in insulin levels between groups, nor were there any significant relationships between insulin and mfERG IT for those who were not fasted.</p><p><strong>Conclusions: </strong>Reduced blood insulin is associated with IT delays under overnight fasted conditions, which suggests a lack of insulin may impair retinal function. Future work should examine these associations of retinal function with insulin under well controlled and standardized postprandial conditions such as during oral glucose tolerance testing.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":"65-72"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ISCEV standard full-field ERG reference limits from 407 healthy subjects, derived from transference and validation of reference data between electrode types and centres.","authors":"Rebecca A Baker, Shaun M Leo, William I N Clowes, Isabelle Chow, Xiaofan Jiang, Anne L Georgiou, Antonio Calcagni, Christopher J Hammond, Magella M Neveu, Omar A Mahroo, Anthony G Robson","doi":"10.1007/s10633-025-10009-2","DOIUrl":"10.1007/s10633-025-10009-2","url":null,"abstract":"<p><strong>Purpose: </strong>To establish age-adjusted reference intervals for the ISCEV standard full-field electroretinogram (ERG) recorded with silver thread electrodes in the lower fornix, based on a combined reference sample involving recordings from reference subjects and transference of data between two centres and two types of electrode.</p><p><strong>Methods: </strong>Silver thread lower fornix ERG reference data from two centres underwent verification for inclusion in the reference sample (n = 251). Comparison analysis was performed to determine whether gold foil reference data could be included in the silver thread reference range, directly or with adjustment. Reference subjects and patients underwent ERG testing with both silver thread and gold foil electrodes (n = 53) and skin electrodes (n = 41). A linear model, fitted to the electrode comparison data, was used to transform gold foil ERG reference data for inclusion in the reference sample (n = 156). The combined sample of 407 reference individuals was used to derive age-adjusted reference limits for the main DA 0.01, DA 3, DA 10, LA 30 Hz and LA 3 ERG components.</p><p><strong>Results: </strong>Silver thread ERG reference data was sufficiently similar across two centres to justify combination into a single reference sample. Peak times for gold foil and silver thread ERGs were closely comparable (r² 0.75-0.98, Bland-Altman bias ≤ 1.6 ms for all ERG components), with LA 30 Hz peak time showing the highest agreement (bias: - 0.2 ms, 95% limits of agreement (LOA): - 1.1 to 0.7 ms, 'silver thread-gold foil'). There was a clinically significant amplitude difference between electrode types: silver thread ERGs were 55-65% of the amplitude of gold foil ERGs (LOA ranged from 29 to 90%) and skin ERGs were 35-38% of the amplitude of silver thread ERGs (LOA ranged from 18 to 54%). Pooled reference data formed a sufficient sample covering 8 decades, from which age-adjusted parametric and nonparametric reference limits were calculated with reference to current guidelines.</p><p><strong>Conclusions: </strong>ISCEV standard silver thread ERG data were consistent across the two centres, allowing transference of reference data. Reference data recorded with gold foil electrodes can be transformed for inclusion in a silver thread ERG reference range. The study highlights methods of pooling multiple sources of reference data into a larger, more robust sample, pertinent to standardization, clinical management, and multi-centre studies. These reference data could be adopted by other centres or combined with other datasets, following suitable verification.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":"47-64"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11991937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}