Documenta Ophthalmologica最新文献

{"title":"Correction: ISCEV extended protocol for the photoreceptor directed ERG using full-field silent substitution stimuli.","authors":"Jan Kremers, Mirella T S Barboni, Andrew J Zele, Beatrix Feigl, J Jason McAnany, Anthony G Robson, Balázs Vince Nagy, Neil Parry, Omar A Mahroo, Cord Huchzermeyer","doi":"10.1007/s10633-026-10101-1","DOIUrl":"10.1007/s10633-026-10101-1","url":null,"abstract":"","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":"257-258"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13083339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147510367","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}

{"title":"Characterization of functional and structural impairments in best vitelliform macular dystrophy using visual electrophysiology and optical coherence tomography in pediatric and adult patients.","authors":"Anna Polosa, Melissa Lu, Allison L Dorfman, Marisse Masis-Solano, Santiago Costantino, Cynthia X Qian","doi":"10.1007/s10633-025-10064-9","DOIUrl":"10.1007/s10633-025-10064-9","url":null,"abstract":"<p><strong>Purpose: </strong>To assess functional and anatomical impairments in pediatric patients and their affected adult family members with juvenile-onset Best vitelliform macular dystrophy (BVMD).</p><p><strong>Methods: </strong>Fifteen genetically confirmed BVMD patients (10 pediatric and 5 adults) underwent a comprehensive ophthalmic examination with multimodal imaging and electrophysiological testing. We quantified BVMD lesion volumes using sequential spectral-domain OCT (SD-OCT) scans, facilitating correlation with clinical parameters and electroretinogram (ERG) findings.</p><p><strong>Results: </strong>Children presented less advanced stages of BVMD than adults, had better visual acuity [Log MAR 0.13 ± 0.17] than adults [Log MAR 0.91 ± 0.52, p < 0.001], and displayed lower lesion volumes [0.93 ± 0.71 mm³] compared to adults [1.80 ± 0.79 mm³, p < 0.001]. Interestingly, in 3 eyes in Stage 3 disease (pseudohypopyon stage), despite a high lesion volume (1.74 ± 0.66 mm³), a good visual acuity was still observed (LogMAR of 0.00 in all 3 eyes). Multifocal ERG (mfERG) revealed macular dysfunction in all patients mostly pronounced in the 3 central rings [% of P1 reduction from control in Ring 1 in children and adults: 51% and 51%, Ring 2: 17% and 36% and Ring 3: 8% and 15%, respectively]. Furthermore, higher lesion volumes showed more affected mfERG responses. Full-field flash ERGs were normal in children, while reduced amplitudes and delayed responses were observed in some adults.</p><p><strong>Conclusion: </strong>While juvenile presentations of BVMD are less severe and more circumscribed, adult presentations demonstrate more widespread functional abnormalities in both amplitude and implicit times correlated with anatomical progression and clinical progression. Interestingly, mfERG responses in children with 20/20 vision also revealed functional impairment, correlating more strongly with the degree of vitelliform liquefaction on OCT than with visual acuity. Our findings suggest that mfERG may serve as an early, reliable indicator of functional defects in BVMD.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":"129-144"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145494914","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":"Monitoring outcomes of the first human whole eye allotransplant.","authors":"Vaidehi S Dedania, Alay R Shah, Sachin R Chinta, David L Tran, Scott E Brodie, Bruce E Gelb, Daniel J Ceradini, Eduardo D Rodriguez","doi":"10.1007/s10633-026-10083-0","DOIUrl":"10.1007/s10633-026-10083-0","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the first successful whole eye transplantation (WET) in a human, performed with concurrent partial face transplantation, and to characterize postoperative outcomes.</p><p><strong>Design: </strong>Case report.</p><p><strong>Participant: </strong>A 46-year-old male with severe facial and ocular deficits following high-voltage electrical injury, including left eye enucleation and extensive soft tissue and aesthetic deformities.</p><p><strong>Methods: </strong>Comprehensive preoperative evaluation, precise microsurgical techniques including vascular anastomosis and optic nerve coaptation, and serial postoperative assessments with optical coherence tomography (OCT), fluorescein angiography (FA), electroretinography (ERG), and visual evoked potentials (VEP).</p><p><strong>Main outcome measures: </strong>Sustained globe viability, vascular perfusion, retinal structural integrity, and electrophysiological function.</p><p><strong>Results: </strong>The transplanted globe demonstrated robust vascular perfusion and structural preservation over 12 months. Outer retinal function was maintained, as indicated by ERG, despite retinal nerve fiber layer loss and optic nerve transection. VEP confirmed absence of visual perception. The procedure achieved substantial aesthetic restoration.</p><p><strong>Conclusions: </strong>This study establishes the feasibility of WET in humans, with sustained globe viability and preserved outer retinal function. These findings serve as a critical step toward future exploration of ocular transplantation.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":"235-246"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324774","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":"Anomalous contrast as an adaptive violation of the Talbot-Plateau law.","authors":"Ernest Greene, Jack Morrison","doi":"10.1007/s10633-026-10098-7","DOIUrl":"https://doi.org/10.1007/s10633-026-10098-7","url":null,"abstract":"<p><strong>Purpose: </strong>To better understand anomalous contrast mechanisms that allow flicker-fused stimuli to be visible even when they provide the same physical contrast as background.</p><p><strong>Method: </strong>Stimulus flicker was used to elicit differential activation of ON and OFF retinal channels at frequencies above the flicker-fusion threshold. Providing balanced light energy to ON and OFF channels will normally cause the stimulus to vanish into the background.</p><p><strong>Results: </strong>We used ultrabrief bright pulses, combined with ultralong dark pulses, to elicit \"anomalous contrast\" that rendered the stimulus visible, even though it had the same average luminance as the background. The duration and intensity of flicker components were varied to gain insight into the conditions that would elicit this effect.</p><p><strong>Conclusions: </strong>Anomalous contrast displays violated the Talbot-Plateau law, but in doing so, provided an adaptive way to register and signal contours that matched background luminance. These findings contribute additional details about this visual adaptation, and we discuss how the retinal circuitry provides for stimulus visibility.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572219","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":"Measuring electroretinograms in tree shrews with a portable electrophysiology device.","authors":"Rohit Dhakal, Nilda C Sanchez, Timothy J Gawne, Safal Khanal","doi":"10.1007/s10633-026-10095-w","DOIUrl":"https://doi.org/10.1007/s10633-026-10095-w","url":null,"abstract":"<p><strong>Purpose: </strong>The RETeval portable flash electrophysiology device is extensively used for assessing retinal function in humans. However, its utility in measuring electroretinograms in preclinical studies has been less explored. Tree shrews (small diurnal mammals closely related to primates) are a well-established animal model of emmetropization known to exhibit robust responses to visual cues and mimic human juvenile-onset myopia. This study aimed to evaluate the intra- and inter-session repeatability of full-field photopic electroretinograms (ERGs) recorded using the RETeval system in tree shrews.</p><p><strong>Methods: </strong>At 24 ± 1 days of visual experience (DVE), twelve juvenile tree shrews housed in broadband colony light (100-300 lx) underwent electrophysiology testing of the normally developing eye using the RETeval system (LKC Technologies, MD, USA). Measurements were repeated twice in each session, as well as at 30 and 35 DVE. The amplitudes and peak times of the flash, flicker, photopic negative response, S-cone, and On-Off ERGs were analyzed. The intra- and inter-session repeatability was assessed using the coefficient of variation (CoV), intra-class correlation coefficient (ICC), mean bias (%), paired t-test, and Bland-Altman analysis.</p><p><strong>Results: </strong>Tree shrew ERGs exhibited well-defined and robust waveforms comparable to those of human ERGs. Flash and flicker ERGs showed excellent intra-session repeatability for both amplitudes and peak times (CoV < 5%, mean bias ≤ 5%, and ICC ≥ 0.98). While the ERGs were also repeatable across different sessions, the repeatability metrics were comparatively better for peak times (CoV: < 10%, mean bias: < 15%) than for amplitudes (CoV: 13.36-29.35%, mean bias: 18.89-41.51%) with ICC values between 0.4 and 0.86 for inter-session ERGs, indicating modest repeatability.</p><p><strong>Conclusions: </strong>The RETeval measurements of full-field photopic ERGs in tree shrews were robust and reliable, with waveforms morphologically similar to human ERGs, demonstrating the utility of the RETeval system in measuring retinal function in this species. The photopic ERGs were repeatable across sessions on different days, indicating the feasibility of using this device in longitudinal studies of retinal function in tree shrews, for example, in studying the neural basis of emmetropization.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572396","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":"L- and M-cone-directed Global flash multifocal electroretinogram: conceptualization and development.","authors":"Nandini Ravi, Henry H L Chan","doi":"10.1007/s10633-026-10092-z","DOIUrl":"https://doi.org/10.1007/s10633-026-10092-z","url":null,"abstract":"<p><strong>Background and purpose: </strong>Multifocal Electroretinogram (mfERG) applies a fast flicker-based stimulation on the human retina and is considered a valuable tool in studying the cone photoreceptor functional pathways. At the same time, the global flash paradigm of the mfERG (MOFO mfERG) is found to be advantageous in the simultaneous evaluation of retinal responses arising from outer (direct component, DC) and inner (induced component, IC) retinal levels. Incorporating a silent substitution stimulus to the MOFO mfERG remains unexplored yet has broad potential utility. The present study aimed to develop an L- and M-cone directed global flash mfERG.</p><p><strong>Methods: </strong>A silent substitution stimulus was created appropriate for the commercially available LED monitor. Using the conventional 96% contrast MOFO mfERG as a reference, L- and M-cone directed MOFO mfERG with 19-hexagon stimulation was created and tested in 36 Chinese adults with normal colour vision. Experimental validation was conducted using high-intensity red and green light adaptation to simulate colour vision deficiency.</p><p><strong>Results: </strong>Mathematical validation was performed by calculating and ensuring that proper cone quantal catches are achieved at both targeted and non-targeted cone photoreceptors. The cone response amplitude from participants with simulated protanopia and deuteranopia showed a reduction of up to 50% (p < 0.05) following pigment bleach due to light adaptation. The mean L/M cone amplitude ratio for the Chinese adults concerning the DC and IC was 0.84 ± 0.29 and 0.77 ± 0.32, respectively, for all rings combined. The M-cone amplitudes were higher than that of the L-cone. The M-cone responses were phase-advanced or faster compared to the L-cone responses (p < 0.001).</p><p><strong>Conclusion: </strong>The L- and M-cone-directed global flash mfERG protocols may provide valuable details on the specific cone-related outer and inner retinal responses and hold extensive utility in cone-related diseases and the evaluation of colour vision.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147456278","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":"Validation of a novel multi-luminance shape discrimination test for assessment of functional vision.","authors":"Andres Emanuelli, Benjamin Bakall, Byron L Lam, Charles C Wykoff, David Liao, Lance Bergstrom, Zak Vitaliy, Michael Carlson, Sanghoon Kim, Subrata Batabyal, Jean Chang, John Koester, Mark Von Tress, Mark Kosinski, Samuel B Barone, Samarendra K Mohanty","doi":"10.1007/s10633-026-10086-x","DOIUrl":"https://doi.org/10.1007/s10633-026-10086-x","url":null,"abstract":"<p><strong>Background: </strong>In low-vision patients, traditional measures often fall short of capturing functional vision improvements. The study aims to assess the reliability and validity of a novel functional low-vision outcome assessment, the Multi-luminance Shape Discrimination Test (MLSDT).</p><p><strong>Methods: </strong>This is a prospective, observational study in 25 participants with severe vision loss due to retinitis pigmentosa (RP) with visual acuity worse than or equal to LogMAR 1.6, and in 10 normal vision participants. The MLSDT utilizes three differently shaped objects, randomly positioned on pressure sensors, to enable an automated, quantifiable response in a controlled multi-luminance environment. The assessment accuracy (recognizing the correct object and picking it up) was measured using the MLSDT. Convergent validity of MLSDT was evaluated with measures of visual acuity and visual field, as well as patient-reported outcomes.</p><p><strong>Results: </strong>The 35 study participants (60% male and 40% female) had a mean age of 46.5 years old (range: 19-78 years), with 24 Hispanic individuals. Estimates of test-retest reliability for MLSDT exceeded 0.50. The correlations between MLSDT test scores and LogMAR visual acuity were strong (> -0.7). For a difference of 0.3 LogMAR between the groups of RP participants, a decrease of ~ 2-level MLSDT score was observed. Moderate to strong correlations were also observed between MLSDT test scores and the measures of visual field and patient-reported outcome measures.</p><p><strong>Conclusion: </strong>Psychometric evaluation demonstrates the reliability and validity of the novel functional vision endpoint, MLSDT. The MLSDT test performance in participants with different visual acuities showed improved object recognition when the luminance level was enhanced.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147456229","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":"Anterior segment, static and dynamic pupillography changes in patients using different types of alpha-1 blockers.","authors":"Ramazan Birgul, Esat Kaan Akbay, Atilim Armağan Demirtaş, Hatice Daldal","doi":"10.1007/s10633-026-10094-x","DOIUrl":"https://doi.org/10.1007/s10633-026-10094-x","url":null,"abstract":"<p><strong>Aim: </strong>To investigate anterior segment and pupillary changes in patients with BPH (benign prostate hyperplasia) using different types of alpha-1 blockers.</p><p><strong>Materials and methods: </strong>The right eye of male patients using tamsulosin, siladosin, alfuzosin or doxazosin, and the right eye of male subjects in the control group were measured in the study. Anterior segment and pupillography measurements were performed using a Scheimpflug imaging technique of Sirius device. Central corneal thickness (CCT), corneal volume (CV), anterior chamber depth (ACD), anterior chamber angle (ACA), anterior chamber volume (ACV), scotopic, mesopic and photopic pupil sizes and dynamic pupil sizes at 0, 1, 2, 4, 6, 8 and 10 s (s) were measured.</p><p><strong>Results: </strong>Thirty-three patients using tamsulosin, 32 patients using siladosin, 31 patients using alfuzosin and 30 patients using doxazosin were compared with 34 patients in a control group. There was no statistically significant difference between the groups in age, CCT, CV, ACD, ACA, ACV, static pupillography under mesopic and photopic conditions. For three of the groups there was no statistically significant difference from the control group for either scotopic or dynamic pupillography, however pupil size was significantly smaller in the doxazosin group under both static and dynamic conditions.</p><p><strong>Conclusion: </strong>The alpha-1 blockers included in this study were those most commonly used in clinical practice. Our results showed that, as aspected, alpha-1 blockers do not change the anterior segment. Three of the groups showed no abnormal pupil behaviour, but the diameter was significantly smaller in the doxazosin group.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389713","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":"Review of the clinical electrooculogram - Part 2: the bestrophinopathies and modified protocols.","authors":"Srikanta Kumar Padhy, Maja Šuštar Habjan, Paul A Constable","doi":"10.1007/s10633-026-10093-y","DOIUrl":"10.1007/s10633-026-10093-y","url":null,"abstract":"<p><p>The light-rise of the electro-oculogram (EOG) is used as a clinical marker for a collection of disorders known as the 'bestrophinopathies.' This review provides an overview of these conditions including Best Vitelliform Macular Dystrophy (BVMD, Autosomal Recessive Bestrophinopathy (ARB), Adult Onset Vitelliform Macular Dystrophy (AVMD) and Autosomal Dominant Vitreoretinalchoriodopathy (ADVIRC) and potential future therapies. One drawback of the EOG is the time to administer the test and shortened protocols that have been developed to improve the clinical testing of the EOG which include incorporating measures during recordings of the ERG or shortening the period of dark and light adaptation. The companion paper summarizes the cellular mechanism of the EOG, and this review is focused on the clinical applications of the EOG.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147376421","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":"Beyond the snellen chart: exploring the clinical potential of sweep visual evoked potentials for visual acuity measurement.","authors":"Asma Hermas, Michael Dollin, Rustum Karanjia, Ange-Lynca Kantungane, Hong-An Nguyen, Catherine Tsilfidis, Stuart Coupland","doi":"10.1007/s10633-026-10091-0","DOIUrl":"https://doi.org/10.1007/s10633-026-10091-0","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the agreement between Snellen visual acuity (VA) and sweep visual evoked potential (sVEP) VA in individuals with normal vision and assess sVEP variability and reproducibility across multiple test sessions.</p><p><strong>Methods: </strong>Thirty-nine healthy participants (78 eyes) underwent Snellen and sVEP VA testing. Ten participants (20 eyes) also underwent sVEP testing twice daily (morning and afternoon) on three separate days (120 total recordings). and Snellen VA measurements showed strong agreement, with a mean absolute difference of 0.03 LogMAR (less than one Snellen line). Forty of 78 eyes had differences within one Snellen line, while the largest discrepancy reached four lines. Statistical analysis (P = 0.201) indicated no significant difference between the two methods. sVEP reproducibility was also high, with no significant variation between morning and afternoon recordings (P = 0.67), confirming its stability as a clinical tool.</p><p><strong>Conclusion: </strong>sVEP provides objective and reproducible VA measurements comparable to Snellen VA, suggesting its potential as an alternative clinical assessment tool, particularly for patients with communication challenges, cognitive impairments, or suspected malingering vision loss.</p>","PeriodicalId":11207,"journal":{"name":"Documenta Ophthalmologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364454","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}