Xiaofan Jiang, Taha Bhatti, Ambreen Tariq, Shaun M Leo, Nancy Aychoua, Andrew R Webster, Pirro G Hysi, Christopher J Hammond, Omar A Mahroo
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Responses to 13 cd m<sup>-2</sup> s white xenon flashes (similar to the standard DA 10 flash), delivered on a blue background, were analysed. Photopic and scotopic strengths of the background were 1.3 and 30 cd m<sup>-2</sup>, respectively; through a dilated pupil, this is expected to largely saturate the rods, but adapt the cones much less than the standard ISCEV background.</p><p><strong>Results: </strong>Mean (SD) participant age was 62.5 (11.3) years (93% female). ERGs from 203 right and 204 left eyes were included, with mean (SD) b/a ratios of 1.22 (0.28) and 1.18 (0.28), respectively (medians, 1.19 and 1.17). Proportions with negative waveforms were 23 and 26%, respectively. Right and left eye b/a ratios were strongly correlated (correlation coefficient 0.74, p < 0.0001). We found no significant correlation of b/a ratio with age.</p><p><strong>Conclusions: </strong>Over 20% of eyes showed b/a ratios less than 1, consistent with the notion that dark-adapted cone-driven responses to standard bright flashes can have negative waveforms. The majority had ratios greater than 1. Thus, whilst selective loss of rod function can yield a negative waveform (with reduced a-wave) in some, our findings also suggest that loss of rod function can occur without necessarily yielding a negative ERG. 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引用次数: 0
摘要
目的：视杆和视锥驱动的信号都有助于由黑暗中的标准强闪光引发的视网膜电图（ERG）。阴性ERG通常反映视网膜内部功能障碍。然而，在杆状光感受器功能选择性丧失的疾病中，负波形可能代表暗适应锥体系统的反应。为了研究健康个体中暗适应的锥体驱动波形，我们在暗蓝色背景上提供闪光，旨在使杆饱和，但对锥体的适应程度最低。方法：使用导电纤维电极记录来自TwinsUK队列的成年人的ERG。分析了在蓝色背景下发射的13 cd m-2 s白色氙闪光（类似于标准DA 10闪光）的响应。背景的光照强度和暗照强度分别为1.3和30cdm-2；通过扩张的瞳孔，这预计会在很大程度上使视杆饱和，但对视锥的适应程度远低于标准ISCEV背景。结果：参与者的平均年龄为62.5（11.3）岁（93%为女性）。包括203只右眼和204只左眼的ERG，平均（SD）b/a比率分别为1.22（0.28）和1.18（0.28）（中位数为1.19和1.17）。负波形的比例分别为23%和26%。右眼和左眼b/a比率强相关（相关系数0.74，p 结论：超过20%的眼睛显示b/a比小于1，这与暗适应锥驱动的对标准闪光的反应可能具有负波形的概念一致。大多数人的比率大于1。因此，虽然选择性的杆功能丧失在某些情况下会产生负波形（a波减少），但我们的研究结果也表明，杆功能丧失可能发生，而不一定会产生负ERG。一个潜在的限制是可能由背景引起的轻度锥形系统适应。
Cone-driven strong flash electroretinograms in healthy adults: Prevalence of negative waveforms.
Purpose: Both rod and cone-driven signals contribute to the electroretinogram (ERG) elicited by a standard strong flash in the dark. Negative ERGs usually reflect inner retinal dysfunction. However, in diseases where rod photoreceptor function is selectively lost, a negative waveform might represent the response of the dark-adapted cone system. To investigate the dark-adapted cone-driven waveform in healthy individuals, we delivered flashes on a dim blue background, designed to saturate the rods, but minimally adapt the cones.
Methods: ERGs were recorded, using conductive fibre electrodes, in adults from the TwinsUK cohort. Responses to 13 cd m-2 s white xenon flashes (similar to the standard DA 10 flash), delivered on a blue background, were analysed. Photopic and scotopic strengths of the background were 1.3 and 30 cd m-2, respectively; through a dilated pupil, this is expected to largely saturate the rods, but adapt the cones much less than the standard ISCEV background.
Results: Mean (SD) participant age was 62.5 (11.3) years (93% female). ERGs from 203 right and 204 left eyes were included, with mean (SD) b/a ratios of 1.22 (0.28) and 1.18 (0.28), respectively (medians, 1.19 and 1.17). Proportions with negative waveforms were 23 and 26%, respectively. Right and left eye b/a ratios were strongly correlated (correlation coefficient 0.74, p < 0.0001). We found no significant correlation of b/a ratio with age.
Conclusions: Over 20% of eyes showed b/a ratios less than 1, consistent with the notion that dark-adapted cone-driven responses to standard bright flashes can have negative waveforms. The majority had ratios greater than 1. Thus, whilst selective loss of rod function can yield a negative waveform (with reduced a-wave) in some, our findings also suggest that loss of rod function can occur without necessarily yielding a negative ERG. One potential limitation is possible mild cone system adaptation by the background.
期刊介绍：
Documenta Ophthalmologica is an official publication of the International Society for Clinical Electrophysiology of Vision. The purpose of the journal is to promote the understanding and application of clinical electrophysiology of vision. Documenta Ophthalmologica will publish reviews, research articles, technical notes, brief reports and case studies which inform the readers about basic and clinical sciences related to visual electrodiagnosis and means to improve diagnosis and clinical management of patients using visual electrophysiology. Studies may involve animals or humans. In either case appropriate care must be taken to follow the Declaration of Helsinki for human subject or appropriate humane standards of animal care (e.g., the ARVO standards on Animal Care and Use).
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