Carina Kelbsch1, Fumiatsu Maeda1,2, Jolanta Lisowska1,3, Lukasz Lisowski1,3, Torsten Strasser1,4, Krunoslav Stingl1,4, Barbara Wilhelm1, Helmut Wilhelm1, Tobias Peters1. 1. Pupil Research Group at the Centre for Ophthalmology, University of Tübingen, Tübingen, Germany. 2. Department of Orthoptics and Visual Sciences, Faculty of Medical Technology, Niigata University of Health and Welfare, Niigata, Japan. 3. Medical University of Bialystok, Bialystok, Poland. 4. Institute for Ophthalmic Research, University of Tübingen, Tübingen, Germany.
Abstract
PURPOSE: To analyse pupil responses to specific chromatic stimuli in patients with advanced retinitis pigmentosa (RP) to ascertain whether chromatic pupillography can be used as an objective marker for residual retinal function. To examine correlations between parameters of the pupil response and the perception threshold of electrically evoked phosphenes. METHODS: Chromatic pupillography was performed in 40 patients with advanced RP (visual acuity < 0.02 or visual field ≤5°, non-recordable ERGs) and 40 age-matched healthy subjects. Pupil responses to full-field red (605 nm) and blue (420 nm) stimuli of 28 lx corneal illumination were recorded and analysed for two stimulus durations (1 and 4 seconds). The perception threshold of phosphenes to transcorneal electrostimulation was ascertained and correlated to the pupil responses and visual acuity. RESULTS: Patients with RP showed significantly reduced pupil responses to red and blue stimuli compared with the controls. With red stimuli, pupillary escape could be observed; blue stimuli resulted in a well-preserved postillumination pupil response. Phosphene thresholds were significantly increased in patients with RP and correlated with the parameters of the pupil response if all subjects were considered. Within the RP group alone, this relationship was less pronounced and statistically not significant. CONCLUSIONS: Chromatic pupillography demonstrated a significant decrease in outer retinal photoreceptor responses but a persisting and disinhibited intrinsic photosensitive retinal ganglion cell function in advanced RP. These phenomena may be useful as an objective marker for the efficacy of any interventional treatment for hereditary retinal diseases as well as for the selection of suitable patients for an electronic retinal implant.
PURPOSE: To analyse pupil responses to specific chromatic stimuli in patients with advanced retinitis pigmentosa (RP) to ascertain whether chromatic pupillography can be used as an objective marker for residual retinal function. To examine correlations between parameters of the pupil response and the perception threshold of electrically evoked phosphenes. METHODS: Chromatic pupillography was performed in 40 patients with advanced RP (visual acuity < 0.02 or visual field ≤5°, non-recordable ERGs) and 40 age-matched healthy subjects. Pupil responses to full-field red (605 nm) and blue (420 nm) stimuli of 28 lx corneal illumination were recorded and analysed for two stimulus durations (1 and 4 seconds). The perception threshold of phosphenes to transcorneal electrostimulation was ascertained and correlated to the pupil responses and visual acuity. RESULTS:Patients with RP showed significantly reduced pupil responses to red and blue stimuli compared with the controls. With red stimuli, pupillary escape could be observed; blue stimuli resulted in a well-preserved postillumination pupil response. Phosphene thresholds were significantly increased in patients with RP and correlated with the parameters of the pupil response if all subjects were considered. Within the RP group alone, this relationship was less pronounced and statistically not significant. CONCLUSIONS: Chromatic pupillography demonstrated a significant decrease in outer retinal photoreceptor responses but a persisting and disinhibited intrinsic photosensitive retinal ganglion cell function in advanced RP. These phenomena may be useful as an objective marker for the efficacy of any interventional treatment for hereditary retinal diseases as well as for the selection of suitable patients for an electronic retinal implant.
Authors: Arun K Krishnan; Samuel G Jacobson; Alejandro J Roman; Bhavya S Iyer; Alexandra V Garafalo; Elise Héon; Artur V Cideciyan Journal: Vision Res Date: 2020-02-20 Impact factor: 1.886
Authors: Carina Kelbsch; Torsten Strasser; Yanjun Chen; Beatrix Feigl; Paul D Gamlin; Randy Kardon; Tobias Peters; Kathryn A Roecklein; Stuart R Steinhauer; Elemer Szabadi; Andrew J Zele; Helmut Wilhelm; Barbara J Wilhelm Journal: Front Neurol Date: 2019-02-22 Impact factor: 4.003
Authors: Krunoslav T Stingl; Laura Kuehlewein; Nicole Weisschuh; Saskia Biskup; Frans P M Cremers; M Imran Khan; Carina Kelbsch; Tobias Peters; Marius Ueffing; Barbara Wilhelm; Eberhart Zrenner; Katarina Stingl Journal: Transl Vis Sci Technol Date: 2019-12-20 Impact factor: 3.283
Authors: Agnieszka Zielinska; Piotr Ciacka; Maciej Szkulmowski; Katarzyna Komar Journal: Invest Ophthalmol Vis Sci Date: 2021-12-01 Impact factor: 4.799
Authors: Anton Sonntag; Carina Kelbsch; Ronja Jung; Helmut Wilhelm; Torsten Strasser; Tobias Peters; Krunoslav Stingl; Barbara Wilhelm Journal: Int Ophthalmol Date: 2021-11-26 Impact factor: 2.029