Lower Mean Sensitivity Research Articles

Baseline Microperimetry and OCT in the RUSH2A Study: Structure−Function Association and Correlation With Disease Severity

PurposeTo investigate baseline mesopic microperimetry (MP) and spectral domain optical coherence tomography (OCT) in the Rate of Progression in USH2A-related Retinal Degeneration (RUSH2A) study. DesignNatural history study MethodsSetting: 16 clinical sites in Europe and North AmericaStudy Population: Participants with Usher syndrome type 2 (USH2) (N = 80) or autosomal recessive nonsyndromic RP (ARRP) (N = 47) associated with biallelic disease-causing sequence variants in USH2AObservation Procedures: General linear models were used to assess characteristics including disease duration, MP mean sensitivity and OCT intact ellipsoid zone (EZ) area. The associations between mean sensitivity and EZ area with other measures, including best corrected visual acuity (BCVA) and central subfield thickness (CST) within the central 1 mm, were assessed using Spearman correlation coefficients.Main Outcome Measures: Mean sensitivity on MP; EZ area and CST on OCT. ResultsAll participants (N = 127) had OCT, while MP was obtained at selected sites (N = 93). Participants with Usher syndrome type 2 (USH2, N = 80) and nonsyndromic autosomal recessive Retinitis Pigmentosa (ARRP, N = 47) had the following similar measurements: EZ area (median (interquartile range [IQR]): 1.4 (0.4, 3.1) mm2 vs 2.3 (0.7, 5.7) mm2) and CST (median (IQR): 247 (223, 280) µm vs 261 (246, 288), and mean sensitivity (median (IQR): 3.5 (2.1, 8.4) dB vs 5.1 (2.9, 9.0) dB). Longer disease duration was associated with smaller EZ area (P < 0.001) and lower mean sensitivity (P = 0.01). Better BCVA, larger EZ area, and larger CST were correlated with greater mean sensitivity (r > 0.3 and P < 0.01). Better BCVA and larger CST were associated with larger EZ area (r > 0.6 and P < 0.001). ConclusionsLonger disease duration correlated with more severe retinal structure and function abnormalities, and there were associations between MP and OCT metrics. Monitoring changes in retinal structure-function relationships during disease progression will provide important insights into disease mechanism in USH2A-related retinal degeneration.

The Effects of Visual Field Loss from Optic Disc Drusen on Performance in a Driving Simulator

ABSTRACT The purpose of this study was to compare the driving simulator performance of participants with visual field loss (VFL) from optic disc drusen (ODD) with a normally sighted control group and a group of individuals with glaucoma. Data on performance and safety from a traffic simulator test for five participants with VFL from ODD were retrospectively compared with data from 49 male individuals without visual deficits in a cross-sectional study. VFL of the ODD group was also compared with a group of 20 male glaucoma participants who had failed the same simulator test. Four individuals with ODD regained their driving licences after a successful simulator test and were then followed in a national accident database. All participants with ODD passed the test. No significant differences in safety or performance measures were detected between the normally sighted participants and the ODD group despite severe concentric visual field constrictions. Compared with failed glaucoma male participants, the ODD group had even lower mean sensitivity in the peripheral and peripheral inferior field of vision. None of the four participants with a regained licence were involved in a motor vehicle accident during a 3-year follow-up period after the simulator test. Despite having severe VFL, participants with ODD had no worse performance or safety than controls. As even individuals with severe VFL might drive safely, there is a need for individual practical assessments on licencing issues.

The effects of visual-field loss from panretinal photocoagulation of proliferative diabetic retinopathy on performance in a driving simulator.

The purpose of this study was to compare driving-simulator performance of participants with visual-field loss (VFL) from panretinal photocoagulation (PRP) of proliferative diabetic retinopathy (PDR) with a normally sighted control group. Furthermore, we investigated the effects of VFL of different extent on driving. Data on performance and safety from a traffic-simulator test for 27 participants with VFL from PRP of PDR were retrospectively compared with data from 83 individuals without visual deficits in a cross-sectional study. Individuals with diabetes that regained their driving licences after a successful simulator test were then followed in a national accident database. Diabetes participants passed the test in 56% of the cases. Compared with the control group, diabetes participants had more risky "failed to give way" events and longer reaction times. Failed diabetes participants had lower mean sensitivity in the superior visual field than those who passed. None of the participants with a regained licence were involved in a motor vehicle accident during the 3-6-year follow-up after the simulator test. Diabetes participants had worse performance and safety than the controls. However, even individuals with VFL from PRP might drive safely, which highlights the need for individual assessments in licencing issues.

Evaluation of magnocellular pathway abnormalities in schizophrenia: a frequency doubling technology study and clinical implications

Visual processing deficits have been reported for patients with schizophrenia. Previous studies demonstrated differences in early-stage processing of schizophrenics, although the nature, extent, and localization of the disturbance are unknown. The magnocellular and parvocellular visual pathways are associated with transient and sustained channels, but their respective contributions to schizophrenia-related visual deficits remains controversial. The aim of this study was to evaluate magnocellular dysfunction in schizophrenia using frequency doubling technology. Thirty-one patients with schizophrenia and 34 healthy volunteers were examined. Frequency doubling technology testing was performed in one session, consisting of a 15-minute screening strategy followed by the C-20 program for frequency doubling technology. Schizophrenic patients showed lower global mean sensitivity (30,97 ± 2,25 dB) compared with controls (32,17 ± 3,08 dB), p<0.009. Although there was no difference in the delta sensitivity of hemispheres, there was a difference in sensitivity analysis of the fibers crossing the optic chiasm, with lower mean sensitivity in the patient group (28,80 dB) versus controls (30,66 dB). The difference was higher in fibers that do not cross the optic chiasm, with lower mean sensitivity in patients (27,61 dB) versus controls (30,26 dB), p<0.005. Our results suggest that there are differences between global sensitivity and fiber sensitivity measured by frequency doubling technology. The different sensitivity of fibers that do not cross the optic chiasm is consistent with most current etiological hypotheses for schizophrenia. The decreased sensitivity responses in the optic radiations may significantly contribute to research assessing early-stage visual processing deficits for patients with schizophrenia.

Climate relationships with tree-ring width and δ13C of three Callitris species from semiarid woodlands in south-western Australia

Proxy measures of climate based on tree rings can allow reconstruction of climate back past the limit of instrumental records, thereby improving understanding of natural climate variability. We assessed the dendroclimatic potential of tree-ring widths and δ13C of three broadly co-occurring species of Callitris in south-western Western Australia. Ring width chronologies of C. columellaris F.Muell., C. canescens (Parl.) S.T. Blake and C. preissii Miq. met standard measures of dendrochronological acceptability. For all three species, the Expressed Population Signal (EPS) was &gt;0.93 and mean correlations between series in each chronology was &gt;0.79. In contrast, δ13C chronologies were of poorer statistical quality (EPS ranged 0.59 to 0.88, mean correlations ranged 0.33 to 0.65) with both less year-to-year and lower-frequency information (lower mean sensitivity and standard deviation values). The dominant climatic signal in the ring width chronologies was related to rainfall and was strongest over the March–September season (correlations ranged 0.27 to 0.70, all P &lt; 0.05). Consistent with the poorer quality of the δ13C chronologies compared with those from ring widths, tree-ring δ13C was also less strongly correlated with rainfall and rarely significant (P = 0.05). The weaker δ13C correlations may be due to a strong water conservation strategy by Callitris. Our analysis of the whole ring rather than latewood and low sampling effort may also have dampened the δ13C response. However, combining the ring width and δ13C chronologies using Principal Components Analysis did not enhance the extraction of a climatic signal. While the variance explained by the first principal component (PC) was high for all three species (76 to 87%), correlations between the first PC and rainfall were not stronger than for ring widths alone. Tree-ring δ13C, in conjunction with δ18O in particular, may nevertheless provide insight into physiological responses of Callitris to climate variation. However, dendroclimatic studies using Callitris to develop past rainfall records should focus on developing chronologies from ring widths. Further effort to find sites with old trees (250 years or more) should be undertaken and are likely to provide much needed information on past rainfall in Australia.

Is There Evidence for Continued Learning Over Multiple Years in Perimetry?

The existence of learning effects in perimetry, whereby a subject's first test is more variable and has lower mean sensitivity (MS) than subsequent tests, is well established. However, studies have typically examined this issue by testing subjects at a frequency that would be unusual in a clinical setting. This study seeks to determine the validity of these conclusions for less frequent, yet more clinically realistic, testing rates. One hundred sixty eyes of 80 subjects with suspected or early glaucoma were included. Subjects were tested annually for 8 years using white-on-white standard automated perimetry (SAP) and short wavelength automated perimetry (SWAP). All subjects had undergone at least one test with both paradigms before entering the study. For SAP, MS increased by 0.5 dB over the first year, and then showed no significant change until after year 5 (despite expected effects of aging and disease progression), after which it started to decline. For SWAP, MS of the average eye continued to improve until year 6 of the study. Our findings seem to indicate a prolonged learning effect for SWAP, with MS increasing for several years. A smaller prolonged learning effect may also be present for SAP, counteracting the effects of aging and disease progression. Deterioration of the subject's visual field may be underestimated within this period.