Structure-functional correlation using adaptive optics, OCT, and microperimetry in a case of occult macular dystrophy / Correlação de estrutura e função da retina utilizando óptica adaptativa, OCT e microperimetria em um caso de distrofia macular oculta

ABSTRACT We report retinal functional and structural changes of a 40-year-old man diagnosed with occult macular dystrophy. Comprehensive ophthalmological evaluation was performed, followed by spectral-domain optical coherence tomography (SD-OC - Heidelberg) and image acquisition using an adaptive optics (AO) camera (RTX1, Imagine Eyes) for photoreceptor density analysis. Functional tests included full-field ERG (ERG) and multifocal electroretinography (mfERG) (Diagnosys, LLC) and microperimetry with scanning laser ophthalmoscope (SLO) fixation controlled (MAIA, CenterVUE). OCT revealed a line of discontinuity corresponding to cone outer-segment photoreceptors associated with a loss of cone density, highlighted by a dark blue spot on the AO co ne-density map on the fovea in both eyes. Loss of central sensitivity was revealed using microperimetry; ERG was within the normal range, although the mfERG showed a reduced central response amplitude.

RESUMO Relatamos exames de função e estrutura retiniana de paciente masculino, de 40 anos, com diagnóstico clínico de Distrofia Macular Oculta (DMO). Avaliação oftalmológica completa foi seguida por tomografia de Coerência Óptica (SD-OCT - Heidelberg) e exame com câmara de fundo de olho com tecnologia "Adaptive Optics" (AO - RTX1, Imagine Eyes) para análise da densidade de fotorreceptores. Os exames funcionais incluíram: Eletroretinografia de campo total (ERG) e multifocal (mfERG) (Diagnosys - LLC) e microperimetria com controle de fixação (MAIA - CenterVUE). Os exames revelam descontinuidade da camada de fotorreceptores na região central da fóvea em ambos os olhos pelo SD-OCT em associação com perda de densidade no mosaico cones, representado por mancha azulada no mapa do AO. Os exames de função apresentam diminuição da acuidade visual (20/80; 20/50), redução de sensibilidade central na microperimetria. Como esperado, o ERG está dentro da normalidade, mas há redução da amplitude das respostas centrais do mfERG em ambos os olhos.

The relationship between hypothyroidism and color vision deficiency among Filipino adults seen at the Makati Medical Center

OBJECTIVE: To determine the relationship between hypothyroidism and color vision deficiency among Filipinos ages 20-60 yearsDESIGN AND METHODS: A cross-sectional study was performed on 91 biochemically hypothyroid and euthyroid patients seen at the Makati Medical Center from July to December 2013. All subjects underwent the Ishihara color test, followed by the Farnsworth-Munsell D15 test if this was positive. The patient who tested positive in the Farnsworth-Munsell D15 test was referred to an ophthalmologist to rule out any anatomic problem, and was excluded from the study if found to have any. Fisher's exact test assessed the significant correlation between hypothyroidism and color vision deficiency. A p-value less than 0.05 was considered significant.RESULTS: Of the 91 patients that were included in the study, the average age was 42 years, majority (87%) were females, and 41% were biochemically hypothyroid. All euthyroid patients (100%) had normal color vision, while one hypothyroid patient (3.0%) tested positive for color vision deficiency (p-value 0.407).CONCLUSION: Based on this study, the hypothyroid state of the patients had no effect on their color vision, unlike those seen in rodents, probably because mature human cones are not as easily affected by changes in thyroid hormone levels.

Color signals in retina and lateral geniculate nucleus of marmoset monkeys

Marmosets show sex-linked polymorphism of color vision, whereby all males and some females show dichromatic ("red-green color-blind") vision based on two classes of photoreceptor sensitive to short or medium wavelength bands. Most female marmosets by contrast express three photoreceptor classes, one sensitive to short wavelengths and two classes in the medium-long wavelength sensitivity band. We used this 'natural knock-out' to study the organization of color vision pathways in primates. We review here results from our and other laboratories showing how the primordial dichromatic blue-yellow pathway is characterized by selective connections to short wavelength sensitive cones in the retina and that signals for blue-yellow color vision travel through an ancient part of the subcortical visual pathway called the koniocellular system. Signals serving red-green color vision by contrast are tightly linked to retinal circuits serving high-resolution spatial vision at the fovea and show little sign of specific patterns of connections with medium- and long-wavelength sensitive cones. Routine trichromatic color vision thus is based on converging signals from two quite distinct retinal and subcortical pathways...

Asymmetries in the contributions of On- and Off-mechanisms to the ERG signal

ERG responses were recorded to rapid-on and rapid-off L- and M-cone isolating sawtooth stimuli of different cone contrasts. In addition, the responses were recorded to simultaneous in-phase stimulation of the L- and M-cones at equal cone contrast. Linear responses to mirror imaged rapid-on and rapid-off sawtooth stimuli are also mirror imaged. By adding on- and off-responses, linear response components will cancel and nonlinearities will remain. Because nonlinearities that occur at a certain stage of visual processing will influence subsequent stages, linear response components will probably have an outer retinal origin and nonlinearities probably originate mainly in the inner (post-receptoral) retina...

Electroretinogram and histopathologic changes of the retina after methanol intoxication / 法医学杂志

In order to study the functional and structural alterations of the retina in SD rat model after methanol intoxication, 35 rats were divided randomly into five groups administrated with saline, 3-day high dose, 7-day high dose, 3-day low dose and 7-day low dose methanol separately. The retinal function of each group was assessed by flash electroretinogram (F-ERG) 3 and 7 days after methanol poisoning. The microstructure and ultrastructure of the retina were observed at the same time. The high-dose methanol intoxication induced irreversible retinal functional and structural damages 3 days after poisoning, which included prolonged latency and reduced amplitude of the Max-reaction of F-ERG. These injuries were aggravated 7 days after poisoning. Meanwhile, the latency and amplitude of the Cone-reaction of F-ERG were also affected 3 days after poisoning, but there were no further worsening tendency 7 days after poisoning. The retinal histological analysis showed cellular edema, heteromorphy and disarrangement, tissular loosen of the inner nuclear layer and photoreceptors layer. The mitochondrial damage began at the photoreceptors layer and developed further into the inner nuclear layer. The low-dose methanol intoxication only caused transient damage of the retina. Our results showed that the function and structure of the photoreceptor and inner nuclear layer were the primary target of methanol intoxication and that the rod cells were more sensitive to methanol intoxication than the cone cells. The mitochondrial damage developed from outer layer to inner layer of the retina.

Morphologic Characteristics of the Outer Retina in Cone Dystrophy on Spectral-domain Optical Coherence Tomography

PURPOSE: To investigate the morphologic changes in the outer retina of patients with cone dystrophy, using spectral-domain optical coherence tomography (SD-OCT). METHODS: The medical records of 15 cone dystrophy patients examined from January 2007 to January 2012 were reviewed retrospectively. All patients underwent ophthalmic evaluation including best-corrected visual acuity (BCVA), color vision testing, fundus examination, full-field standard electroretinography (ERG), multifocal (mf) ERG, and SD-OCT. Qualitative and quantitative SD-OCT data and ERG responses were analyzed and compared among the patient categories and the normal control group. RESULTS: There were 4 major categories of SD-OCT findings, based on the status of the ellipsoid portion of the photoreceptor inner segment (ISe), outer segment (OS) contact cylinder, and retinal pigment epithelium (RPE) layer. Category 0 showed no structural abnormalities. Category 1 showed foveal ISe loss and obscurity of the border between the ISe band and the external limiting membrane (ELM). Category 2 showed foveal thinning and focal foveal ISe disruption with an intact ELM. Category 3 showed foveal thickening and perifoveal disruption of the ISe layer. Category 1 to 3 showed OS contact cylinder layer absence and RPE thickening. The patients in category 0 tended to be younger (mean, 10.0 years) than those in categories 1 to 3 (mean, 17.6 years), although this difference was not statistically significant. Category 1 to 3 patients exhibited statistically significant thinning of the central retina and outer nuclear layer and thickening of the RPE layer relative to the category 0 and normal control group. There was a significant correlation between the central foveal thickness and BCVA in the patients with cone dystrophy. ERG and mfERG responses did not differ significantly among the different cone dystrophy categories. CONCLUSIONS: The morphologic features of cone dystrophy as revealed by SD-OCT, could be categorized as either normal or 1 of 3 different types of outer retinal changes. The presence of normal retinal structures in young cone dystrophy patients with functional impairment (category 0) indicates that electrophysiologic studies are superior to current imaging modalities for the early diagnosis of cone dystrophy. The characteristic SD-OCT findings in cone dystrophy patients may aid in differential diagnosis and be useful for future research on the pathology of cone dystrophy.

Etapa maculotópica: una propuesta sobre el inicio de la señalización visual según nuestra teoría sobre la visión / Maculotopic stage: one proposal on the start of the visual signpost according to our theory on the vision

Estamos considerando que a nivel de la mácula, región de la retina de máxima agudeza visual por su alta densidad de conos, debe conformarse una representación o mapa maculotópico de aquella imagen del mundo exterior donde fijamos nuestra atención. La estimulación fotónica reflectante del mundo exterior excitaría a los conos de la mácula, y la distribución topográfica de estos conos absorbentes de luz o excitados, coincidiría exactamente con la topografía de la imagen exterior excitante. Uno o más fotorreceptores excitados conformarían un componente de la imagen o de información visual. La sumatoria de estos componentes de información visual conformaría la imagen total

We are considering that the level of the macula, the retinal region of maximum visual acuity due to its high density of cones, must conform maculotopic representation or map of that image of the outside world where we focus our attention. Reflecting photonic stimulation from the outside world excite the cones in the macula, and the topographic distribution of these linght- absorbing cones or excited, coindice exictly with the topography of the exciting exterior image. One or more photorececeptors excited would form a component of the image or visual information. The sum of these componets of visual information would form the total picture

The effect of Vaccinium uliginosum on rabbit retinal structure and light-induced function damage / 中国结合医学杂志

<p><b>OBJECTIVE</b>To study the effect of Vaccinium uliginosum L., (VU) on the electroretinogram (ERG) and retinal pathological changes in rabbits after light-induced damage.</p><p><b>METHODS</b>Twenty-eight Chinchilla rabbits were randomly divided into four groups: administration beforehand (A), administration after injury (B), light injury without administration (C), and blank (D) groups. After a 4-week administration of VU homogenate at 4.8 g/(kg·d) once a day in group A, ERG in groups A, B and C were recorded according to the standards set by the International Society for Clinical Electrophysiology of Vision (ISCEV). Except for group D, the groups were then exposed to strong light. Just after that, group A stopped receiving VU treatment and group B started to receive it. Then ERGs in all groups were recorded after 1 day, 1 week, and 2 weeks. Throughout the whole process groups which were not fed with VU were fed with normal saline. Finally, the tissues and structures of all the groups were observed and the thickness of the outer nuclear layers (ONL) was measured.</p><p><b>RESULTS</b>(1) After 4-week feeding with VU, the latency time of ERG in group A became shorter than those in the other groups and the amplitude increased. After being exposed to strong light, the latency time lengthened and amplitude decreased in all the injury groups, but comparing at each time point, the measured values in group A were better than those in group C. With the accumulation of VU, the ERG in group B improved, and finally, all of the detected values became better than those in group C. (2) Retinae in group D were normal in histology and the layers were in order but those in group C became disarranged. The injuries in groups A and B were minor compared with those in group C. The thickness of the ONL in group C was significantly thinner than in the other groups (P=0.000), and that in groups A and B was thicker than that in group C, although thinner than in group D. That in group A was thicker than in group B.</p><p><b>CONCLUSIONS</b>VU can relieve the injury to rabbit retinae exposed to normal day and night rhythm, alleviate the harm caused by light when used beforehand, and repair the light damage to the retina.</p>

Functional assessment of magno, parvo and konio-cellular pathways; current state and future clinical applications

The information generated by cone photoreceptors in the retina is compressed and transferred to higher processing centers through three distinct types of ganglion cells known as magno, parvo and konio cells. These ganglion cells, which travel from the retina to the lateral geniculate nucleus [LGN] and then to the primary visual cortex, have different structural and functional characteristics, and are organized in distinct layers in the LGN and the primary visual cortex. Magno cells are large, have thick axons and usually collect input from many retinal cells. Parvo cells are smaller, with fine axons and less myelin than mango cells. Konio cells are diverse small cells with wide fields of input consisting of different cells types. The three cellular pathways also differ in function. Magno cells respond rapidly to changing stimuli, while parvo cells need time to respond. The distinct patterns of structure and function in these cells have provided an opportunity for clinical assessment of their function. Functional assessment of these cells is currently used in the field of ophthalmology where frequency-doubling technology perimetry selectively assesses the function of magno cells. Evidence has accrued that the three pathways show characteristic patterns of malfunctions in multiple sclerosis, schizophrenia, Parkinson's and Alzheimer's diseases, and several other disorders. The combination of behavioral assessment with other techniques, such as event related potentials and functional magnetic resonance imaging, seems to bear promising future clinical applications

Comparison of steady-state visually evoked potential evoked by different monochromatic light / 生物医学工程学杂志

The cone cell on the retina of human is the sensor of vision under illumination; it can be classified into three types: red cone cell, green cone cell, and blue cone cell. There is different property of absorbing light for each type of cone cell. In this work, a 10 Hz pulse was used to drive red, green and blue light emitting diodes respectively, and the different monochromatic light with the same luminance was obtained. The eyes of ten subjects were stimulated by different monochromatic light independently; an EGI system with 128 channels was used to record the steady-state visually evoked potential (SSVEP). After applying the fast fourier transform (FFT) to the SSVEP data, we found that the distribution of the neural network in the initial vision cortex activated by the output of the different-typed cone cell remained mainly identical, but there was some difference in intensity between the three types of network: the activity by blue light is the strongest one, that by red light is in the middle, and that by green light is the weakest one.

Avaliação da autofluorescência do fundo de olho nas distrofias de retina com o aparelho Heidelberg Retina Angiograph2 / Evaluation of fundus autofluorescence in hereditary retinal diseases using Heidelberg Retina Angiograph2

OBJETIVOS: Definir características do exame de autofluorescência, verificando sua utilidade no diagnóstico e acompanhamento de distrofias retinianas. MÉTODOS: Participaram do estudo, 28 pacientes, adultos, divididos igualmente em quatro grupos com diagnósticos de doença de Stargardt, distrofia de Cones, retinose pigmentar e voluntários saudáveis para estabelecimento do padrão de normalidade. Em média foram obtidas nove imagens com o filtro para angiofluoresceinografia para a formação da imagem autofluorescente no Heidelberg Retina Angiograph2. As imagens de cada grupo de pacientes foram analisadas para verificar características comuns. RESULTADOS: As imagens fundoscópicas autofluorescentes dos voluntários do grupo controle mostraram área foveal hipoautofluorescente em relação à retina do pólo posterior. As imagens dos portadores de doença de Stargardt, em geral, apresentaram lesão hipoautofluorescente, correspondendo à área macular. As principais alterações da autofluorescência em pacientes com distrofia de cones foram hipoautofluorescência macular com halo hiperautofluorescente. Nos portadores de retinose pigmentar, foram encontrados pigmentos periféricos causando hipoautofluorescência. Na região macular, hipoautofluorescência ou apenas desorganização do pigmento. CONCLUSÃO: O estudo mostrou a existência de padrões de autofluorescência de fundo nas distrofias de retina que permitem o diagnóstico e melhor interpretação da fisiopatogenia destas doenças.

PURPOSE: To define characteristics of the fundus autofluorescence examination, verifying usefulness in the diagnosis and care of hereditary retinal diseases. METHODS: 28 patients, adults, divided equally into four groups with diagnoses of Stargardt macular dystrophy, cone dystrophy, retinitis pigmentosa and healthy volunteers for the establishment of the normality pattern. An average of nine images with the filter for fluorescein angiography was obtained for the formation of the image autofluorescence using Heidelberg Retina Angiograph2. The images of each group of patients were analyzed to verify common characteristics. RESULTS: The fundus autofluorescence of healthy volunteers showed the foveal area darker than the surrounding retina. The images of Stargardt macular dystrophy, in general, presented an oval central lesion, with reduced autofluorescence. The main alterations of the autofluorescence in patients with cone dystrophy were reduced foveal autofluorescence with a parafoveal ring of increased autofluorescence. In general, the images of retinitis pigmentosa showed outlying pigments with reduced autofluorescence, and of the foveal area, in some cases disorganization or reduced autofluorescence. CONCLUSION: The study showed the existence of patterns of fundus autofluorescence in the hereditary retinal diseases that allow the diagnosis and better interpretation of the pathogenesis of these diseases.

Estudo eletrorretinográfico de visão cromática / Electroretinographic study of chromatic vision

OBJETIVO: O objetivo deste estudo é descrever o traçado eletrorretinográfico no gambá sul-americano (Didelphis aurita) obtido com estímulo cromático de comprimento de onda seletivo. O eletrorretinograma é o registro das variações de voltagem nas células retinianas, desencadeadas por estímulo luminoso. O eletrorretinograma representa a atividade elétrica combinada de diferentes células, e sofre variações dependendo da fisiologia retiniana e do método de exame. MÉTODOS: Foram registrados os eletrorretinogramas de seis animais em adaptação ao escuro utilizando filtros cromáticos Kodak Wratten®, e registrada a sensibilidade espectral para comprimentos de onda específicos nas faixas de cores do azul, verde, amarelo, laranja e vermelho. RESULTADOS: Os resultados eletrorretinográficos mais consistentes foram obtidos quando o animal foi estimulado por faixas espectrais seletivas, ao invés de luz branca; e são consistentes com a curva de absorbância das opsinas descritas em fotorreceptores de marsupiais. Estudos prévios sugeriram a tricromacia dos marsupiais por microespectrofotometria de opsinas e imuno-histoquímica de retina. Esse fundamento morfológico não tinha demonstração fisiológica eletrorretinográfica, até este estudo. CONCLUSÃO: O gambá sul-americano tem se mostrado interessante como animal experimental no estudo comparativo da fisiologia visual em mamíferos, especialmente no estudo filogenético da visão cromática. Os marsupiais apresentam um modelo retiniano que superpõe os sistemas fotópico e escotópico; e o gênero Didelphis conserva características encontradas em fósseis do período pleoceno. Portanto, o sistema visual de um marsupial resgata características dos primórdios da evolução dos mamíferos, até o desenvolvimento dos padrões retinianos modernos.

PURPOSE: To describe the electroretinogram of the South-American opossum (Didelphis aurita) obtained by chromatic stimulus of specific wavelengths. The electroretinogram records voltage variations of retinal cells triggered by light stimulation. The electroretinogram represents the combination of electric activity of many different cells and varies according to retinal physiology and examination methods. METHODS: We recorded the electroretinogram of six animals in dark adaptation using chromatic Kodak Wratten® filters, and recorded the spectral sensitivity to specific wavelengths in the spectrum of blue, green, yellow, orange and red light bands. RESULTS: The most consistent electrorretinographic results were obtained when the animals were stimulated by selective spectral bands instead of white light. These results are consistent with the absorbance curve of the opsins described in marsupial photoreceptors. Previous studies using microspectrophotometry of opsins and retinal immunohistochemistry suggested marsupial trichromacy. This morphologic knowledge has not before been physiologically demonstrated by electroretinographic methods. CONCLUSION: The South-American opossum has proven to be an interesting experimental animal for comparative visual physiology studies among other mammals, especially studies on phylogenetic of chromatic vision. The opossum represents a retinal model that superimposes both the photopic and scotopic systems; and the Didelphis genus shows few changes when compared to the fossils of the Pleocene period. Therefore the marsupial's visual system retrieves characteristics from ancient mammal evolution to the retinal patterns found in modern mammals.

Prevalência de discromatopsia em estudantes de medicina da Universidade Federal de Santa Catarina / Dyschromatopsia`s prevalence among medicine students of the Federal University Santa Catarina

Objetivo: Avaliar a prevalência de discromatopsia em estudantes de medicina da Universidade Federal de Santa Catarina. Método: Foi realizado um estudo transversal, de cunho epidemiológico, no período de outubro de 2003 a junho de 2004. A amostragem utilizada foi de 604 estudantes, de ambos os sexos, com idades variando entre 17 e 35 anos.Os estudantes foram avaliados através da leitura da edição simplificada e modificada do livro de Ishihara, constituída de oito lâminas pseudo-isocromáticas. Os indivíduos com alteração ao exame eram questionados sobre o conhecimento prévio da deficiência, história familiar, uso de medicamentos e dificuldades nas atividades diárias. Resultados: Encontrou-se uma prevalência de discromatopsia de 2,6% (n = 16) na amostra total e 4,95% entre os estudantes do sexo masculino. No grupo que foi detectada a deficiência, 31,3% (n = 5) referiam alguma dificuldade e 81,2% (n = 13) já tinham o conhecimento prévio da deficiência visual.Conclusão: A prevalência de discromatopsia nos estudantes de medicina foi de 2,6%, sendo encontrada exclusivamente no sexo masculino (4,95%)...

Postsynaptic calcium pathway contributes to synaptic plasticity between retinal cones and luminosity-type horizontal cells / 生理学报

It was previously found that the efficacy of synaptic transmission between retinal cone systems and luminosity-type horizontal cells (LHCs) was activity-dependent. Repetitive activation of red-cone pathway increased the LHCos hyperpolarizing response to red light, and the response enhancement was reversible. In this study, intracellular recording and pharmacological method were applied to investigate the mechanism(s) underlying red-flickering-induced response enhancement. Lowering intracellular Ca(2+) in the LHC by intracellular injection of Ca(2+) chelator EGTA prevented the development of red-flickering-induced response enhancement, which implicates the importance of postsynaptic calcium signal. The response enhancement could also be eliminated by a potent antagonist of Ca(2+)-permeable AMPA receptor (CP-AMPAR), which suggests the possibility that Ca(2+) influx via glutamate-gated calcium channels is related to the changes of [Ca(2+)](i). Furthermore, the administration of ryanodine or caffeine also attenuated the phenomenon, which gives evidence that the local calcium signal caused by intracellular calcium-induced calcium release (CICR) may be involved. Taken together, our data implicate that postsynaptic CICR and CP-AMPAR are related to the activity-dependent response enhancement.

Distrofias retinianas da infância: análise retrospectiva / Retinal dystrophies in childhood: retrospective analysis

OBJETIVOS: Descrever o quadro clínico e os resultados dos exames complementares dos pacientes portadores das seguintes distrofias retinianas: amaurose congênita de Leber (ACL), acromatopsia, distrofia de cones e distrofia mista, atendidos no Serviço de Visão Subnormal do Hospital São Geraldo da UFMG, no período de 1992 a 2003. MÉTODOS: Análise retrospectiva dos prontuários de 40 pacientes, sendo 10 portadores de ACL, 17 com acromatopsia, 6 com distrofia de cones e 7 com distrofia mista. RESULTADOS: A acuidade visual foi extremamente baixa na ACL, variando de 20/710 a percepção luminosa. Situou-se em torno de 20/200 na acromatopsia, 20/280 na distrofia de cones e 20/260 na mista. A alta hipermetropia foi o erro refracional mais comum na ACL, ao passo que a hipermetropia predominou na acromatopsia e na distrofia de cones e a miopia na mista. A fundoscopia mostrou-se alterada na maioria dos casos de ACL, distrofia de cones e distrofia mista e normal na maioria dos acromatas. A compressão óculo-digital e o enoftalmo foram exclusivos da ACL, ao passo que a fotofobia e a dificuldade na discriminação de cores predominaram nos outros grupos. O nistagmo e o estrabismo foram freqüentes em todos eles. O atraso no desenvolvimento neuro-psico-motor foi muito freqüente no grupo da ACL e quase ausente nos demais. A ACL apareceu associada a síndromes genéticas em 2 casos. Os sintomas da ACL e da acromatopsia se manifestaram ao nascimento ou no 1º ano de vida, ao passo que na distrofia de cones e na mista surgiram também em idades mais avançadas, porém não depois dos 10 anos. A consangüinidade e a história familiar positiva foram altamente prevalentes em todos os grupos. O ERG mostrou ausência de resposta na ACL, redução da resposta fotópica na acromatopsia e na distrofia de cones e redução difusa na mista. Os testes de visão de cores mostraram alterações principalmente na acromatopsia e na distrofia de cones. CONCLUSÕES: As distrofias retinianas da infância são um grupo heterogêneo de doenças que se manifestam por meio de sintomas inespecíficos. Uma análise cuidadosa dos sintomas, o exame oftalmológico completo e os exames complementares, principalmente ERG, testes de visão de cores e campo visual, podem ser úteis em seu diagnóstico.

Estabilidad de la película lagrimal post-lasik con solución de ácido hialurónico al 0.3 por ciento / Tear film stability lasik and hialuronic acid solution 0.3 percent

Determinar el efecto en la estabilidad de la película lagrimal de Acido Hialurónico en solución el 0.3 por ciento en pacientes sometidos a cirugía fotorefractiva con técnica de Lasik. Se estudiaron 59 ojos, de 30 pacientes, sometidos a cirugía fotorefractiva, con técnica de Lasik, divididos en 3 grupos; el grupo 1 con aplicación de Hialuronato de sodio al 0.4 por ciento, grupo 2 aplicación de Alcohol Polivinílico, grupo 3 Acido Hialurónico al 0.3 por ciento, a cada uno de los grupos se les realizaron pruebas de: Ruptura de película lagrimal, Grosor de capa lipídica, Schirmer 1, Tinción con Fluoresceína, Tinción con Rosa de Bengala, en el preoperatorio, postoperatorio a las 24 hrs, 7 días y 15 días. La aplicación de Acido Hialurónico en solución al 0.3 por ciento, demostró una diferencia estadísticamente significativa prolongando el tiempo de ruptura de la película lagrimal. Se encontró una diferencia estadísticamente significativa con la aplicación de la solución de Acido Hialurónico al 0.3 por ciento en la mejoría de la estabilidad de película lagrimal. La aplicación del Acido Hialurónico, mejora la estabilidad en la película lagrimal, disminuyendo la sintomatología de ojo seco en el postoperatorio inmediato post-lasik

Enzyme Histochemical Identification of a Subtype of Cone Photoreceptor in the Mammalian Retina

PURPOSE: To identify a subtype of cone photoreceptor in the mammalian retina using enzyme histochemical method. METHODS: In human, rabbits and cats, identification of cone photoreceptor was tried with carbonic anhydrase after retinal tissue isolation and section. RESULTS: In human, subtype of cone photoreceptor was identified. In rabbits, one type of carbonic anhydrase negative regular cell was detected and suspected as rod cells. In cats, only blue cone cell and rod cell were detected and no red-green cone cell was detected. CONCLUSIONS: In cats and rabbits, identification of red-green cone cell and blue cone cell was difficult. So, enzyme histochemical identification of cone photoreceptor using carbonic anhydrase need more research to imply in mammalian retina.

The opossum photoreceptors: a model for evolutionary trends in early mammalian retina

The topography and spectral characteristics of mammalian photoreceptors correlate with both, the present ecological demands and the evolutionary history. The South American Opossum is a marsupial mammal with unspecialized habitus and crepuscular lifestyle. A sparse population of cones (max. = 3000/mm2) can be differentiated into four subtypes by morphological, topographical and immunocytochemical criteria. In spite of this unusual diversity the cone types can be split into two functional groups: The population of single cones labeled by antibody OS-2 for short wavelenght sensitive pigments was ubiquitous but at very low densities (200/mm2). The single cones labeled by antibody (COS-1) against long wavelength sensitive pigments constitute the dominant population in the area centralis (2300/mm2). These two single cone types correlate with the pair typically present in placental mammals. Discrimination of spatial and color contrast may be provided by this "modern" set. The COS-1 labeled double and single cones bearing an oil droplet, display a different pattern by being restricted to the inferior (non-tapetal) half of the retina (max = 800/mm2). This additional set of cones with oil droplets and long wavelength pigments is a conservative feature of the opossum retina and other marsupials. As an accessory cone system it is possibly providing enhanced sensitivity at mesopic conditions. During the early evolution of nocturnal mammals with its prominent expansion of rod vision these cone types were conserved but then were lost in placental mammals. Thus the unique features of mammalian are the result of two evolutionary steps: first a reduction of cone based vision, followed by a secondary differentiation of photopic vision and behaviour relying on the remaining set of cones.

Avaliaçäo da funçäo macular e da funçäo dos cones em pacientes com retinose pigmentar por meio de: potencial visual evocado por padräo reverso, potencial visual evocado focal, flicker perimetria / Valuation of the remaining macular and cone function in retinitis pigmentosa patients. The electrophysiologycal tests of pattern visual evoked potencial, focal visual evoked potencial, flicker perimetry

Objetivo: Avaliar a funçäo da mácula e a funçäo dos cones em pacientes com retinose pigmentar (RP) por meio dos exames de potencial visual evocado (PVE) por padräo reverso (PVE-P) potencial visual evocado focal (PVE-F) e da flicker perimetria (FP). Método: O PVE-P realizado foi do tipo steady-state, com uma frequência de reversäo dos quadrados de 6 Hz. Foram testados cinco padröes diferentes: 160, 80, 40, 20 e 10 minutos de arco. Para a realizaçäo do PVE-F foi utilizada uma iluminaçäo homogênea que compreendia 4,5§ de ângulo visual do paciente. A intensidade de luz era controlada através de filtros de densidade neutra. A intensidade do estímulo sem nenhum filtro era de 14.290 mL. A FP era realizada em ambiente fotópico, com um estímulo de 2§, cuja frequência de piscamento era reduzida até que o paciente percebesse. Estimulava-se o centro (0§), e os pontos periféricos (5§, 10§, 20§, 30§, 40§, 50§ e 60§, no meridiano horizontal, tanto no sentido nasal como no temporal). Conclusöes: Em pacientes com RP e AV relativamente preservada, a funçäo da mácula e dos cones pôde ser mensurada pelos exames de PVE-P, PVE-F e FP. Houve uma boa correlaçäo positiva entre a AV e os testes de PVE-P, PVE-F e FP. Houve uma boa correlaçäo positiva entre o CV e o PVE-P. A correlaçäo entre o CV e o resultado do PVE-F e da FP foi fraca. A CAFP do PVE-P teve uma conformaçäo achatada. O gráfico da FP teve uma configuraçäo em montanha. Os cones da retina de pacientes com RP e AV relativamente preservada estavam acometidos em toda a extensäo testada, incluindo a mácula, porém o acometimento foi mais marcante nos cones da periferia do que nos cones da retina central. A funçäo visual remanescente na retina de pacientes com RP e AV relativamente preservada pode ser quantificada pelos exames de PVE-P, PVE-F e FP, permitindo que estes exames sejam incorporados à rotina de avaliaçäo e acompanhamento da progressäo da retinose pigmentar...