Abstract
There is no ideal electrophysiological test for retinal pigment epithelial (RPE) function. The light-induced responses (EOG, c-wave, fast oscillation) that require photoreception are not pure RPE signals, and even the widely-used EOG has not been associated with any specific physiological disturbance of the RPE or retina. The discovery of non-photic RPE responses (hyperosmolarity, acetazolamide and bicarbonate) has enhanced the possibility of finding tissue-specific RPE tests, but these responses have yet to be correlated with specific RPE functional activity or pathology. We may face a dilemma in our search for RPE tests, insofar as electrophysiology measures membrane changes, but RPE membrane activity is related only indirectly to many functions of the RPE cell. These concerns notwithstanding, RPE electrophysiology can be a valuable clinical tool if one accounts for the physiological limitations and assets of the procedures.
Similar content being viewed by others
References
Marmor MF, Lurie M. Light-induced electrical responses of the pigment epithelium: Physiological properties and clinical significance of the c-wave, standing potential changes (EOG) and melanin response. In: Zinn K, Marmor MF, eds. The retinal pigment epithelium. Cambridge: Harvard University Press, 1979: 226–46.
Marmor MF. Clinical electrophysiologic tests for evaluating the retinal pigment epithelium. In: Zingirian M, Piccolino FC, eds. Retinal pigment epithelium: Proceedings of the International Meeting of S. Margherita Ligure, Italy, 1988. Amsterdam: Kugler & Ghedini Publications, 1989: 9–15.
Holmgren F. Method att objectivera effecten afljusintryck pa retina. Upsala Lakarforenings Forhandlingar 1865, 1: 184–98.
Dewar J, M'Kendrick JG. On the physiological action of light. Trans R Soc. Edinburgh 1873; 27: 141–66.
Miles WR. Modifications of the human-eye potential by dark and light adaptation. Science 1940; 91: 456.
Kolder H. Spontane und experimentelle Anderungen des Bestandpotenials des menschlichen Auges. Pfluegers Arch 1959; 268: 258–72.
Arden GB, Kelsey JH. Changes produced by light in the standing potential of the human eye. J Physiol 1962; 161: 189–204.
Arden GB, Barrada A, Kelsey, JH. New clinical test of retinal function based upon the standing potential of the eye. Br J Ophthalmol 1962; 46: 449–67.
Thaler A, Heilig P, Gordesch J. Light peak to dark trough ratio in clinical electrooculography. Bibl Ophthal 1976; 85: 110–4.
Cross HE. Electro-oculography in Best's macular dystrophy. Am J Ophthalmol 1974; 77: 46–50.
Taumer R, Rohde N, Wollensak J. Course of disturbance of EOG in retinal vessel occlusions. Graefes Arch Clin Exp Ophthalmol 1982; 219: 29–33.
Krill AE. Retinopathy secondary to rubella. Int Ophthalmol Clin 1972; 12: 89–103.
Weingeist TA, Kobrin JL, Watzke RC. Histopathology of Best's macular dystrophy. Arch Ophthalmol 1982; 100: 1108–14.
Frangieh GT, Green WR, Fine SL. A histopathologic study of Best's macular dystrophy. Arch Ophthalmol 1982; 100: 1115–21.
Steinberg RH, Miller SS. Transport and membrane properties of the retinal pigment epithelium. In: Zinn K, Marmor MF, eds. The retinal pigment epithelium, Cambridge: Harvard University Press, 1979: 205–25.
Steinberg RH, Schmidt R, Brown KT. Intracellular responses to light from cat pigment epithelium: origin of the electroretinogram c-wave. Nature 1970; 227: 728–30.
Oakley B II, Green DG. Correlation of light-induced changes in retinal extracellular potassium concentration with c-wave of the electroretinogram. J Neurophysiol 1976; 39: 1117–33.
Lurie M, Marmor MF. Similarities between the c-wave and slow PIII in the rabbit eye. Invest Ophthalmol Vis Sci 1980; 19: 1113–7.
Lurie M, Marmor MF. Light-induced electrical responses of the retinal pigment epithelium. In Tazawa Y, ed. XXIII Concilium Ophthalmologicum, Kyoto, 1978. Jap J Ophthalmol 1979; 1: 129–33.
Hanitzsch R. The time course of the light-induced extracellular potassium change around receptors and at the vitreal surface compared with the time course of slow PIII wave in the isolated rabbit retina. Physiol Bohemoslov 1988; 37: 227–33.
Steinberg RH, Linsermeier RA, Griff ER. Three light-evoked responses of the retinal pigment epithelium. Vision Res 1983; 23: 1315–23.
Gallemore RP, Griff ER, Steinberg RH. Evidence in support of a photoreceptoral origin for the ‘light-peak’ substance. Invest Ophthalmol Vis Sci 1988; 29: 566–71.
Yonemura D, Kawasaki K. New approaches to ophthalmic electrodiagnosis by retinal oscillatory potential, drug-induced responses from retinal pigment epithelium and cone potential. Doc Ophthalmol 1979; 48: 163–222.
Kawasaki K, Mukoh S, Yonemura D, Fujii S, Segawa Y. Acetazolamide-induced changes of the membrane potentials of the reinal pigment epithelial cell. Doc Ophthalmol 1986; 63: 375–81.
Mukoh S, Kawasaki K, Yonemura D, Tanabe J. Hyperosmolarity-induced hyperpolarization of the membrane potential of the retinal pigment epithelium. Doc Ophthalmol 1985; 60: 369–74.
Segawa Y. Electrical response of the retinal pigment epithelium to sodium bicarbonate, I: experimental studies in animals. J Juzen Med Soc 1987; 96: 1008–21.
Nilsson SE, Andersson BE. Corneal D.C. recordings of slow ocular potential changes such as the ERG c-wave and the light peak in clinical work. Doc Ophthalmol 1988; 68: 313–25.
Marmor MF, Hock PA. A practical method for c-wave recording in man. Doc Ophthalmol Proc Series 1982; 31: 67–72.
Hock PA, Marmor MF. Variability of the human c-wave. Doc Ophthalmol Proc Series 1983; 37: 151–7.
Nilsson SE, Skoog K-O. The ERG c-wave in vitelliruptive macular degeneration (VMD). Acta Ophthalmol 1980; 58: 659–66.
Rover J, Bach M. The C-wave in hereditary degenerations of the ocular fundus. Doc Ophthalmol 1985; 60; 127–32.
Marmor MF. Retinal detachment from hyperosmotic intravitreal injection. Invest Ophthalmol Vis Sci 1979; 18: 1237–44.
Kolder H, Brecher GA. Fast oscillations of the corneoretinal potential in man. Arch Ophthalmol 1966; 75: 232–37.
Thaler ARG, Lessel MR, Heilig P, Scheiber V. The fast oscillation of the electro-oculogram. Ophthalmic Res 1982; 14: 210–14.
DeRouck A, Kayembe D. A clinical procedure for the simultaneous recording of fast and slow EOG oscillations. Int Ophthalmol 1981; 3: 179–89.
Weleber RG. Fast and slow oscillations of the electro-oculogram in Best's macular dystrophy and retinitis pigmentosa. Arch Ophthalmol 1989; 107: 530–7.
Steinberg RH. Monitoring communications between photoreceptors and pigment epithelial cells: effects of ‘mild’ systemic hypoxia [Friedenwald Lecture]. Invest Ophthalmol Vis Sci 1987; 27: 1888–1904.
Marmor MF, Donovan WJ, Gaba DM. Effects of hypoxia and hyperoxia on the human standing potential. Doc Ophthalmol 1985; 60: 347–52.
Yonemura D, Kawasaki K, Madachi-Yamamoto S. Hyperosmolarity response of ocular standing potential as a clinical test for retinal pigment epithelium activity. Chorioretinal Dystrophies 1984; 56: 163–73.
Yonemura D, Kawasaki K, Wakabayashi K, Madachi-Yamamoto S, Kawaguchi I. New approach to electrophysiological analysis of flecked retina syndrome. Doc Ophthalmol Proc Series 1982; 31: 165–75.
Yonemura D, Kawasaki K, Wakabayashi K, Tanabe J. EOG application for Stargardt's disease and X-lined juvenile retinoschisis. Doc Ophthalmol Proc Series 1983; 37: 115–20.
Kawasaki K, Madachi-Yamamoto S, Yonemura D. Hyperosmolarity response of ocular standing potential as a clinical test for retinal pigment epithelium activity: rhegmatogenous retinal detachment. Doc Ophthalmol 1984; 57: 175–80.
Kawasaki K, Yonemura D, Yanagida T, Segawa Y, Wakabayashi K, Mukoh S, Ishida H, Fujii S, Takahara Y. Suppression of hyperosmolarity response after cataract surgery. Doc Ophthalmol 1986; 63: 367–73.
Segawa Y. Electrical response of the retinal pigment epithelium to sodium bicarbonate: II. Clinical use for electrophysiological evaluation of the retinal pigment epithelium activity. J Juzem Med Soc 1987; 96: 1022–41.
Mori T, Miyoshi K, Tazawa Y, Marmor MF. Combining photic and non-photic EOG responses for clinical evaluation of the RPE. Invest Ophthalmol Vis Sci 1989; 30 (suppl): 235.
Joseph D, Miller S. Alpha-adrenergic receptors mediate basal membrane voltage and resistance changes in bovine and retinal pigment epithelium (RPE). Invest Ophthalmol Vis Sci 1988; 29 (suppl): 20.
Marmor MF, Maack, T. Enhancement of retinal adhesion and subretinal fluid resorption by acetazolamide. Invest Ophthalmol Vis Sci 1982; 23: 121–4.
Cox SN, Hay E, Bird AC. Treatment of chronic macular edema with acetazolamide. Arch Ophthalmol 1988; 106: 1190–95.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Marmor, M.F. Clinical electrophysiology of the retinal pigment epithelium. Doc Ophthalmol 76, 301–313 (1991). https://doi.org/10.1007/BF00142668
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00142668