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Erschienen in: Documenta Ophthalmologica 2/2020

16.10.2019 | Original Research Article

Verifying complaints of difficulties in night vision using electroretinography and dark adaptation tests

verfasst von: Gilad Allon, Yolanda Friedrich, Eedy Mezer, Aviran Itzhaki, Rina Leibu, Ido Perlman

Erschienen in: Documenta Ophthalmologica | Ausgabe 2/2020

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Abstract

Purpose

To determine the electroretinographical and psychophysical parameters that can help to verify patients’ complaints of reduced night vision.

Methods

We tested 275 consecutive patients with normal appearing fundi, complaining of visual difficulties at night, using flash electroretinography (ERG) and dark adaptation (DA) test. Two ERG parameters were used to assess a scotopic retinal function: the amplitude of the response to dim blue flash (the rod response) and the b-wave ratio (measured/expected). Dark adaptation was measured with green- and red-light stimuli after exposure to a bright, bleaching light. The psychophysical parameter of night vision was defined as the threshold for detection of the blue-green stimulus that was measured after 40–45 min in complete darkness.

Results

Fifty-five patients were excluded from the analysis because of a discrepancy between the two ERG parameters in assessment of scotopic retinal function. The remaining 220 patients were divided into 4 groups: (1) normal ERG and normal DA, (2) subnormal ERG and subnormal DA, (3) normal ERG and subnormal DA and (4) subnormal ERG and normal DA. The ERG and DA tests supported the complaint of visual difficulties at night in 67 patients (group 2), while 34 patients were characterized as having normal scotopic visual function (group 1). The other 119 patients (groups 3 and 4) presented a diagnostic dilemma because one test (ERG or dark adaptation) showed normal scotopic function, while the other indicated subnormal scotopic function.

Conclusion

Our findings indicate that ERG is an essential, but not sufficient test for verifying patient’s complaint on visual difficulties in the dark. We suggest using both electroretinography and psychophysical dark adaptation to test patients complaining of reduced night vision.
Literatur
1.
Zurück zum Zitat Dryja TP (2000) Molecular genetics of Oguchi disease fundus albipunctatus, and other forms of stationary night blindness: LVII Edward Jackson Memorial Lecture. Am J Ophthalmol 130:547–563CrossRef Dryja TP (2000) Molecular genetics of Oguchi disease fundus albipunctatus, and other forms of stationary night blindness: LVII Edward Jackson Memorial Lecture. Am J Ophthalmol 130:547–563CrossRef
2.
Zurück zum Zitat Audo I, Robson AG, Holder GE, Moore AT (2008) The negative ERG: clinical phenotypes and disease mechanisms of inner retinal dysfunction. Surv Ophthalmol 53:16–40CrossRef Audo I, Robson AG, Holder GE, Moore AT (2008) The negative ERG: clinical phenotypes and disease mechanisms of inner retinal dysfunction. Surv Ophthalmol 53:16–40CrossRef
3.
Zurück zum Zitat Zeitz C, Robson AG, Audo I (2015) Congenital stationary night blindness: an analysis and update of genotype-phenotype correlations and pathogenic mechanisms. Prog Retinal Eye Res 45:58–110CrossRef Zeitz C, Robson AG, Audo I (2015) Congenital stationary night blindness: an analysis and update of genotype-phenotype correlations and pathogenic mechanisms. Prog Retinal Eye Res 45:58–110CrossRef
4.
Zurück zum Zitat Miyake Y, Yagasaki K, Horiguchi M, Kawase Y, Kanda T (1986) Congenital stationary night blindness with negative electroretinogram. A new classification. Arch Ophthalmol 104:1013–1020CrossRef Miyake Y, Yagasaki K, Horiguchi M, Kawase Y, Kanda T (1986) Congenital stationary night blindness with negative electroretinogram. A new classification. Arch Ophthalmol 104:1013–1020CrossRef
5.
Zurück zum Zitat Sergouniotis PI, Robson SG, Li Z, Devery S, Holder GE, Moore AT, Webster AR (2012) A phenotype study of congenital stationary night blindness (CSNB) associated with mutations in the GRM6 gene. Acta Ophthalmol 90:e192–e197CrossRef Sergouniotis PI, Robson SG, Li Z, Devery S, Holder GE, Moore AT, Webster AR (2012) A phenotype study of congenital stationary night blindness (CSNB) associated with mutations in the GRM6 gene. Acta Ophthalmol 90:e192–e197CrossRef
6.
Zurück zum Zitat Perlman I, Barzilai D, Haim T, Schramek A (1983) Night vision in a case of vitamin A deficiency due to malabsorption. Br J Ophthalmol 67:37–42CrossRef Perlman I, Barzilai D, Haim T, Schramek A (1983) Night vision in a case of vitamin A deficiency due to malabsorption. Br J Ophthalmol 67:37–42CrossRef
7.
Zurück zum Zitat Berson EL, Lessell S (1988) Paraneoplastic night blindness with malignant melanoma. Am J Ophthalmol 106:307–311CrossRef Berson EL, Lessell S (1988) Paraneoplastic night blindness with malignant melanoma. Am J Ophthalmol 106:307–311CrossRef
8.
Zurück zum Zitat Lei B, Bush RA, Milam AH et al (2000) Human melanoma-associated retinopathy (MAR) antibodies alter the retinal ON-response of the monkey ERG in vivo. Invest Ophthalmol Vis Sci 41:262–266PubMed Lei B, Bush RA, Milam AH et al (2000) Human melanoma-associated retinopathy (MAR) antibodies alter the retinal ON-response of the monkey ERG in vivo. Invest Ophthalmol Vis Sci 41:262–266PubMed
9.
Zurück zum Zitat Perlman I (1983) Relationship between the amplitudes of the b wave and the a wave as a useful index for evaluating the electroretinogram. Br J Ophthalmol 67:443–448CrossRef Perlman I (1983) Relationship between the amplitudes of the b wave and the a wave as a useful index for evaluating the electroretinogram. Br J Ophthalmol 67:443–448CrossRef
10.
Zurück zum Zitat Hecht S, Haig C, Chase AM (1937) The influence of light adaptation on subsequent dark adaptation of the eye. J Gen Physiol 20:831–850CrossRef Hecht S, Haig C, Chase AM (1937) The influence of light adaptation on subsequent dark adaptation of the eye. J Gen Physiol 20:831–850CrossRef
11.
Zurück zum Zitat Pugh EN Jr (1975) Rushton’s paradox: rod dark adaptation after fash photolysis. J Physiol 248:413–431CrossRef Pugh EN Jr (1975) Rushton’s paradox: rod dark adaptation after fash photolysis. J Physiol 248:413–431CrossRef
12.
Zurück zum Zitat Riggs LA (1954) Electroretinography in cases of night blindness. Am J Ophthalmol 38:70–78CrossRef Riggs LA (1954) Electroretinography in cases of night blindness. Am J Ophthalmol 38:70–78CrossRef
13.
Zurück zum Zitat Auerbach E, Godel V, Rowe H (1954) An electrophysiological and psychophysical study of two forms of congenital night blindness. Invest Ophthalmol 8:332–345 Auerbach E, Godel V, Rowe H (1954) An electrophysiological and psychophysical study of two forms of congenital night blindness. Invest Ophthalmol 8:332–345
14.
Zurück zum Zitat Marmor MF, Zeitz C (2018) Riggs-type dominant congenital stationary night blindness: ERG findings, a new GNAT1 mutation and a systemic association. Doc Ophthalmol 137:57–62CrossRef Marmor MF, Zeitz C (2018) Riggs-type dominant congenital stationary night blindness: ERG findings, a new GNAT1 mutation and a systemic association. Doc Ophthalmol 137:57–62CrossRef
15.
Zurück zum Zitat Khan NW, Kondo M, Hiriyanna KT, Jamison JA, Bush RA, Sievng PA (2005) Primate retinal signalling pathways: suppressing ON-pathway activity in monkey with glutamate analogues mimics human CSNB1-NYX genetic night blindness. J Neurophysiol 93:481–492CrossRef Khan NW, Kondo M, Hiriyanna KT, Jamison JA, Bush RA, Sievng PA (2005) Primate retinal signalling pathways: suppressing ON-pathway activity in monkey with glutamate analogues mimics human CSNB1-NYX genetic night blindness. J Neurophysiol 93:481–492CrossRef
16.
Zurück zum Zitat Oh A, Loew ER, Foster ML et al (2018) Phenotypic characterization of complete CSNB in the inbred research beagle: how common is CSNB in research and companion dogs? Doc Ophthalmol 137:87–101CrossRef Oh A, Loew ER, Foster ML et al (2018) Phenotypic characterization of complete CSNB in the inbred research beagle: how common is CSNB in research and companion dogs? Doc Ophthalmol 137:87–101CrossRef
17.
Zurück zum Zitat Slaughter MM, Miller RF (1981) 2-amini-4-phosphonobutyric acid: a mew pharmacological tool for retina research. Science 211:182–185CrossRef Slaughter MM, Miller RF (1981) 2-amini-4-phosphonobutyric acid: a mew pharmacological tool for retina research. Science 211:182–185CrossRef
18.
Zurück zum Zitat Stockton RA, Slaughter MM (1989) B-wave of the electroretinogram. A reflection of ON bipolar cell activity. J Gen Physiol 93:101–122CrossRef Stockton RA, Slaughter MM (1989) B-wave of the electroretinogram. A reflection of ON bipolar cell activity. J Gen Physiol 93:101–122CrossRef
19.
Zurück zum Zitat Sieving PA, Murayama K, Naareddrop F (1994) Push-pull model of the primate photopic electroretinogram: a role for hyperpolarizing neurons in shaping the b-wave. Vis Neurosci 11:519–532CrossRef Sieving PA, Murayama K, Naareddrop F (1994) Push-pull model of the primate photopic electroretinogram: a role for hyperpolarizing neurons in shaping the b-wave. Vis Neurosci 11:519–532CrossRef
20.
Zurück zum Zitat Rodieck RW (1973) The vertebrate retina: principles of structure and function. W.H. Freeman, San Francisco Rodieck RW (1973) The vertebrate retina: principles of structure and function. W.H. Freeman, San Francisco
21.
Zurück zum Zitat Perlman I (1995) The electroretinogram: ERG. In: Kolb H, Fernandez E, Nelson R (eds) Webvision: the organization of the retina and visual system. University of Utah Health Sciences Center, Salt Lake City Perlman I (1995) The electroretinogram: ERG. In: Kolb H, Fernandez E, Nelson R (eds) Webvision: the organization of the retina and visual system. University of Utah Health Sciences Center, Salt Lake City
22.
Zurück zum Zitat Fitzgerald KM, Cibis GW, Giambrone SA, Harriz DJ (1994) Retinal signal transmission in duchenne muscular dystrophy: evidence for dysfunction in the photoreceptor/depolarizing bipolar cell pathwy. J Clin Invest 93:2425–2430CrossRef Fitzgerald KM, Cibis GW, Giambrone SA, Harriz DJ (1994) Retinal signal transmission in duchenne muscular dystrophy: evidence for dysfunction in the photoreceptor/depolarizing bipolar cell pathwy. J Clin Invest 93:2425–2430CrossRef
23.
Zurück zum Zitat Tremblay F, De Becker I, Riddell DC, Dooley JM (1994) Duchenne muscular dystrophy: negative scotopic bright-flash electroretinogram and normal dark adaptation. Can J Ophthalmol 29:280–283PubMed Tremblay F, De Becker I, Riddell DC, Dooley JM (1994) Duchenne muscular dystrophy: negative scotopic bright-flash electroretinogram and normal dark adaptation. Can J Ophthalmol 29:280–283PubMed
24.
Zurück zum Zitat Jensen H, Warburg M, Sjo O, Schwartz M (1995) Duchenne muscular dystrophy: negative electroretinogram and normal dark adaptation. Reappraisal of assignment of X linked incomplete congenital stationary night blindness. J Med Genet 32:348–351CrossRef Jensen H, Warburg M, Sjo O, Schwartz M (1995) Duchenne muscular dystrophy: negative electroretinogram and normal dark adaptation. Reappraisal of assignment of X linked incomplete congenital stationary night blindness. J Med Genet 32:348–351CrossRef
25.
Zurück zum Zitat Fitzgerald KM, Hashimoto T, Hug TE, Cibis GW, Harris DJ (2001) Autosomal dominant inheritance of a negative electroretinogram phenotype in three generations. Am J Ophthalmol 131:495–502CrossRef Fitzgerald KM, Hashimoto T, Hug TE, Cibis GW, Harris DJ (2001) Autosomal dominant inheritance of a negative electroretinogram phenotype in three generations. Am J Ophthalmol 131:495–502CrossRef
26.
Zurück zum Zitat Sobaci G, Erdem U, Uysal Y, Gundogan FC, Bayraktar MZ (2007) Negative electroretinogram in the differential diagnosis of malingering of night blindness in the military. Mil Med 172:402–404CrossRef Sobaci G, Erdem U, Uysal Y, Gundogan FC, Bayraktar MZ (2007) Negative electroretinogram in the differential diagnosis of malingering of night blindness in the military. Mil Med 172:402–404CrossRef
27.
Zurück zum Zitat Asi H, Perlman I (1992) Relationship between the electroretinogram a-wave, b-wave and oscillatory potentials and their application to clinical diagnosis. Doc Ophthalmol 79:125–139CrossRef Asi H, Perlman I (1992) Relationship between the electroretinogram a-wave, b-wave and oscillatory potentials and their application to clinical diagnosis. Doc Ophthalmol 79:125–139CrossRef
Metadaten
Titel
Verifying complaints of difficulties in night vision using electroretinography and dark adaptation tests
verfasst von
Gilad Allon
Yolanda Friedrich
Eedy Mezer
Aviran Itzhaki
Rina Leibu
Ido Perlman
Publikationsdatum
16.10.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Documenta Ophthalmologica / Ausgabe 2/2020
Print ISSN: 0012-4486
Elektronische ISSN: 1573-2622
DOI
https://doi.org/10.1007/s10633-019-09729-z

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