Toward a Clinical Protocol for Assessing Rod, Cone, and Melanopsin Contributions to the Human Pupil Response


Autoria(s): PARK, Jason C.; MOURA, Ana L.; RAZA, Ali S.; RHEE, David W.; KARDON, Randy H.; HOOD, Donald C.
Contribuinte(s)

UNIVERSIDADE DE SÃO PAULO

Data(s)

20/10/2012

20/10/2012

2011

Resumo

PURPOSE. To better understand the relative contributions of rod, cone, and melanopsin to the human pupillary light reflex (PLR) and to determine the optimal conditions for assessing the health of the rod, cone, and melanopsin pathways with a relatively brief clinical protocol. METHODS. PLR was measured with an eye tracker, and stimuli were controlled with a Ganzfeld system. In experiment 1, 2.5 log cd/m(2) red (640 +/- 10 nm) and blue (467 +/- 17 nm) stimuli of various durations were presented after dark adaptation. In experiments 2 and 3, 1-second red and blue stimuli were presented at different intensity levels in the dark (experiment 2) or on a 0.78 log cd/m(2) blue background (experiment 3). Based on the results of experiments 1 to 3, a clinical protocol was designed and tested on healthy control subjects and patients with retinitis pigmentosa and Leber`s congenital amaurosis. RESULTS. The duration for producing the optimal melanopsin-driven sustained pupil response after termination of an intense blue stimulus was 1 second. PLR rod-and melanopsin-driven components are best studied with low-and high-intensity flashes, respectively, presented in the dark (experiment 2). A blue background suppressed rod and melanopsin responses, making it easy to assess the cone contribution with a red flash (experiment 3). With the clinical protocol, robust melanopsin responses could be seen in patients with few or no contributions from the rods and cones. CONCLUSIONS. It is possible to assess the rod, cone, and melanopsin contributions to the PLR with blue flashes at two or three intensity levels in the dark and one red flash on a blue background. (Invest Ophthalmol Vis Sci. 2011; 52: 6624-6635) DOI: 10.1167/iovs.11-7586

National Institutes of Health (NIH)

National Institutes of Health (NIH)[R01-EY-09076]

Department of Veterans Affairs (Rehabilitation, Research and Development Division)

Department of Veterans Affairs (Rehabilitation, Research and Development Division)

National Institutes of Health/National Eye Institute (NIH)[1R01EY018853-01A2]

National Institutes of Health/National Eye Institute (NIH)

US Department of Defense (DoD)

US Department of Defense (DoD)[TATRC VRP09]

Research to Prevent Blindness

Research to Prevent Blindness

Pomerantz Family Endowed Chair

Pomerantz Family Endowed Chair

Identificador

INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE, v.52, n.9, p.6624-6635, 2011

0146-0404

http://producao.usp.br/handle/BDPI/32176

10.1167/iovs.11-7586

http://dx.doi.org/10.1167/iovs.11-7586

Idioma(s)

eng

Publicador

ASSOC RESEARCH VISION OPHTHALMOLOGY INC

Relação

Investigative Ophthalmology & Visual Science

Direitos

restrictedAccess

Copyright ASSOC RESEARCH VISION OPHTHALMOLOGY INC

Palavras-Chave #RETINAL GANGLION-CELLS #LEBERS CONGENITAL AMAUROSIS #HEREDITARY OPTIC NEUROPATHY #SWINGING FLASHLIGHT TEST #LIGHT REFLEX #IMPLANTATION #BISTABILITY #ADAPTATION #TRANSIENT #VISION #Ophthalmology
Tipo

article

original article

publishedVersion