Refractive changes after descemet stripping endothelial keratoplasty: a simplified mathematical model.

PURPOSE: To develop a mathematical model that can predict refractive changes after Descemet stripping endothelial keratoplasty (DSEK). METHODS: A mathematical formula based on the Gullstrand eye model was generated to estimate the change in refractive power of the eye after DSEK. This model was applied to four DSEK cases retrospectively, to compare measured and predicted refractive changes after DSEK. RESULTS: The refractive change after DSEK is determined by calculating the difference in the power of the eye before and after DSEK surgery. The power of the eye post-DSEK surgery can be calculated with modified Gullstrand eye model equations that incorporate the change in the posterior radius of curvature and change in the distance between the principal planes of the cornea and lens after DSEK. Analysis of this model suggests that the ratio of central to peripheral graft thickness (CP ratio) and central thickness can have significant effect on refractive change where smaller CP ratios and larger graft thicknesses result in larger hyperopic shifts. This model was applied to four patients, and the average predicted hyperopic shift in the overall power of the eye was calculated to be 0.83 D. This change reflected in a mean of 93% (range, 75%-110%) of patients' measured refractive shifts. CONCLUSIONS: This simplified DSEK mathematical model can be used as a first step for estimating the hyperopic shift after DSEK. Further studies are necessary to refine the validity of this model.

The steady-state visual evoked potential in vision research: A review.

Periodic visual stimulation and analysis of the resulting steady-state visual evoked potentials were first introduced over 80 years ago as a means to study visual sensation and perception. From the first single-channel recording of responses to modulated light to the present use of sophisticated digital displays composed of complex visual stimuli and high-density recording arrays, steady-state methods have been applied in a broad range of scientific and applied settings.The purpose of this article is to describe the fundamental stimulation paradigms for steady-state visual evoked potentials and to illustrate these principles through research findings across a range of applications in vision science.

A subcortical source of visual input to the frontal eye field

Many neurons in the frontal eye field (FEF) exhibit visual responses and are thought to play important roles in visuosaccadic behavior. The FEF, however, is far removed from striate cortex. Where do the FEF's visual signals come from? Usually they are reasonably assumed to enter the FEF through afferents from extrastriate cortex. Here we show that, surprisingly, visual signals also enter the FEF through a subcortical route: a disynaptic, ascending pathway originating in the intermediate layers of the superior colliculus (SC). We recorded from identified neurons at all three stages of this pathway (n=30-40 in each sample): FEF recipient neurons, orthodromically activated from the SC; mediodorsal thalamus (MD) relay neurons, antidromically activated from FEF and orthodromically activated from SC; and SC source neurons, antidromically activated from MD. We studied the neurons while monkeys performed delayed saccade tasks designed to temporally resolve visual responses from presaccadic discharges. We found, first, that most neurons at every stage in the pathway had visual responses, presaccadic bursts, or both. Second, we found marked similarities between the SC source neurons and MD relay neurons: in both samples, about 15% of the neurons had only a visual response, 10% had only a presaccadic burst, and 75% had both. In contrast, FEF recipient neurons tended to be more visual in nature: 50% had only a visual response, none had only a presaccadic burst, and 50% had both a visual response and a presaccadic burst. This suggests that in addition to their subcortical inputs, these FEF neurons also receive other visual inputs, e.g. from extrastriate cortex. We conclude that visual activity in the FEF results not only from cortical afferents but also from subcortical inputs. Intriguingly, this implies that some of the visual signals in FEF are pre-processed by the SC.

The frontal eye field sends predictively remapped visual signals to the superior colliculus

We perceive a stable visual world even though saccades often move our retinas. One way the brain may achieve a stable visual percept is through predictive remapping of visual receptive fields: just before a saccade, the receptive field of many neurons moves from its current location ("current receptive field") to the location it is expected to occupy after the saccade ("future receptive field"). Goldberg and colleagues found such remapping in cortical areas, e.g. in the frontal eye field (FEF), as well as in the intermediate layers of the superior colliculus (SC). In the present study we investigated the source of the SC's remapped visual signals. Do some of them come from the FEF? We identified FEF neurons that project to the SC using antidromic stimulation. For neurons with a visual response, we tested whether the receptive field shifted just prior to making a saccade. Saccadic amplitudes were chosen to be as small as possible while clearly separating the current and future receptive fields; they ranged from 5-30 deg. in amplitude and were directed contraversively. The saccadic target was a small red spot. We probed visual responsiveness at the current and future receptive field locations using a white spot flashed at various times before or after the saccade. Predictive remapping was indicated by a visual response to a probe flashed in the future receptive field just before the saccade began. We found that many FEF neurons projecting to the SC exhibited predictive remapping. Moreover, the remapping was as fast and strong as any previously reported for FEF or SC. It is clear, therefore, that remapped visual signals are sent from FEF to SC, providing direct evidence that the FEF is one source of the SC's remapped visual signals. Because remapping requires information about an imminent saccade, we hypothesize that remapping in FEF depends on corollary discharge signals such as those ascending from the SC through MD thalamus (Sommer and Wurtz 2002).