scholarly journals Exploratory Study of the Association between the Severity of Idiopathic Intracranial Hypertension and Electroretinogram Photopic Negative Response Amplitude Obtained Using a Handheld Device

Life ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 437
Author(s):  
Antony Raharja ◽  
Shaun M. Leo ◽  
Isabelle Chow ◽  
Mathura Indusegaran ◽  
Christopher J. Hammond ◽  
...  
Keyword(s):  
Intracranial Hypertension ◽  
Disease Severity ◽  
Idiopathic Intracranial Hypertension ◽  
Retinal Nerve Fibre Layer ◽  
Negative Response ◽  
Photopic Negative Response ◽  
Mean Deviation ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Handheld Device

The photopic negative response (PhNR) is a negative component of the photopic flash electroretinogram that follows the b-wave and is thought to arise from the retinal ganglion cells. Reduction in its amplitude in idiopathic intracranial hypertension (IIH) has been previously documented using formal electroretinography. This study explored the use of a handheld device (RETeval, LKC technologies, USA) in 72 IIH patients of varying stages and severity (and seven controls) and investigated associations between PhNR parameters and disease severity. PhNR amplitudes at 72ms (P72) and p-ratio (ratio to b-wave peak value) differed significantly across groups, with a trend towards smaller amplitudes in those with severe IIH, defined as papilloedema with Modified Frisén Scale (MFS) ≥ 3, retinal nerve fibre layer (RNFL) ≥ 150μm or atrophic papilloedema (p = 0.0048 and p = 0.018 for P72 and p-ratio, respectively). PhNR parameters did not correlate with MFS, RNFL thickness, standard automated perimetry mean deviation or macular ganglion cell layer volume. This study suggests that PhNR measurement using a handheld device is feasible and could potentially augment the assessment of disease severity in IIH. The clinical utility of PhNR monitoring in IIH patients requires further investigation.

scholarly journals Clinical Applications of the Photopic Negative Response to Optic Nerve and Retinal Diseases

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Shigeki Machida
Keyword(s):  
Optic Nerve ◽  
Ganglion Cells ◽  
Objective Assessment ◽  
Visual Sensitivity ◽  
Negative Response ◽  
Photopic Negative Response ◽  
Retinal Diseases ◽  
Automated Perimetry ◽  
Retinal Ganglion ◽  
Standard Automated Perimetry

The photopic negative response (PhNR) in response to a brief flash is a negative-going wave following the b-wave of the cone electroretinogram (ERG) that is driven by retinal ganglion cells (RGCs). The function of RGCs is objectively evaluated by analysing the PhNR. We reviewed articles regarding clinical use of the PhNR. The PhNR was well correlated with the visual sensitivity obtained by standard automated perimetry and morphometric parameters of the inner retina and optic nerve head in optic nerve and retinal diseases. Moreover, combining the PhNR with focal or multifocal ERG techniques enables the objective assessment of local function of RGCs. The PhNR is therefore likely to become established as an objective functional test for optic nerve and retinal diseases involving RGC injury.

scholarly journals Association between visual field damage and corneal structural parameters

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alexandru Lavric ◽  
Valentin Popa ◽  
Hidenori Takahashi ◽  
Rossen M. Hazarbassanov ◽  
Siamak Yousefi
Keyword(s):  
Machine Learning ◽  
Visual Field ◽  
Structural Parameters ◽  
Corneal Thickness ◽  
Anterior Segment ◽  
Mean Deviation ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Visual Field Damage ◽  
Corneal Shape

AbstractThe main goal of this study is to identify the association between corneal shape, elevation, and thickness parameters and visual field damage using machine learning. A total of 676 eyes from 568 patients from the Jichi Medical University in Japan were included in this study. Corneal topography, pachymetry, and elevation images were obtained using anterior segment optical coherence tomography (OCT) and visual field tests were collected using standard automated perimetry with 24-2 Swedish Interactive Threshold Algorithm. The association between corneal structural parameters and visual field damage was investigated using machine learning and evaluated through tenfold cross-validation of the area under the receiver operating characteristic curves (AUC). The average mean deviation was − 8.0 dB and the average central corneal thickness (CCT) was 513.1 µm. Using ensemble machine learning bagged trees classifiers, we detected visual field abnormality from corneal parameters with an AUC of 0.83. Using a tree-based machine learning classifier, we detected four visual field severity levels from corneal parameters with an AUC of 0.74. Although CCT and corneal hysteresis have long been accepted as predictors of glaucoma development and future visual field loss, corneal shape and elevation parameters may also predict glaucoma-induced visual functional loss.

scholarly journals Visual Field Mean Deviation at Diagnosis of Idiopathic Intracranial Hypertension Predicts Visual Outcome

2019 ◽  
Vol 39 (2) ◽  
pp. 186-190 ◽  
Author(s):  
Shravani Mikkilineni ◽  
Jonathan D. Trobe ◽  
Wayne T. Cornblath ◽  
Lindsey De Lott
Keyword(s):  
Visual Field ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Visual Outcome ◽  
Mean Deviation

scholarly journals Comparison of Machine Learning Approaches to Improve Diagnosis of Optic Neuropathy Using Photopic Negative Response Measured Using a Handheld Device

2021 ◽  
Vol 8 ◽  
Author(s):  
Tina Diao ◽  
Fareshta Kushzad ◽  
Megh D. Patel ◽  
Megha P. Bindiganavale ◽  
Munam Wasi ◽  
...  
Keyword(s):  
Machine Learning ◽  
Time Series ◽  
Optic Neuropathy ◽  
Negative Response ◽  
Photopic Negative Response ◽  
Learning Approaches ◽  
Data Set ◽  
Full Field ◽  
Handheld Device ◽  
Technical Requirements

The photopic negative response of the full-field electroretinogram (ERG) is reduced in optic neuropathies. However, technical requirements for measurement and poor classification performance have limited widespread clinical application. Recent advances in hardware facilitate efficient clinic-based recording of the full-field ERG. Time series classification, a machine learning approach, may improve classification by using the entire ERG waveform as the input. In this study, full-field ERGs were recorded in 217 eyes (109 optic neuropathy and 108 controls) of 155 subjects. User-defined ERG features including photopic negative response were reduced in optic neuropathy eyes (p < 0.0005, generalized estimating equation models accounting for age). However, classification of optic neuropathy based on user-defined features was only fair with receiver operating characteristic area under the curve ranging between 0.62 and 0.68 and F1 score at the optimal cutoff ranging between 0.30 and 0.33. In comparison, machine learning classifiers using a variety of time series analysis approaches had F1 scores of 0.58–0.76 on a test data set. Time series classifications are promising for improving optic neuropathy diagnosis using ERG waveforms. Larger sample sizes will be important to refine the models.

scholarly journals Estimating Rates of Progression and Predicting Future Visual Fields in Glaucoma Using a Deep Variational Autoencoder

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Samuel I. Berchuck ◽  
Sayan Mukherjee ◽  
Felipe A. Medeiros
Keyword(s):  
Visual Field ◽  
Learning Algorithm ◽  
Visual Fields ◽  
Visual Field Loss ◽  
Absolute Error ◽  
Rate Of Change ◽  
Mean Deviation ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Deep Learning Algorithm

AbstractIn this manuscript we develop a deep learning algorithm to improve estimation of rates of progression and prediction of future patterns of visual field loss in glaucoma. A generalized variational auto-encoder (VAE) was trained to learn a low-dimensional representation of standard automated perimetry (SAP) visual fields using 29,161 fields from 3,832 patients. The VAE was trained on a 90% sample of the data, with randomization at the patient level. Using the remaining 10%, rates of progression and predictions were generated, with comparisons to SAP mean deviation (MD) rates and point-wise (PW) regression predictions, respectively. The longitudinal rate of change through the VAE latent space (e.g., with eight dimensions) detected a significantly higher proportion of progression than MD at two (25% vs. 9%) and four (35% vs 15%) years from baseline. Early on, VAE improved prediction over PW, with significantly smaller mean absolute error in predicting the 4th, 6th and 8th visits from the first three (e.g., visit eight: VAE8: 5.14 dB vs. PW: 8.07 dB; P < 0.001). A deep VAE can be used for assessing both rates and trajectories of progression in glaucoma, with the additional benefit of being a generative technique capable of predicting future patterns of visual field damage.

scholarly journals Threshold Static Automated Perimetry of the Full Visual Field in Idiopathic Intracranial Hypertension

2019 ◽  
Vol 60 (6) ◽  
pp. 1898 ◽  
Author(s):  
Michael Wall ◽  
Ashwin Subramani ◽  
Luke X. Chong ◽  
Ramon Galindo ◽  
Andrew Turpin ◽  
...  
Keyword(s):  
Visual Field ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Automated Perimetry

scholarly journals Influence of Optic Nerve Appearance on Visual Outcome in Pediatric Idiopathic Intracranial Hypertension

2020 ◽  
Vol 47 (5) ◽  
pp. 661-665 ◽  
Author(s):  
Jonathan A. Micieli ◽  
Beau B. Bruce ◽  
Caroline Vasseneix ◽  
Richard J. Blanch ◽  
Damian E. Berezovsky ◽  
...  
Keyword(s):  
Intracranial Hypertension ◽  
Optic Disc ◽  
Idiopathic Intracranial Hypertension ◽  
Visual Outcome ◽  
Mean Deviation ◽  
Visual Outcomes ◽  
Cotton Wool Spots ◽  
Institutional Review ◽  
Diagnostic Lumbar Puncture

ABSTRACT:Objectives:To determine whether optic disc hemorrhages (ODH) and cotton wool spots (CWS) at presentation are associated with worse visual outcomes in pediatric patients with idiopathic intracranial hypertension (IIH).Methods:Retrospective institutional review of 100 eyes of 50 consecutive pediatric IIH patients (aged 16 years or less) who had baseline optic disc photographs before or within 30 days of their diagnostic lumbar puncture and initiation of medical treatment. Optic disc photographs were independently graded by three ophthalmologists in a standardized manner. Visual function was assessed using visual acuity (VA) and visual field grade (VFG).Results:At least one ODH was found in 41% of eyes, at least one CWS was found in 27% of eyes, and 20% of eyes had both ODH and CWS. At presentation, Frisén grade was associated with the presence of CWS (p = 0.013) and showed no association with ODH (p = 0.060). When controlling for Frisén grade, ODH and CWS were not associated with worse VA or VFG at final follow-up. Severe ODH were associated with worse VA and VFG at presentation (p < 0.03), but not at final follow-up. Severe CWS at presentation was strongly associated with a worse Humphrey mean deviation of 5.0 dB (95% confidence interval 1.6–8.3) at final follow-up (p = 0.002).Conclusion:When controlling for the severity of papilledema, ODH do not provide any additional prognostic value in pediatric IIH patients. Frisén grade and severe CWS at presentation were independently associated with worse visual outcomes at the final follow-up.

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