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Full-Field Pupillary Light Responses, Luminance Thresholds, and Light Discomfort Thresholds in CEP290 Leber Congenital Amaurosis Patients
Journal article   Open access   Peer reviewed

Full-Field Pupillary Light Responses, Luminance Thresholds, and Light Discomfort Thresholds in CEP290 Leber Congenital Amaurosis Patients

Frederick T Collison, Jason C Park, Gerald A Fishman, J Jason McAnany and Edwin M Stone
Investigative ophthalmology & visual science, Vol.56(12), pp.7130-7136
11/2015
DOI: 10.1167/iovs.15-17467
PMCID: PMC4634626
PMID: 26529047
url
https://doi.org/10.1167/iovs.15-17467View
Published (Version of record) Open Access

Abstract

To investigate visual function in patients with CEP290 Leber congenital amaurosis (LCA-CEP290), using three full-field tests that can be performed by patients with poor fixation. Six patients (age range, 9-39 years) with LCA-CEP290 participated in the study. Stimuli for all three tests (full-field stimulus test [FST], pupillometry, and light discomfort threshold [LDT] testing) were generated by the Diagnosys ColorDome ganzfeld, by using achromatic stimuli as well as long- and short-wavelength stimuli to target rod and cone photoreceptors with all three tests and, in the latter two tests, melanopsin photoreceptors. Dark-adapted FST thresholds in LCA-CEP290 patients were cone mediated and elevated between 4.8 and 6.2 log units above the normal achromatic threshold. The FST threshold was not measurable in one patient. The rod-mediated transient pupillary light reflex (PLR) was absent in all but the youngest patient, where unreliable responses precluded PLR quantification. Cone-mediated transient PLRs were subnormal in five patients, and absent in another. Sustained melanopsin-mediated PLRs were measurable in all patients. Full-field LDT thresholds were elevated compared to normal controls, and were lower for short-wavelengh than for long-wavelength stimuli. The FST thresholds and transient PLRs were cone mediated in our cohort LCA-CEP290 patients. Rod-mediated PLRs were undetectable, whereas melanopsin-mediated sustained responses were detected in all patients, suggesting a relative preservation of inner-retina function. The LDT elevations for the patients are somewhat paradoxical, given their subjective perception of photoaversion. Relative aversion to short-wavelength light suggests influence from melanopsin on LDTs in these patients.
Antigens, Neoplasm - genetics Leber Congenital Amaurosis - physiopathology Neoplasm Proteins - biosynthesis Humans Antigens, Neoplasm - biosynthesis Retinal Cone Photoreceptor Cells - physiology Dark Adaptation - physiology Male Leber Congenital Amaurosis - genetics Reflex, Pupillary - physiology Young Adult Sensory Thresholds - physiology Leber Congenital Amaurosis - metabolism Adolescent Adult Female Neoplasm Proteins - genetics Photic Stimulation Child

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