Рhotopic Negative Response for Testing the Function of Inner Retina: Registration Requirements and Comparison in the Eyes with Natural Pupil Width and in Conditions of Drug Mydriasis

Purpose: To evaluate the possibility of registration of the photopic negative response (PhNR) without pupil dilatation in healthy individuals to determine the dysfunction of neurons of the inner retina.

Methods: 12 healthy persons (23 eyes) aged 24 to 40 years were examined. Refraction anomalies did not exceed 0.5 diopters. A PhNR was evaluated in photopic ERGs recorded on a blue background with red flashes of four intensities (0.375, 0.75, 1.5, 3.0 cd·s/m2) using the RETIport/scan21 (Roland Consult). First, ERG was recorded with the natural pupil (3.5 ± 0.2 mm). Then, the recording was repeated after drug mydriasis (average pupil size 8.7 ± 0.1 mm).

Results. In eyes with natural pupil width, in comparison with drug mydriasis, PhNR amplitudes in responses to weakest stimuli (0.375 cd·s/m2) were significantly reduced. The effect of pupil size on the PhNR amplitude from a baseline was virtually absent in responses to higher strength flashes. This phenomenon can be associated with an irregular distribution of light over the retina with small pupil size, the effect of which is maximal in responses to weak flashes. For the maximal brightness stimuli (3.0 cd·s/m2), differences were found between groups of non-dilated and dilated pupils in the amplitudes of the b-wave and PhNR from the b-peak, which may reflect a decrease in the number of stimulated photoreceptors during ganzfeld stimulation when the pupil is not dilated.

Conclusion. The effect of pupil size on the parameters of the PhNR was most significant in the ERG with minimal flash strength and it decreases in responses to flashes of higher brightness. If it is necessary to record the ERG without drug mydriasis, especially in screening studies, it is recommended to limit the protocol to estimate the PhNR from a baseline in responses to maximal flashes, and use the relative parameter — the amplitude ratio of PhNR/b. Keywords: photopic negative response, electroretinography, pupil width

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