Dark Adaptation in Locally Detached Retina
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Investigative Ophthalmology & Visual Science, Vol. 31, No. 7, July 1990 Copyright © Association for Research in Vision and Ophthalmology Dark Adaptation in Locally Detached Retina Toshiro Mori,* David R. Pepperberg,t and Michael F. Marmor* Nonrhegmatogenous retinal detachments were formed in the eyes of Dutch rabbits by subretinal injection of Hanks' balanced salt solution. The electroretinogram (ERG) was recorded locally from the acutely detached retina, and simultaneously from the surrounding attached retina (vitreal ERG [YERG]), before and after exposure to diffuse intense irradiation. Light adaptation elevated b-wave threshold for both the local ERG (LERG) and VERG by about 3 log units; thresholds for both responses recovered fully within 60-90 min after the irradiation. The normal time course of dark adaptation of the LERG suggests the occurrence of substantial rhodopsin regeneration in the rod photoreceptors of nonrhegmatogenously detached retina. These results differ from reports that visual pigment regeneration is slow in central serous chorioretinopathy, possibly because our detachments were studied within hours of formation, whereas some photoreceptor degeneration may be present in older clinical detachments. Invest Ophthalmol Vis Sci 31:1259-1263,1990 Under most conditions in vivo, the regeneration of ical experience that rhegmatogenous detachments rhodopsin in bleached rod photoreceptors requires typically cause an immediate loss of visual function, the delivery, to the rods, of 1 \-cis retinoid formed in measured psychophysically or electrophysiologically. the retinal pigment epithelium (RPE).1"6 Support for Even small serous detachments, such as found in pa- this view comes from studies of the isolated retina tients with central serous chorioretinopathy (CSC), preparation, in which the photoreceptors are re- are characterized by abnormally slow regeneration of moved from this RPE source of 1 l-cis retinoid. For visual pigment.13"15 However, in patients with CSC, example, after exposure to intense light, isolated ret- the focal electroretinogram (ERG) frequently re- inas ordinarily regenerate little if any rhodopsin and mains subnormal after resolution of the detachment, do not exhibit the component of electrophysiologic ie, after reassociation of the retina with the RPE.1617 recovery ("photochemical" dark adaptation7) that Thus, the retinal dysfunction in CSC may reflect de- depends on rhodopsin regeneration.89 However, the generative changes in the retina or RPE rather than, external application of l\-cis retinoid to bleached, or in addition to, the interruption of retinoid de- isolated retinas induces both the formation of rho- livery. dopsin and a substantial recovery of rod sensi- We recently have developed procedures that allow tivity.10"12 recording of the ERG from locally detached retina These findings raise a question relevant to the con- within the living rabbit eye as well as comparison of dition of retinal detachment in the living eye: To this response with the ERG generated by surrounding what extent does separation of the retina and RPE areas of attached retina.18 We report the use of this impair the delivery of 1 l-cis retinoid to the rods and technique to investigate the recovery of ERG sensitiv- thus retard or abolish photochemical dark adaptation ity in locally detached retina after strong light adapta- in the detached region of retina? We know from clin- tion.19 Since our detachments were made immedi- ately before the electrophysiologic experiments, we were able to study the effects of detachment in the From the *Department of Ophthalmology, Stanford University absence of the deteriorative changes that can develop School of Medicine, Stanford, California, and the tDepartment of Ophthalmology, University of Illinois, College of Medicine, Chi- in the retina or RPE after detachment. cago, Illinois. TM is currently affiliated with the Department of Ophthalmol- Materials and Methods ogy, Iwate Medical University, Morioka, Japan. Supported by National Institutes of Health-National Eye Insti- Experiments were performed on Dutch rabbits and tute research grants EY-01678 and EY-05831 (MFM) and adhered to the ARVO Resolution on the Use of Ani- EY-05494 and EY-01792 (DRP). DRP is a Robert E. McCormick mals in Research. We studied seven animals, which Scholar of Research to Prevent Blindness, Inc. were anesthetized with ketamine (30 mg/kg IV) and Submitted for publication: May 10, 1989; accepted November 3, urethan (1.4 g/kg IP); additional doses of ketamine 1989. Reprint requests: Michael F. Marmor, MD, Department of Oph- were given as needed. The eyes were dilated with 10% thalmology, Stanford University School of Medicine, Stanford, CA phenylephrine and 1% atropine. Local retinal de- 94305. tachments, 4-5 mm in diameter, were made as de- 1259 Downloaded from iovs.arvojournals.org on 09/29/2021 1260 INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE / July 1990 Vol. 31 20 scribed previously. Briefly, a glass micropipette of I£R6 tip diameter 40-50 nm was advanced through a scleral incision near the limbus until it entered the subretinal space. Hanks' balanced salt solution was injected through the micropipette to form small, functionally nonrhegmatogenous detachments. Procedures used for recording the local ERG (LERG) were similar to those described.18 In brief, a double-barrelled micropipette filled with 3 M sodium chloride agar was advanced through the scleral inci- sion so that the longer tip penetrated the detached retina through the small hole formed in creation of the detachment (Figure 1). The longer tip was posi- Fig. 2. Representative LERG and VERG responses from a dark- tioned within the subretinal space, while the shorter adapted eye to the unattenuated stimulus. Note the opposite polari- one remained in the vitreous. Signals from the mi- ties of the LERG and VERG responses. cropipettes were led through a silver-silver chloride bridge, alternating current (AC)-amplified and dis- played on a storage oscilloscope. The LERG was re- adapted eye. The LERG waveform is inverted, but corded between the tips of the subretinal and vitreal shows typical a- and b-waves. We have shown pre- electrodes. The mass, or vitreal, ERG (VERG) was viously that the LERG response arises only from de- recorded between the vitreal electrode and a reference tached retina and is free of contamination from sur- electrode on the sclera. The formation of retinal de- rounding, attached retina.18 The small size of the tachments and positioning of the recording electrodes LERG may in part reflect shunting of the transretinal were performed under dim red light. The animals current through the hole made in the formation of the were dark-adapted for an additional 30 min before detachment. Figure 3 shows the results of bleaching recording was begun. on the VERG. Before exposure to the bleaching light, ERG responses were recorded on the presentation a stimulus of —4.0 log units in intensity elicited a of 200-ms test flashes of white light from a 100-W criterion (40 nV) response. The 7-min bleach ele- lamp. The stimulating beam was controlled by an vated threshold for this criterion by 3 log units, as electronic shutter and attenuated with neutral density shown by the responses recorded § min after extinc- filters. The focused beam was led through a fiberoptic tion of the bleaching light. Over the next 90 min, guide that terminated 1 cm above the eye. The inten- threshold for the 40-/iV response returned to its origi- sity of the unattenuated light (log 1 = 0) was 8 X 103 nal level. lux at the cornea. The adapting irradiations, 7 min in Figure 4 shows LERG data recorded simulta- duration, used white light from a different source that neously with the VERG signals of Figure 3. Although produced an intensity of 6 X 105 lux at the cornea. the responses are of smaller amplitude than those of the VERG, a stimulus of log I = -4.0 was sufficient Results to elicit a detectable (20 ftV) response. Bleaching ele- Figure 2 shows representative LERG and VERG vated threshold for this criterion LERG response by responses recorded simultaneously from the dark- an extent similar to that observed for VERG thresh- old, 3 log units. At 90 min after bleaching, LERG responses were virtually identical to those recorded double-barrelled before the bleach. microelectrode Figure 5 shows the LERG and VERG thresholds from Figures 3 and 4. Figure 6 illustrates the averaged Ag-AgCI threshold data from all seven experiments of this electrode study. The thresholds for both the LERG and VERG were elevated to a similar degree (on average, about 2.6 log units) by the adapting irradiation, and thresh- olds for both responses declined with similar time retinal detachment course during the subsequent period of dark adapta- tion. In the three experiments in which thresholds Fig. 1. The recording procedure. The local ERG was recorded from the longer tip, within the retinal detachment. The ERG from were obtained at 90 min of dark adaptation, the final surrounding attached retina was recorded simultaneously from the thresholds for both the LERG and VERG were lower shorter vitreal tip. on average than those observed immediately before Downloaded from iovs.arvojournals.org on 09/29/2021 No. 7 ADAPTATION IN LOCAL DETACHMENT / Mori er ol 1261 Dark- Adapted Recovery Stimulous Intensity (Log) 90 min -4.6 Fig. 3. Example of VERG 30 min recovery after light adapta- tion. The threshold for a 40-MV criterion response was raised 3 log units by bleaching, but recovered to its original level within 90 min. 100 ^V | 50 msec light adaptation. This slight pre-bleach desensitiza- hibits complete recovery of ERG b-wave sensitivity, tion may represent a residual effect of the light with a normal time course. Since recovery of the needed for the surgical procedures. VERG and LERG exhibited similar properties, one might argue that the LERG is contaminated by elec- Discussion tric currents generated in surrounding, attached ret- The current results show that, after intense illumi- ina.