Abnormal retinal electrophysiology is present in 80% of patients with
DMD.
20 It is characterized by a delayed implicit time and
by an amplitude reduction of the b-wave of the electroretinogram (ERG)
recorded under scotopic conditions. The b-wave is the sum of the
electrical activities of more than one cell type but is believed
primarily to reflect the activation of depolarizing bipolar
cells.
21 This bipolar depolarization is initiated by a
photoreceptor hyperpolarization that results in the a-wave of the ERG.
It is also known that the Müller glial cells (MGCs) amplify the
b-wave signal of the ERG generated by the bipolar cell. At the cellular
level, photoreceptors are depolarized in the dark and continuously
release glutamate, the major excitatory transmitter of the CNS. The
metabotropic glutamate receptor mGluR6
22 causes
depolarized bipolar cells to be hyperpolarized in the dark. When light
shines on the retina, photoreceptors hyperpolarize, stopping the
Ca
2+-dependent release of glutamate and, in consequence,
the bipolar cell depolarizes. When the glutamate is washed away from
the synaptic cleft, depolarizing bipolar cells depolarize in response
to light. Müller cells are crucial in this process of reuptake of
glutamate and K
+ released by depolarized neurons.
Nevertheless, it remains controversial whether the elicited
K
+ buffering currents through MGCs cause much of the
b-wave. In toad retina, the spatial buffering fluxes of K
+ can be abolished by blocking Müller cell K
+ conductance with Ba
2+, and the
K
+-evoked Müller cell depolarization and the b-wave
are decreased in amplitude.
23 24 On the contrary, in
rabbit retina, Müller cells generate the M-wave, and a portion of
the b-wave, but a stronger direct contribution from depolarizing
bipolar cells is suggested.
25 26 Thus, any search for the
causes of the ERG phenotype in DMD must involve both neuronal and glial
cells of the retina.