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Guillaume Carcenac, Céline Chayer, Marie-Jeanne Kergoat, Josée Filion, Christian Bocti, Alain Robillard, Ron Postuma, Serge Gauthier, Hélène Kergoat; Reduced Retinal Function In Dark-Adaptation In Lewy Body Disease. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3524.
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Lewy Body Disease (LBD) is a form of dementia characterized by fluctuations in cognition, recurrent visual hallucinations, and parkinsonian motor disturbances. It is accompanied by a dysfunction in the cholinergic and dopaminergic systems. Our objective was to evaluate if retinal function was reduced in individuals with LBD considering that the human retina has acetylcholine and dopamine activity.
Eleven healthy elderly subjects and twelve elderly individuals with LBD between 62 and 85 years of age participated in this study. The diagnosis of LBD was made by the referring neurologists and geriatricians based on published guidelines (McKeith et al 2005). The Mini-Mental State Examination (MMSE) score was measured on the day of testing. Scotopic flash electroretinograms (fERGs) and oscillatory potentials (OPs) were recorded from the test eye with a DTL-type electrode after pupillary dilation and a 20 minute dark-adaptation period. Data acquisition consisted of 3 trials of an average of 20, 100 msec epochs obtained after retinal stimulation with standard intensity white flashes (1.86 cd/m2/s) presented in a Ganzfeld bowl. The fERG amplitudes and implicit times were measured and averaged across subjects in each study group. Statistics consisted of ANOVAs for an alpha level of 0.05.
The MMSE scores were 30 ± 0 and 23.8 ± 1.0 for the control and LBD groups (p< 0.001), respectively. There were no significant changes in the fERG a- and b-wave and the OP implicit times between the 2 groups. However, the amplitude of the a- and b-wave was reduced by 28% (p= 0.024) and 25% (p= 0.011) respectively, in the LBD group. The amplitude of all 5 OPs was also reduced by more than 25% in the LBD group, with OP2 and OP3 reaching statistical significance (p< 0.0001).
Our results indicate that LBD is accompanied by a reduction in the function of the photoreceptor and inner nuclear layers of the dark-adapted retina. These findings may suggest that the deficits in acetylcholine and dopamine known to occur in the brain of individuals with LBD are also present in the retina.
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