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Article ; Online: Chromatic Pupillometry - a New Technique for Assessing Function in Glaucoma?

Huchzermeyer, Cord

Klinische Monatsblatter fur Augenheilkunde

2023 Volume 240, Issue 12, Page(s) 1350–1358

Abstract: Chromatic pupillometry allows quantification of photoreceptor-driven (extrinsic) and melanopsin-driven (intrinsic) responses of the intrinsic-photosensitive retinal ganglion cells (ipRGCs). This small subpopulation of retinal ganglion cells is also ... ...

Title translation	Chromatische Pupillometrie – ein neuer Weg zur funktionellen Glaukomdiagnostik?
Abstract	Chromatic pupillometry allows quantification of photoreceptor-driven (extrinsic) and melanopsin-driven (intrinsic) responses of the intrinsic-photosensitive retinal ganglion cells (ipRGCs). This small subpopulation of retinal ganglion cells is also affected by glaucoma, making chromatic pupillometry a potential diagnostic tool. Studies show reduced phasic and tonic responses in glaucoma patients. The diagnostic value in earlier studies depended on the technical details and the study design. The purpose of this article is to give an introduction into the principles of chromatic pupillometry and to discuss the potential applications in the management of glaucoma.
MeSH term(s)	Humans ; Reflex, Pupillary/physiology ; Glaucoma/diagnosis ; Retinal Ganglion Cells/physiology ; Light ; Photic Stimulation
Language	German
Publishing date	2023-09-07
Publishing country	Germany
Document type	Journal Article
ZDB-ID	80175-6
ISSN	1439-3999 ; 0344-6360 ; 0344-6387 ; 0023-2165
ISSN (online)	1439-3999
ISSN	0344-6360 ; 0344-6387 ; 0023-2165
DOI	10.1055/a-2130-0546
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Article: Chromatische Pupillometrie – ein neuer Weg zur funktionellen Glaukomdiagnostik?

Huchzermeyer, Cord

Klinische Monatsblätter für Augenheilkunde

2023 Volume 240, Issue 12, Page(s) 1350–1358

Abstract: Die chromatische Pupillometrie erlaubt die Quantifizierung der photorezeptorvermittelten (extrinsischen) und der melanopsinvermittelten (intrinsischen) Antwort der intrinsisch-photosensitiven retinalen Ganglienzellen (ipRGCs). Diese kleine ... ...

Abstract	Die chromatische Pupillometrie erlaubt die Quantifizierung der photorezeptorvermittelten (extrinsischen) und der melanopsinvermittelten (intrinsischen) Antwort der intrinsisch-photosensitiven retinalen Ganglienzellen (ipRGCs). Diese kleine Subpopulation der Ganglienzellen wird beim Glaukom ebenfalls geschädigt, und somit ist die chromatische Pupillometrie für die Glaukomdiagnostik potenziell interessant. Die bisherigen Studien zeigen sowohl eine Verminderung der phasischen Antwort als auch der tonischen Antwort beim Glaukom. Die diagnostische Wertigkeit unterschied sich abhängig von der verwendeten Technik und dem Studiendesign. Der vorliegende Artikel soll vor allem die Grundlagen der chromatischen Pupillometrie und die potenziellen Anwendungen beim Glaukom darstellen. Chromatic pupillometry allows quantification of photoreceptor-driven (extrinsic) and melanopsin-driven (intrinsic) responses of the intrinsic-photosensitive retinal ganglion cells (ipRGCs). This small subpopulation of retinal ganglion cells is also affected by glaucoma, making chromatic pupillometry a potential diagnostic tool. Studies show reduced phasic and tonic responses in glaucoma patients. The diagnostic value in earlier studies depended on the technical details and the study design. The purpose of this article is to give an introduction into the principles of chromatic pupillometry and to discuss the potential applications in the management of glaucoma.
Keywords	Glaukom ; Pupillometrie ; retinale Ganglienzellen ; Neuroophthalmologie ; glaucoma ; pupillometry ; retinal ganglion cells ; neuroophthalmology
Language	German
Publishing date	2023-09-07
Publisher	Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	80175-6
ISSN	1439-3999 ; 0023-2165 ; 0344-6360 ; 0344-6387
ISSN (online)	1439-3999
ISSN	0023-2165 ; 0344-6360 ; 0344-6387
DOI	10.1055/a-2130-0546
Database	Thieme publisher's database

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Book ; Thesis: Verwendung von Strain-Rate-Imaging zur Messung der regionalen Myokardfunktion bei nicht transmuralem und transmuralem myokardialem Infarkt

Huchzermeyer, Cord Robert Hermann

2006

Author's details	vorgelegt von Cord Robert Hermann Huchzermeyer
Language	German
Size	57 Bl. : Ill., graph. Darst.
Publishing country	Germany
Document type	Book ; Thesis
Thesis / German Habilitation thesis	Erlangen, Nürnberg, Univ., Diss., 2006
HBZ-ID	HT015011252
Database	Catalogue ZB MED Medicine, Health

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2007 E 696	order for loan	Magazin

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Article ; Online: Selective Stimulation of the Different Photoreceptor Classes by Silent Substitution in Psychophysical and Electroretinographic Measurements.

Huchzermeyer, Cord / Kremers, Jan

Klinische Monatsblatter fur Augenheilkunde

2022 Volume 239, Issue 12, Page(s) 1433–1439

Abstract: The silent substitution technique allows creating photoreceptor-selective stimuli for psychophysical and electrophysiological tests. In contrast to other techniques, the purpose of silent substitution is not to make the targeted photoreceptor type more ... ...

Title translation	Selektive Stimulation der verschiedenen Fotorezeptorklassen mittels Silent Substitution bei psychophysischen und elektroretinografischen Messungen.
Abstract	The silent substitution technique allows creating photoreceptor-selective stimuli for psychophysical and electrophysiological tests. In contrast to other techniques, the purpose of silent substitution is not to make the targeted photoreceptor type more sensitive in comparison to the other types, but to make the stimulus invisible ("silent") to the other photoreceptor types. This allows selectivity independent of the retinal state of adaptation and enables comparing photoreceptor types under identical conditions. The foundations of these techniques will be explained in this paper. Furthermore, the importance of postreceptoral processing for the perception of photoreceptor-selective stimuli is discussed here. Although this technique is currently only available in specialized vision science labs, there is an enormous potential for clinical application.
Language	German
Publishing date	2022-12-09
Publishing country	Germany
Document type	Journal Article
ZDB-ID	80175-6
ISSN	1439-3999 ; 0344-6360 ; 0344-6387 ; 0023-2165
ISSN (online)	1439-3999
ISSN	0344-6360 ; 0344-6387 ; 0023-2165
DOI	10.1055/a-1937-9901
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Article ; Online: Perimetrie in der Glaukomdiagnostik.

Lämmer, Robert / Huchzermeyer, Cord

Klinische Monatsblatter fur Augenheilkunde

2021

Title translation	Value of Perimetric Measurements for Glaucoma Detection.
Language	German
Publishing date	2021-02-16
Publishing country	Germany
Document type	Journal Article
ZDB-ID	80175-6
ISSN	1439-3999 ; 0344-6360 ; 0344-6387 ; 0023-2165
ISSN (online)	1439-3999
ISSN	0344-6360 ; 0344-6387 ; 0023-2165
DOI	10.1055/a-1351-9080
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Article ; Online: Pattern electroretinogram, blue-yellow visual evoked potentials and the risk of developing visual field defects in glaucoma suspects: a longitudinal "survival" analysis with a very long follow-up.

Huchzermeyer, Cord / Lämmer, Robert / Mardin, Christian Y / Kruse, Friedrich E / Kremers, Jan / Horn, Folkert K

Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie

2024 Volume 262, Issue 5, Page(s) 1607–1618

Abstract: Purpose: Estimating glaucoma suspects' risk for visual field defects helps to avoid under- and over-treatment. In this retrospective, longitudinal cohort study with a very long follow-up, we studied whether pattern electroretinograms (PERG) amplitudes ... ...

Abstract	Purpose: Estimating glaucoma suspects' risk for visual field defects helps to avoid under- and over-treatment. In this retrospective, longitudinal cohort study with a very long follow-up, we studied whether pattern electroretinograms (PERG) amplitudes and blue-on-yellow visual evoked potential (BY-VEP) latencies can predict visual field defects. Methods: Participants of the Erlangen Glaucoma Study were examined with PERG and BY-VEP between 9/1991 and 8/2001. Stimuli were created using an optical bench with Maxwellian view and consisted of vertical gratings (0,88 cpd) in a 32° field for both PERG and BY-VEP. Patients were treated according to clinical standards and performed standard automated perimetry (SAP) annually. Retrospectively, patients with normal SAP at baseline were selected. Primary endpoint was conversion to perimetric glaucoma. Predictive value was modeled using Kaplan-Meier analyses and a multivariate cox proportional hazards model with the continuous variables PERG amplitude, BY-VEP peak time and SAP square-root of loss variance (sLV) after stratification for Jonas classification of the optic discs. Results: Of 412 patients (288: Jonas 0, 103: I, and 21: II; baseline age: 20-60 years), 65 converted to perimetric glaucoma during follow-up (0.5-23.3 years; median 5.5 years). Optic disc classification was a strong risk factor for conversion (log rank p < 0.0001), and patients with more advanced changes progressed earlier. In the multivariate analysis (log rank p = 0.005), only PERG amplitude remained an independent risk factor after stratification for optic disc morphology (p = 0.021), with a ~ 30% higher risk per μV amplitude decrease. Conclusions: PERG helps to estimate glaucoma suspects' risk for visual field defects.
MeSH term(s)	Humans ; Young Adult ; Adult ; Middle Aged ; Visual Field Tests ; Evoked Potentials, Visual ; Retrospective Studies ; Visual Fields ; Follow-Up Studies ; Longitudinal Studies ; Intraocular Pressure ; Ocular Hypertension/drug therapy ; Glaucoma/diagnosis ; Electroretinography ; Vision Disorders/diagnosis
Language	English
Publishing date	2024-01-06
Publishing country	Germany
Document type	Journal Article
ZDB-ID	8435-9
ISSN	1435-702X ; 0721-832X
ISSN (online)	1435-702X
ISSN	0721-832X
DOI	10.1007/s00417-023-06364-y
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Article: Selektive Stimulation der verschiedenen Fotorezeptorklassen mittels Silent Substitution bei psychophysischen und elektroretinografischen Messungen

Huchzermeyer, Cord / Kremers, Jan

Klinische Monatsblätter für Augenheilkunde

2022 Volume 239, Issue 12, Page(s) 1433–1439

Abstract: Mittels der sog. Silent-Substitution-Technik können fotorezeptorselektive Reize für psychophysische und elektrophysiologische Untersuchungen erzeugt werden. Im Gegensatz zu anderen Methoden ... versucht Silent Substitution nicht, die selektiv zu reizende ... ...

Abstract	Mittels der sog. Silent-Substitution-Technik können fotorezeptorselektive Reize für psychophysische und elektrophysiologische Untersuchungen erzeugt werden. Im Gegensatz zu anderen Methoden versucht Silent Substitution nicht, die selektiv zu reizende Fotorezeptorklasse empfindlicher zu machen als die anderen, sondern es wird versucht, den Stimulus für die anderen Fotorezeptorklassen „unsichtbar“ zu machen. Da die Selektivität hierbei auch unabhängig vom Adaptationszustand ist, können verschiedene Fotorezeptorklassen unter identischen Bedingungen verglichen werden. Die Grundlagen dieser Technik werden hier erklärt. Außerdem wird darauf eingegangen, welchen Einfluss die postrezeptorale Verarbeitung auf die Wahrnehmung von fotorezeptorselektiven Reizen hat. Obwohl die Technik derzeit spezialisierten sinnesphysiologischen Laboren vorbehalten ist, hat sie ein großes Potenzial zur klinischen Anwendung. The silent substitution technique allows creating photoreceptor-selective stimuli for psychophysical and electrophysiological tests. In contrast to other techniques, the purpose of silent substitution is not to make the targeted photoreceptor type more sensitive in comparison to the other types, but to make the stimulus invisible (“silent”) to the other photoreceptor types. This allows selectivity independent of the retinal state of adaptation and enables comparing photoreceptor types under identical conditions. The foundations of these techniques will be explained in this paper. Furthermore, the importance of postreceptoral processing for the perception of photoreceptor-selective stimuli is discussed here. Although this technique is currently only available in specialized vision science labs, there is an enormous potential for clinical application.
Keywords	Elektrophysiologie ; Retina ; Glaukom ; Psychophysik ; electrophysiology ; glaucoma ; retina ; psychophysics
Language	German
Publishing date	2022-12-01
Publisher	Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	80175-6
ISSN	1439-3999 ; 0023-2165 ; 0344-6360 ; 0344-6387
ISSN (online)	1439-3999
ISSN	0023-2165 ; 0344-6360 ; 0344-6387
DOI	10.1055/a-1937-9901
Database	Thieme publisher's database

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Article ; Online: Objective detection of visual field defects with multifrequency VEPs.

Crux, Katja / Huchzermeyer, Cord / Kremers, Jan / Horn, Folkert K

Documenta ophthalmologica. Advances in ophthalmology

2023 Volume 148, Issue 1, Page(s) 15–24

Abstract: Purpose: To correlate multifrequency pattern reversal VEPs in quadrants (QmfrVEPs) with perimetric field losses for objective detection of visual field losses.: Methods: QmfrVEP measurements were performed using four LED-based checkerboard ... ...

Abstract	Purpose: To correlate multifrequency pattern reversal VEPs in quadrants (QmfrVEPs) with perimetric field losses for objective detection of visual field losses. Methods: QmfrVEP measurements were performed using four LED-based checkerboard stimulators to stimulate the four quadrants of the visual field. QmfrVEPs were measured monocularly in 5 normal subjects and in 5 glaucoma patients who showed losses in conventional Octopus perimetry. The pattern reversal frequency varied slightly between the stimulators: (11.92, 12.00, 12.08 and 12.16 reversals/sec). The responses to the different stimuli were identified by discrete Fourier analysis. VEPs were recorded using different electrode configurations, and the recording with the highest signal-to-noise ratio (SNR) was used for further analysis. Results: QmfrVEP responses from the different quadrants can be reliably measured and separated using the 0.08 reversals/sec interstimulus reversal frequency differences. The signal-to-noise ratio in the four quadrants was significantly correlated with the equivalent visual field losses obtained with perimetry (Spearman rank correlation: P < 0.001). In the five glaucoma patients, the SNR was reduced in 15 out of the 16 quadrants with a perimetric defect, in comparison to the results in quadrants of healthy subjects. This confirms the sensitivity of the procedure. Conclusion: QmfrVEP responses can be measured reliably. This pilot study suggests that high SNR values exclude visual field defects and that focal defects can be identified in glaucoma patients. Trial registration: www. Clinicaltrials: gov . NCT00494923.
MeSH term(s)	Humans ; Visual Field Tests/methods ; Visual Fields ; Pilot Projects ; Electroretinography ; Vision Disorders/diagnosis ; Glaucoma/diagnosis ; Evoked Potentials, Visual
Language	English
Publishing date	2023-09-26
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	212594-8
ISSN	1573-2622 ; 0012-4486
ISSN (online)	1573-2622
ISSN	0012-4486
DOI	10.1007/s10633-023-09949-4
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Article ; Online: Modulation of flash ERGs by dynamic backgrounds.

Kremers, Jan / Aher, Avinash J / Huchzermeyer, Cord

Documenta ophthalmologica. Advances in ophthalmology

2022 Volume 146, Issue 1, Page(s) 33–51

Abstract: Purpose: The aim of this study was to characterize the signal processing mechanisms that lead to an ERG response and to use this characterization for obtaining more robust responses in patients who display feeble responses with standard recordings. We ... ...

Abstract	Purpose: The aim of this study was to characterize the signal processing mechanisms that lead to an ERG response and to use this characterization for obtaining more robust responses in patients who display feeble responses with standard recordings. We studied the influence of sinusoidally modulating backgrounds on flash ERGs and the relationship between the ERG components' amplitudes and the momentary Weber fraction of the flash stimulus. Methods: ERG recordings were performed in nine healthy subjects and three RP patients. In four normal subjects, we measured the response to flashes (500 cd/m Results: The flash ERGs were strongly modulated by the backgrounds particularly at low frequencies and were enhanced when the momentary Weber fraction was large. The amplitudes of the components could be described by the Weber fraction plus a saturating nonlinearity and a delay in the processing of background luminance. The strength of the modulation decreased with increasing peak time of the component. Furthermore the background luminance delay was positively correlated with the peak time. The effect was also present in RP patients. Conclusions: A sine wave background of about 1 Hz can be used to enhance ERG responses. Weber fraction of the flashes is an adequate quantification of stimulus for describing the amplitudes of the ERGs. The data provide basic information on how background luminance is processed in ERG generating mechanisms. The response enhancement can be used in clinical applications to obtain a more robust comparison between normal and patient data.
MeSH term(s)	Humans ; Electroretinography ; Photic Stimulation ; Retinal Diseases ; Healthy Volunteers
Language	English
Publishing date	2022-10-20
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	212594-8
ISSN	1573-2622 ; 0012-4486
ISSN (online)	1573-2622
ISSN	0012-4486
DOI	10.1007/s10633-022-09902-x
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Article: Perimetrie in der Glaukomdiagnostik

Lämmer, Robert / Huchzermeyer, Cord

Augenheilkunde up2date

2021 Volume 11, Issue 01, Page(s) 51–60

Keywords	Glaukom ; Früherkennung ; Gesichtsfeld ; FDT-Perimetrie ; glaucoma ; early detection ; visual field ; frequency doubling perimetry
Language	German
Publishing date	2021-02-01
Publisher	Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	2631961-5
ISSN	1616-9735 ; 1616-9719
ISSN (online)	1616-9735
ISSN	1616-9719
DOI	10.1055/a-1065-2889
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