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Wachtmeister, Lillemor
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Publications (10 of 10) Show all publications
Wang, L., el Azazi, M., Eklund, A., Burstedt, M. & Wachtmeister, L. (2015). The response of the neuronal adaptive system to background illumination and readaptation to dark in the immature retina. Acta Ophthalmologica, 93(2), 146-153
Open this publication in new window or tab >>The response of the neuronal adaptive system to background illumination and readaptation to dark in the immature retina
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2015 (English)In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 93, no 2, p. 146-153Article in journal (Refereed) Published
Abstract [en]

Purpose: Developmental characteristics of the neuronal adaptive system of the retina, focusing on background light (BGL) adaptation and readaptation functions, were studied by measuring the oscillatory response (SOP) of the electroretinogram (ERG).

Methods: Digitally filtered and conventional ERGs were simultaneously recorded. Rats aged 15 and 17 days were studied during exposure to BGLs of two mesopic intensities and during readaptation to dark.

Results: Results were compared to adult rats. In ‘low mesopic’ BGL SOP instantly dropped significantly to about half of its dark-adapted (DA) value contrary to mature rats, in which the SOP significantly increased. In ‘high mesopic’ BGL SOP decreased to about 20% and 30% of DA values in immature and adult rats, respectively. The process of recovery of SOP in darkness lacked the transient enhancement immediately as BGL was turned off, characteristic of adult rats. There were no major age differences in adaptive behaviour of a-wave. In young rats, recovery of b-wave was relatively slower.

Conclusions: Properties of BGL adaptation and readaptation functions of the neuronal adaptive system in baby retina differed compared to the adult one by being less forceful and more restrained. Handling of mesopic illumination and recovery in the dark was immature. Development of these functions of the neuronal adaptive system progresses postnatally and lags behind that of the photoreceptor response and seems to be delayed also compared to that of the bipolar response.

Keywords
background light adaptation, electroretinogram, immature neuronal adaptive system, oscillatory tentials, readaptation to dark
National Category
Ophthalmology
Identifiers
urn:nbn:se:umu:diva-101387 (URN)10.1111/aos.12456 (DOI)000349900200032 ()24924739 (PubMedID)
Available from: 2015-07-07 Created: 2015-03-30 Last updated: 2018-06-07Bibliographically approved
Burstedt, M. S., Ristoff, E., Larsson, A. & Wachtmeister, L. (2009). Rod-cone dystrophy with maculopathy in genetic glutathione synthetase deficiency: a morphologic and electrophysiologic study.. Ophthalmology, 116(2), 324-331
Open this publication in new window or tab >>Rod-cone dystrophy with maculopathy in genetic glutathione synthetase deficiency: a morphologic and electrophysiologic study.
2009 (English)In: Ophthalmology, ISSN 1549-4713, Vol. 116, no 2, p. 324-331Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To describe the retinal findings in 2 young adults with glutathione synthetase (GS) deficiency, an autosomal-recessive inborn error of glutathione (GSH) metabolism. DESIGN: Report of 2 cases. PARTICIPANTS: Binocular study in 2 affected siblings. METHODS: Two sisters with severe GS deficiency underwent a first ophthalmologic examination including full-field electroretinogram (ERGs). The single flash and flicker ERGs and the oscillatory potentials were measured. The clinical examination was repeated after 1 year with the addition of fluorescein angiography, optical coherence tomography (OCT), and electrooculography (EOG). MAIN OUTCOME MEASURES: Angiograms and the retinal OCTs were analyzed, the morphologic findings compared, and the Arden ratio measured. RESULTS: Myopia decreased in both sisters, and visual acuity remained unchanged. Ophthalmoscopy showed bilateral retinal degenerative changes. Binocular cystic macular edema was present in the fovea and perifoveal areas. Cystic changes were located in the inner nuclear layer and outer plexiform layer. The ERGs showed low or no recordable rod-isolated b-waves, mixed rod-cone a- and b-waves, and cone responses. The oscillatory potentials were subnormal or nonrecordable. The EOG values were subnormal except in 1 eye of the older sister that had a normal Arden ratio. CONCLUSIONS: Severe GS deficiency is associated with progressive retinal dystrophy of the rod-cone type, affecting the central retina with advanced macular edema in adulthood. The retinal degenerative changes in GS deficiency may be the result of the increased oxidative stress accumulated generally in the retina and also apparent in the macular area, and an insufficient level of the free radical scavenger GSH. The patients with GS deficiency may represent a model of the retinal response to oxidative stress in humans. FINANCIAL DISCLOSURE(S): The authors have no proprietary or commercial interest in any materials discussed in this paper.

Keywords
maculopathy, Rod-cone dystrophy
National Category
Ophthalmology
Research subject
Ophtalmology
Identifiers
urn:nbn:se:umu:diva-23861 (URN)10.1016/j.ophtha.2008.09.007 (DOI)19111905 (PubMedID)744 (Local ID)744 (Archive number)744 (OAI)
Available from: 2009-06-29 Created: 2009-06-29 Last updated: 2018-06-08
Burstedt, M. S., Sandgren, O., Golovleva, I. & Wachtmeister, L. (2008). Effects of prolonged dark adaptation in patients with retinitis pigmentosa of Bothnia type: an electrophysiological study.. Doc Ophthalmol, 116(3), 193-205
Open this publication in new window or tab >>Effects of prolonged dark adaptation in patients with retinitis pigmentosa of Bothnia type: an electrophysiological study.
2008 (English)In: Doc Ophthalmol, ISSN 0012-4486, Vol. 116, no 3, p. 193-205Article in journal (Other academic) Published
Abstract [en]

Bothnia dystrophy (BD) is a variant of recessive retinitis punctata albescens (RPA), caused by the missense mutation R233W in cellular retinaldehyde-binding protein (CRALBP), which is localized in the retinal pigment epithelium (RPE) and Müller cells of the retina. The purpose of this study was, by examining the electrophysiological responses of the retina, to evaluate the capacity of recovery of the whole retinal area and different cell types induced by extremely prolonged dark adaptation (DA) in BD disease and to gain further understanding of the pathogenesis of BD. Six young patients underwent bilateral full-field ERGs after 24 h of DA in one eye and standard DA in the fellow eye. The results were also compared with the effect of prolonged DA (10 h), previously studied in the same patients. After extremely prolonged DA (24 h) the rod b-wave and the mixed rod-cone a-wave responses reached normal though delayed amplitudes. An increase, up to normal level, in the oscillatory response was found. There was no obvious recovery of the cone response. We conclude that in young BD patients during extremely prolonged DA there is a significant additional capacity of recovery of rod function and also significant gain of activity in the inner retinal layer. A continuous but slow regeneration of rod photopigment seems to occur at least up to 24 h. The visual process in the RPE is retarded and CRALBP acts in this process; also, the Müller cells of the retina seem to be involved. The findings also support an extremely slow synthesis of photopigments and irreversibly disturbed cone function early in BD.

Keywords
Adolescent, Adult, Carrier Proteins/genetics, Dark Adaptation/*physiology, Electroretinography, Female, Genes; Recessive, Humans, Male, Mutation; Missense/genetics, Retina/*physiopathology, Retinal Pigments/physiology, Retinitis Pigmentosa/genetics/*physiopathology, Vision; Ocular, Visual Fields
National Category
Ophthalmology
Research subject
Ophtalmology
Identifiers
urn:nbn:se:umu:diva-11531 (URN)17922155 (PubMedID)744 (Local ID)744 (Archive number)744 (OAI)
Available from: 2009-01-13 Created: 2009-01-13 Last updated: 2018-06-09Bibliographically approved
Lundström, A.-L., Wang, L. & Wachtmeister, L. (2007). Neuronal adaptation in the human retina: a study of the single oscillatory response in dark adaptation and mesopic background illumination.. Acta Ophthalmologica Scandinavica, 85(7), 756-763
Open this publication in new window or tab >>Neuronal adaptation in the human retina: a study of the single oscillatory response in dark adaptation and mesopic background illumination.
2007 (English)In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 85, no 7, p. 756-763Article in journal (Refereed) Published
Abstract [en]

PURPOSE: The single oscillatory response in complete dark adaptation (DA) and the effect of mesopic illumination were studied in order to investigate the behaviour of the neuronal adaptation system as reflected in the oscillatory potentials (OPs) of the electroretinogram (ERG). METHODS: The rapid oscillatory and slow components (a- and b-waves) of single ERGs were simultaneously recorded in nine healthy, young subjects in response to first flash after both DA of 45 mins and light adaptation to a steady background light (BGL) of low mesopic intensity. RESULTS: Two low-amplitude oscillatory peaks were present in the single response to the first flash recorded in DA. There was no increase in the summed amplitudes of the OPs (SOP) when recorded in the single response to the first flash in mesopic BGL. However, the morphology of the oscillatory response altered. The first OP was reduced and a third oscillatory peak appeared. CONCLUSIONS: We conclude that early, scotopically related OPs may indeed be activated in the single response to the first flash in DA (i.e. without using conditioning flashes). Secondly, on its own, adaptation to mesopic BGL does not seem to trigger enhancement of the overall oscillatory response. The altered single oscillatory response to the first flash apparent in the mesopic BGL comprises a third cone-associated OP and seems to reflect a reorganization of the retinal microcircuitry from a predominantly rod-activated system to one of mixed rod/cone neuronal activity in the inner part of the retina at the level at which individual OPs have their respective origins.

Keywords
single oscillatory response, electroretinogram, dark adaptation, mesopic illumination, first single flash response
National Category
Ophthalmology
Research subject
Ophtalmology
Identifiers
urn:nbn:se:umu:diva-22948 (URN)10.1111/j.1600-0420.2007.00935.x (DOI)17488317 (PubMedID)
Available from: 2009-05-20 Created: 2009-05-20 Last updated: 2018-06-08
Ristoff, E., Burstedt, M., Larsson, A. & Wachtmeister, L. (2007). Progressive retinal dystrophy in two sisters with glutathione synthetase (GS) deficiency. J Inherit Metab Dis, 30(1), 102
Open this publication in new window or tab >>Progressive retinal dystrophy in two sisters with glutathione synthetase (GS) deficiency
2007 (English)In: J Inherit Metab Dis, Vol. 30, no 1, p. 102-Article in journal (Refereed) Published
Abstract [en]

We report the ophthalmological findings of two sisters with severe glutathione synthetase deficiency, an autosomal recessive inborn error of metabolism resulting in very low intracellular levels of the free-radical scavenger glutathione. The patients were investigated because of declining visual acuity. The most prominent finding was progressive retinal dystrophy with hyperpigmentations and maculopathy. Generally disturbed functioning of both the outer and inner layers of the retina resulted in attenuated or nearly abolished electroretinograms. These findings agree with a rod/cone type of retinal dystrophy, and we suggest that this is due to glutathione deficiency. Treatment with antioxidants such as vitamins E and C seems to prevent the progression of CNS damage. We speculate that it might also prevent retinal dystrophy in patients with glutathione synthetase deficiency. We suggest that patients with retinal dystrophy and additional neurological signs should be investigated for a defect in glutathione metabolism. Also, we recommend that patients with low levels of glutathione should be examined for retinal dystrophy. Our results suggest that a decreased capacity for scavenging reactive oxygen species and/or increased oxidative stress may cause retinal dystrophy. If this is the case, the redox state in the retina should be a potentially useful therapeutic target to prevent reduced visual function and blindness.

Identifiers
urn:nbn:se:umu:diva-23631 (URN)PMID: 17206463 (PubMedID)
Available from: 2009-06-29 Created: 2009-06-29 Last updated: 2018-06-08
Mönestam, E., Lundquist, B. & Wachtmeister, L. (2005). Visual function and car driving: longitudinal results 5 years after cataract surgery in a population. British Journal of Ophthalmology, 89(4), 459-463
Open this publication in new window or tab >>Visual function and car driving: longitudinal results 5 years after cataract surgery in a population
2005 (English)In: British Journal of Ophthalmology, ISSN 0007-1161, E-ISSN 1468-2079, Vol. 89, no 4, p. 459-463Article in journal (Refereed) Published
Abstract [en]

Aims: To determine visual function in drivers who had cataract surgery 5 years previously, and to analyse longitudinal data, by comparing preoperative and postoperative changes in subjective driving ability and objective visual function.

Methods: All patients (810) who underwent cataract surgery, during a 1 year period, were prospectively studied. Data regarding present driving status were collected from self administered questionnaires and visual acuity (VA) data were measured before and after surgery. All patients who were alive 5 years later were invited to participate with a new eye examination and questionnaire.

Results: Before surgery 36 active drivers (16%) did not fulfil the visual requirements for driving; with improved glasses this number could be reduced to 24 (11%). 5 years after surgery, the corresponding figures were 5% and 3% (5/174), respectively. Before surgery 50% stated visual difficulties while driving in daylight and 79% in darkness. A few months and 5 years after surgery the corresponding figures were 6% and 5%, respectively, for daytime driving and 34% and 44%, respectively, for night-time driving.

Conclusions: Long term results regarding cataract surgery in car drivers are beneficial. 5 years after surgery only a few patients drove not fulfilling the requirements, but there were a larger proportion of patients with problems driving in darkness compared with a few months after surgery.

Place, publisher, year, edition, pages
London: BMJ Publishing Group Ltd, 2005
Keywords
older drivers, Sweden, index, VF-14, impairment
National Category
Ophthalmology
Identifiers
urn:nbn:se:umu:diva-120429 (URN)10.1136/bjo.2004.051151 (DOI)000227713800016 ()15774924 (PubMedID)
Available from: 2016-06-03 Created: 2016-05-16 Last updated: 2018-06-07Bibliographically approved
el Azazi, M., Wang, L., Eklund, A. & Wachtmeister, L. (2004). Background light adaptation of the retinal neuronal adaptive system. II. Dynamic effects. Documenta Ophthalmologica, 109(2), 201-213
Open this publication in new window or tab >>Background light adaptation of the retinal neuronal adaptive system. II. Dynamic effects
2004 (English)In: Documenta Ophthalmologica, ISSN 0012-4486, Vol. 109, no 2, p. 201-213Article in journal (Refereed) Published
Abstract [en]

The dynamic effects of continuous exposure to light on the neuronal adaptive system of the retina, as indicated by the oscillatory response (OPs) of the electroretinogram (ERG) were studied in the albino rat. Digitally filtered OPs and the a- and b-waves of the corneal ERG were simultaneously recorded in dark adaptation, during continuous light adaptation to four levels of background light (BGL) changing in steps of two log units from 1.43 x 10(-6) cd/m2, referred to as 'low and high scotopic, low and high mesopic' levels. Exposed to 'high scotopic' BGL the total oscillatory response (SOP) significantly enhanced within the first minute, whereas the amplitudes of the a- and b-waves were unaffected. In 'low mesopic' BGL the SOP increased within the first minute, whereas the a- and b-waves significantly decreased. 'High mesopic' BGL instantaneously and profoundly reduced both the SOP and the slow potentials. The individual OPs changed in amplitudes mainly within the first minute of BGL. In general, the earlier OPs (O1 and O2) reacted more to the two 'scotopic' BGL levels, whereas the later OPs (O3 and 04) were more affected by the relatively brighter two 'mesopic' conditions. In conclusion, the rapid increase of the OPs within the first minute of 'high scotopic' and 'low mesopic' BGL exposure may represent a rudimentary light adaptational effect in the rod-dominated rat retina. These findings also suggest that the neuronal adaptive mechanism of the retina seems to be a robust system, probably attaining preservation of visual abilities in the rat on exposure to light.

Keywords
background light adaptation, electroretinography, oscillatory potentials, rat
National Category
Ophthalmology
Research subject
Ophtalmology
Identifiers
urn:nbn:se:umu:diva-13961 (URN)doi:10.1007/s10633-004-6206-3 (DOI)15881266 (PubMedID)744 (Local ID)744 (Archive number)744 (OAI)
Available from: 2007-12-27 Created: 2007-12-27 Last updated: 2018-06-09Bibliographically approved
Mönestam, E. & Wachmeister, L. (2004). Impact of cataract surgery on the visual ability of the very old. American Journal of Ophthalmology, 137(1), 145-155
Open this publication in new window or tab >>Impact of cataract surgery on the visual ability of the very old
2004 (English)In: American Journal of Ophthalmology, ISSN 0002-9394, E-ISSN 1879-1891, Vol. 137, no 1, p. 145-155Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To compare the functional outcome of cataract surgery in terms of visual ability between patients ages younger than 84 years, 85 to 89 years, and 90+ years. Survival time will be estimated at 4 years. DESIGN: Population-based, observational case series. METHODS: We prospectively evaluated elderly cataract patients' self-assessed visual ability regarding reading, TV viewing, orientation ability, activities of daily life, satisfaction, and visual acuity (VA) before and approximately 3 months after cataract surgery. All patients operated on during a 1-year period from our geographically defined admitting area that participated with a questionnaire were included (n = 837). Survival was checked after 4 years. RESULTS: Before surgery, the most elderly were significantly more dissatisfied with their visual function (P =.007). Seventy-six percent of 85+ improved their subjective ability to read, and two-thirds of those unable to read newspaper print were able to read after surgery. A total of 79% of 90+ experienced improved postoperative ability to manage their daily lives. Best-corrected VA (BCVA) improved in 94% (90+ years of age), 90% (85 to 89 years of age), and 97% (younger than 84 years of age), respectively. After surgery, VA was significantly worse with increasing age, also after adjustment for ocular comorbidity (P <.0001). Patients with a BCVA improvement of less than 0.3 logarithm of the minimal angle of resolution units, patients with comorbidity, and patients aged 90+ had approximately 3 times the odds of being dissatisfied with vision after surgery. A total of 43% of 90+ years and 62% of 85 to 89 years were alive 4 years after surgery. CONCLUSIONS: Most patients aged 85 and older had improved visual ability, acuity, and satisfaction after cataract surgery. In terms of visual function, surgery of significant cataracts in the very old is beneficial also when life expectancy is taken in account.

Place, publisher, year, edition, pages
Elsevier, 2004
Keywords
cataract surgery, visual ability
National Category
Ophthalmology
Research subject
Ophtalmology
Identifiers
urn:nbn:se:umu:diva-35447 (URN)10.1016/S0002-9394(03)00900-0 (DOI)14700658 (PubMedID)744 (Local ID)744 (Archive number)744 (OAI)
Available from: 2010-08-18 Created: 2010-08-18 Last updated: 2018-06-08Bibliographically approved
Burstedt, M. S., Sandgren, O., Golovleva, I. & Wachtmeister, L. (2003). Retinal function in Bothnia dystrophy. An electrophysiological study.. Vision Research, 43(24), 2559-2571
Open this publication in new window or tab >>Retinal function in Bothnia dystrophy. An electrophysiological study.
2003 (English)In: Vision Research, ISSN 0042-6989, E-ISSN 1878-5646, Vol. 43, no 24, p. 2559-2571Article in journal (Refereed) Published
Abstract [en]

Using prolonged dark adaptometry, standard dark adaptation (DA) and prolonged DA full-field electroretinograms (ERGs), we analysed the retinal function in patients with Bothnia dystrophy (BD), a variant of recessive retinitis punctata albescens (RPA). A compromised rod and cone function, a likely dysfunction of the Müller cells, and indications of disturbed neuronal function of the inner retina, were found. With prolonged DA, a gradual increase in retinal sensitivity to light and an improvement of the ERG components occurred. The findings indicate a prolonged synthesis of photopigments, retardation of the visual process in the retinal pigment epithelium (RPE), and a loss of retinal cells, probably starting at a relatively early age in BD.

Keywords
etinal pigment epithelium; Retinitis pigmentosa, Neural retina, Electroretinogram, Cellular retinyl aldehyde-binding protein (CRALBP)
National Category
Ophthalmology
Research subject
Ophtalmology
Identifiers
urn:nbn:se:umu:diva-34334 (URN)10.1016/S0042-6989(03)00440-1 (DOI)13129542 (PubMedID)744 (Local ID)744 (Archive number)744 (OAI)
Available from: 2010-05-26 Created: 2010-05-26 Last updated: 2018-06-08Bibliographically approved
Mönestam, E. & Wachtmeister, L. (2002). Change of subjective visual function in first-eye cataract patients when the rate of surgery increases in a population.. Medical Care, 40(11), 1080-1089
Open this publication in new window or tab >>Change of subjective visual function in first-eye cataract patients when the rate of surgery increases in a population.
2002 (English)In: Medical Care, ISSN 0025-7079, E-ISSN 1537-1948, Vol. 40, no 11, p. 1080-1089Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The increasing demand for cataract surgery has stimulated interest in outcome research and the potential public health impact of the intervention. OBJECTIVE: To determine the impact of an increased rate of first-eye cataract surgery on visual acuity (VA) and subjective visual ability/disability, before and after surgery, in a geographically defined population. RESEARCH DESIGN: A prospective, observational study. SUBJECTS: All patients who had first-eye cataract extraction at one clinic during two separate 1-year periods. Five hundred seventy-six patients had surgery in 1997, and 353 had surgery in 1992 (17.2 and 10.6 per 1000 population 65 and older, respectively). MEASURES: Best-corrected VAs were measured, and the patients answered self-administered questionnaires, before and after surgery. The questionnaires focused on the patients' subjective difficulties performing some common vision-dependent activities, such as reading, television-viewing, orientation, etc. RESULTS: In 1997 compared with 1992 the VA of the eye to be operated was on average better (chi2 for trend; P<0.0001), and the subjective visual disability was less before surgery (mean disability index 6.9 vs. 7.5; P<0.0001). There was also a smaller percentage of mature cataracts (15% vs. 23%; P<0.0001). After surgery the VA of the operated eye was better in 1997 (chi2 for trend; P<0.001), but there was no difference in improvement of subjective visual ability, nor change in subjective visual disability, compared with 1992. The patients' expectations and actual postoperative improvement of their ability to cope with daily life were higher in 1997 (chi2 for trend; P<0.0001 and P<0.001). CONCLUSIONS: A higher frequency of first-eye cataract surgery in a population was before surgery associated with an on average better VA of the eye to be operated, a less perceived visual disability regarding some common vision-dependent activities, a lower percentage of mature cataracts and thus earlier surgery. Consequently, a higher rate of surgery would likely be associated with a lesser amount of visual impairment because of cataract in the population.

Keywords
Visual function, cataract
National Category
Ophthalmology
Research subject
Ophtalmology
Identifiers
urn:nbn:se:umu:diva-34333 (URN)10.1097/01.MLR.0000032189.35076.88 (DOI)12409853 (PubMedID)744 (Local ID)744 (Archive number)744 (OAI)
Available from: 2010-05-26 Created: 2010-05-26 Last updated: 2018-06-08Bibliographically approved
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