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The ambient daylight variation is coded by melanopsin photoreceptors and their luxotonic activity increases towards midday when colour temperatures are cooler, and irradiances are higher. Although melanopsin and cone photoresponses can be mediated via separate pathways, the connectivity of melanopsin cells across all levels of the retina enables them to modify cone signals. The downstream effects of melanopsin-cone interactions on human vision are however, incompletely understood. Here, we determined how the change in daytime melanopsin activation affects the human cone pathway signals in the visual cortex. A 5-primary silent-substitution method was developed to evaluate the dependence of cone-mediated signals on melanopsin activation by spectrally tuning the lights and stabilizing the rhodopsin activation under a constant cone photometric luminance. The retinal (white noise electroretinogram) and cortical responses (visual evoked potential) were simultaneously recorded with the photoreceptor-directed lights in 10 observers. By increasing the melanopsin activation, a reverse response pattern was observed with cone signals being supressed in the retina by 27% ( p = 0.03) and subsequently amplified by 16% ( p = 0.01) as they reach the cortex. We infer that melanopsin activity can amplify cone signals at sites distal to retinal bipolar cells to cause a decrease in the psychophysical Weber fraction for cone vision.

There is a growing appreciation of the wide range of sleep-wake disturbances that occur frequently in Parkinson's disease. These are known to be associated with a range of motor and non-motor symptoms and significantly impact not only on the quality of life of the patient, but also on their bed partner. The underlying causes for fragmented sleep and daytime somnolence are no doubt multifactorial but there is clear evidence for circadian disruption in Parkinson's disease. This appears to be occurring not only as a result of the neuropathological changes that occur across a distributed neural network, but even down to the cellular level. Such observations indicate that circadian changes may in fact be a driver of neurodegeneration, as well as a cause for some of the sleep-wake symptoms observed in Parkinson's disease. Thus, efforts are now required to evaluate approaches including the prescription of precision medicine to modulate photoreceptor activation ratios that reflect daylight inputs to the circadian pacemaker, the use of small molecules to target clock genes, the manipulation of orexin pathways that could help restore the circadian system, to offer novel symptomatic and novel disease modifying strategies., (© 2023. The Author(s).)

Background: New non-pharmacological treatments for improving non-motor symptoms in Parkinson's disease (PD) are urgently needed. Previous light therapies for modifying sleep behaviour lacked standardised protocols and were not personalised for an individual patient chronotype. We aimed to assess the efficacy of a biologically-directed light therapy in PD that targets retinal inputs to the circadian system on sleep, as well as other non-motor and motor functions., Methods: In this randomised, double-blind, parallel-group, active-controlled trial at the Queensland University of Technology, Australia, participants with mild to moderate PD were computer randomised (1:1) to receive one of two light therapies that had the same photometric luminance and visual appearance to allow blinding of investigators and participants to the intervention. One of these biologically-directed lights matched natural daylight (Day Mel), which is known to stimulate melanopsin cells. The light therapy of the other treatment arm of the study, specifically supplemented the stimulation of retinal melanopsin cells (Enhanced Mel), targeting deficits to the circadian system. Both lights were administered 30 min per day over 4-weeks and personalised to an individual patient's chronotype, while monitoring environmental light exposure with actigraphy. Co-primary endpoints were a change from baseline in mean sleep macrostructure (polysomnography, PSG) and an endocrine biomarker of circadian phase (dim light melatonin secretion onset, DLMO) at weeks 4 and 6. Participants data were analysed using an intention to treat principle. All endpoints were evaluated by applying a mixed model analysis. The trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12621000077864., Findings: Between February 4, 2021 and August 8, 2022, 144 participants with PD were consecutively screened, 60 enrolled and randomly assigned to a light intervention. There was no significant difference in co-primary outcomes between randomised groups overall or at any individual timepoint during follow-up. The mean (95% CI) for PSG, N3% was 24.15 (19.82-28.48) for Day Mel (n = 23) and 19.34 (15.20-23.47) for the Enhanced Mel group (n = 25) in week 4 (p = 0.12); and 21.13 (16.99-25.28) for Day Mel (n = 26) and 18.48 (14.34-22.62) for the Enhanced Mel group (n = 25) in week 6, (p = 0.37). The mean (95% CI) DLMO (decimal time) was 19.82 (19.20-20.44) for Day Mel (n = 22) and 19.44 (18.85-20.04) for the Enhanced Mel group (n = 24) in week 4 (p = 0.38); and 19.90 (19.27-20.53) for Day Mel (n = 23) and 19.04 (18.44-19.64) for the Enhanced Mel group (n = 25) in week 6 (p = 0.05). However, both the controlled daylight (Day Mel) and the enhanced melanopsin (Enhanced Mel) interventions demonstrated significant improvement in primary PSG sleep macrostructure. The restorative deep sleep phase (PSG, N3) significantly improved at week 6 in both groups [model-based mean difference to baseline (95% CI): -3.87 (-6.91 to -0.83), p = 0.04]. There was a phase-advance in DLMO in both groups which did not reach statistical significance between groups at any time-point. There were no safety concerns or severe adverse events related to the intervention., Interpretation: Both the controlled daylight and melanopsin booster light showed efficacy in improving measures of restorative deep sleep in people with mild to moderate PD. That there was no significant difference between the two intervention groups may be due to the early disease stage. The findings suggest that controlled indoor daylight that is personalised to the individuals' chronotype could be effective for improving sleep in early to moderate PD, and further studies evaluating controlled daylight interventions are now required utilising this standardised approach, including in advanced PD., Funding: The Michael J Fox Foundation for Parkinson's Research, Shake IT Up Australia, National Health and Medical Research Council, and Australian Research Council., Competing Interests: BF, DDC and AJZ have a pending patent application (PCT/AU2021/051324) on the principles of a photoreceptor-directed technology. All other authors declare no competing interests., (© 2024 The Author(s).)

Melanopsin-mediated visual and non-visual functions are difficult to study in vivo. To isolate melanopsin responses, non-standard light stimulation instruments are required, with at least as many primaries as photoreceptor classes in the eye. In this protocol, we describe the physical light calibrations of the display instrumentation, control of stimulus artefacts, and correction of individual between-eye differences in human observers. The protocol achieves complete photoreceptor silent substitution in psychophysical, pupillometry, and electroretinographic experiments for probing melanopsin, rod, and cone function. For complete details on the use and execution of this protocol, please refer to Uprety et al. (2022). 1 ., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

To evaluate the nature of interactions between visual pathways transmitting the slower melanopsin and faster rod and cone signals, we implement a temporal phase summation paradigm in human observers using photoreceptor-directed stimuli. We show that melanopsin stimulation interacts with and alters both rod-mediated and cone-mediated vision regardless of whether it is perceptually visible or not. Melanopsin-rod interactions result in either inhibitory or facilitatory summation depending on the temporal frequency and photoreceptor pathway contrast sensitivity. Moreover, by isolating rod vision, we reveal a bipartite intensity response property of the rod pathway in photopic lighting that extends its operational range at lower frequencies to beyond its classic saturation limits but at the expense of attenuating sensitivity at higher frequencies. In comparison, melanopsin-cone interactions always lead to facilitation. These interactions can be described by linear or probability summations and potentially involve multiple intraretinal and visual cortical pathways to set human visual contrast sensitivity., Competing Interests: The authors declare no competing interests., (© 2022 The Author(s).)

A decision during a visual task is marked by a task-evoked pupil dilation (TEPD) that is linked to the global cortical arousal state. Melanopsin expressing intrinsically photosensitive retinal ganglion cells (ipRGCs) form the afferent pathway for this pupil response. Melanopsin activation also influences mood and arousal and increases activity in decision-making brain areas that receive direct ipRGC projections. Here, an optical photostimulation method controlled the excitations of all five photoreceptor classes in the human eye to isolate melanopsin-mediated photoreception. We hypothesised that the TEPD can be driven by directing active visual covert attention through the ipRGC pathway. When observers are completely certain of the stimulus presence, melanopsin-directed stimulation produces a TEPD of similar amplitude to a cone-directed stimulation, with their combination producing larger amplitudes. This dilation is satisfactorily modelled by linear addition with a higher melanopsin weighting in ipRGCs. Visual reaction times were longest in response to melanopsin-directed lights. Next, we asked whether the afferent photoreceptor input and decision certainty, controlled by priming the observer's a priori expectation, interact to drive the TEPD. Signal detection analysis showed that by fixing the predecision certainty (bias), the phasic arousal and TEPD amplitude vary with observer criterion (c') and sensitivity (d') but not with preferential activation of melanopsin. The signature feature of the melanopsin response during attention was a biphasic TEPD. We conclude that active covert attention can be modulated by visual information mediated via ipRGCs, but that phasic arousal responses marked using the TEPD are not increased by higher levels of melanopsin activation., (© 2022 The Authors. European Journal of Neuroscience published by Federation of European Neuroscience Societies and John Wiley & Sons Ltd.)

Purpose: Current chart-based tests of spatial contrast sensitivity (SCS) with fixed or narrow frequency ranges (≤18 cycles/°) cannot characterise the limits of spatial contrast vision. Here we present the design and validation of a chart-based measure of the spatial contrast envelope., Methods: Following the principles of the standard visual acuity (Bailey-Lovie) and contrast sensitivity (Pelli-Robson) charts, a combined spatial-contrast and visual acuity chart was designed using a language-independent triangular symbol for a four-alternative forced-choice procedure plus chart rotation. Symbol frequencies ranged between 0.38 and 60 cycles/° spaced along 10 radial axes (0.55%-100% contrast). The chart was validated with reference to the Bailey-Lovie and Pelli-Robson charts; its reliability and sensitivity to changes in illumination, simulated cataract and blur was evaluated in healthy adults., Results: The photopic SCS function could be measured in 5.5 ± 0.5 min; thresholding around the spatial contrast resolution limit reduced completion times to ~2 min. There was good agreement with high-contrast visual acuity (difference = 0.08 ± 0.02 logMAR) and contrast-sensitivity at 1.5 cycles/° (0.13 ± 0.06 logCS). Test-retest reliability was excellent at all spatial frequencies (ICC = 0.99). Mesopic illumination or simulated cataract caused a generalised SCS loss; myopic blur reduced high-frequency sensitivity. Spatial contrast sensitivity was independent of radial axis orientation (cardinal or oblique)., Conclusions: The chart provides a time-efficient, reliable and inexpensive measure of SCS with applications in research and clinic for detecting subtle deficits in early stages of ocular and neurological conditions that often manifest at higher frequencies. It is sensitive to vision changes occurring in dim lighting and with simulated cataract and blur. The chart is available open-access for self-printing; contrast variation in print can be controlled through user calibration and/or establishing normative SCS functions using the theoretical values., (© 2021 The Authors Ophthalmic and Physiological Optics © 2021 The College of Optometrists.)

Following photopigment bleaching, the rhodopsin and cone-opsins show a characteristic exponential regeneration in the dark with a photocycle dependent on the retinal pigment epithelium. Melanopsin pigment regeneration in animal models requires different pathways to rods and cones. To quantify melanopsin-mediated light adaptation in humans, we first estimated its photopigment regeneration kinetics through the photo-bleach recovery of the intrinsic melanopsin pupil light response (PLR). An intense broadband light (~120,000 Td) bleached 43% of melanopsin compared to 86% of the cone-opsins. Recovery from a 43% bleach was 3.4X slower for the melanopsin than cone-opsin. Post-bleach melanopsin regeneration followed an exponential growth with a 2.5 min time-constant (τ) that required 11.2 min for complete recovery; the half-bleaching level (I p ) was ~ 4.47 log melanopic Td (16.10 log melanopsin effective photons.cm -2 .s -1 ; 8.25 log photoisomerisations.photoreceptor -1 .s -1 ). The effect on the cone-directed PLR of the level of the melanopsin excitation during continuous light adaptation was then determined. We observed that cone-directed pupil constriction amplitudes increased by ~ 10% when adapting lights had a higher melanopic excitation but the same mean photometric luminance. Our findings suggest that melanopsin light adaptation enhances cone signalling along the non-visual retina-brain axis. Parameters τ and I p will allow estimation of the level of melanopsin bleaching in any light units; the data have implications for quantifying the relative contributions of putative melanopsin pathways to regulate the post-bleach photopigment regeneration and adaptation., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Aims: People with type 2 diabetes (T2D) suffer from sleep disorders, with the mechanism not clearly understood. In T2D, the light transducing retinal photoreceptors that regulate sleep behaviours are dysfunctional; hence, we determine here whether supplemental light exposure ameliorates sleep quality and daytime sleepiness in T2D., Methods: Supplemental light (10,000 Lux, polychromatic) was self-administered for 30 min every morning for 14 days by ten participants with T2D with no diabetic retinopathy (DR). The effectiveness of supplemental light was assessed by comparing subjective sleep questionnaire (PSQI and ESS) scores and salivary dim light melatonin onset (DLMO) before and after the light exposure as well as with a self-maintained sleep diary during the light exposure., Results: Compared to the baseline, supplemental light significantly improved the excessive daytime sleepiness score (p = 0.004) and phase-advanced the DLMO on average by ~ 23 min. Sleep diary analyses showed that afternoon nap duration significantly shortened over the first week of supplemental light exposure (p = 0.019). Afternoon naps and midnight awakening were significantly longer in diabetic participants with thinner perifoveal retina., Conclusions: In this case series, we provide initial evidence that supplemental bright light improves daytime sleepiness in T2D with no DR, with the critical period of light exposure showing a beneficial effect after one week. We infer that supplemental light augments photoreceptor signalling in T2D and therefore optimises circadian photoentrainment leading to improved sleep. Our findings inform the development of tailored light therapy protocols in future clinical trials for improving sleep architecture in diabetes., (© 2021. Springer-Verlag Italia S.r.l., part of Springer Nature.)

The intrinsic melanopsin photoresponse may initiate visual signals that differ in spatiotemporal characteristics from the cone-opsin- and rhodopsin-mediated signals. Applying the CIE standard observer functions in silent-substitution methods can require individual differences in photoreceptor spectral sensitivities and pre-receptoral filtering to be corrected; failure to do so can lead to the intrusion of more sensitive cone processes with putative melanopsin-directed stimuli. Here we evaluate heterochromatic flicker photometry (HFP) and photoreceptor-directed temporal white noise as techniques to limit the effect of these individual differences. Individualized luminous efficiency functions ( V ( λ )) were compared to the CIE standard observer functions. We show that adapting chromaticities used in silent-substitution methods can deviate by up to 54% in luminance when estimated with the individual and standard observer functions. These deviations lead to inadvertent cone intrusions in the visual functions measured with melanopsin-directed stimuli. To eliminate the intrusions, individual HFP corrections are sufficient at low frequencies (∼1 H z ) but temporal white noise is also required at higher frequencies to desensitize penumbral cones. We therefore recommend the selective application of individualized observer calibration and/or temporal white noise in silent-substitution paradigms when studying melanopsin-directed photoresponses.

At the absolute threshold of vision, Hecht, Shlaer and Pirenne estimate that 5-14 photons are absorbed within a retinal area containing ~500 rods. Other estimates of scotopic threshold vision based on stimuli with different durations and focal areas range up to ~100,000 photons. Given that rod density varies with retinal eccentricity and the magnitude of the intrinsic noise increases with increasing stimulus area and duration, here we determine whether the scotopic threshold estimates with focal stimuli can be extended to full-field stimulation and whether summation explains inter-study differences. We show that full-field threshold vision (~1018 mm 2 , 10 ms duration) is more sensitive than at absolute threshold, requiring the absorption of ~1000 photons across ~91.96 million rods. A summation model is presented integrating our and published data and using a nominal exposure duration, criterion frequency of seeing, rod density, and retinal area that largely explains the inter-study differences and allows estimation of rods per photon ratio for any stimulus size and duration. The highest signal to noise ratio is defined by a peak rod convergence estimated at 53:4:1:2 (rods:rod bipolar cells:AII amacrine cells:retinal ganglion cells), in line with macaque anatomical estimates that show AII amacrine cells form the bottleneck in the rod pathway to set the scotopic visual limit. Our model estimations that the rods per photon ratio under full-field stimulation is ~3000X higher than at absolute threshold are in accordance with visual summation effects and provide an alternative approach for understanding the limits of scotopic vision., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Purpose: To define the melanopsin and cone luminance retinogeniculate pathway contributions to photophobia in healthy controls and migraineurs., Methods: Healthy controls and migraineurs were categorized according to the International Classification of Headache Disorders criteria. Photophobia was measured under full-field illumination using electromyography in response to narrowband lights spanning the melanopsin and cone luminance action spectra. Migraineurs were tested during their interictal headache-free period. Melanopsin-mediated post-illumination pupil responses quantified intrinsically photosensitive Retinal Ganglion Cell (ipRGC) function., Results: A model combining the melanopsin and cone luminance action spectra best described photophobia thresholds in controls and migraineurs; melanopsin contributions were ∼1.5× greater than cone luminance. In the illumination range causing photophobia, migraineurs had lower photophobia thresholds (∼0.55 log units; p  < 0.001) and higher post-illumination pupil response amplitudes ( p  = 0.03) than controls., Conclusion: Photophobia is driven by melanopsin and cone luminance inputs to the cortex via the retino-thalamocortical pathway. In migraineurs, lower photophobia thresholds reflect hypersensitivity of ipRGC and cone luminance pathways, with the larger and prolonged post-illumination pupil response amplitude indicative of a supranormal melanopsin response. Our findings inform artificial lighting strategies incorporating luminaires with low melanopsin excitation and photopic luminance to limit the lighting conditions leading to photophobia.

Actigraphs are the reference standard for measuring light exposure in human non-laboratory experiments due to their portability and long battery lives. However, actigraphs typically have a limited illuminance operating range not representative of real-world conditions, and for many actigraphs, the accuracy of their light measurement has not been verified independently. We assessed the illuminances recorded by Activinsights GENEActiv Original and Philips Actiwatch 2 actigraphs in comparison to a calibrated, laboratory-standard photometer, under both artificial light-emitting diode (LED) and natural sunlight illuminations that might be encountered by a person under real-world conditions. We show that in response to ~20,000 lux white LED light, the GENEActiv and Actiwatch 2 underestimate illuminance by recording 50% and 25% of the true value, respectively. Under ~30,000 lux sunlight, the GENEActiv readily saturates whereas the Actiwatch 2 reports ~46% of the true illuminance. These underestimations are highly linear and we provide correction factors to estimate the illuminance levels of the ambient environment measured by the actigraphs. We also evaluate the application of neutral density filters for extending the operating range of both devices in natural sunlight illuminations (as high as 30,000 lux during our measurements) and demonstrate that this may be a viable approach for increasing the operating range of the Actiwatch 2 but not the GENEActiv. We conclude that both actigraphs provide good performance in monitoring the temporal patterning of light, whereas the absolute illuminance values require correction to accurately evaluate the effects of light intensity on human health and behaviours., (© 2019 European Sleep Research Society.)

We examined the contributions of rhodopsin and melanopsin to human brightness estimation under dim lighting. Absolute brightness magnitudes were estimated for full-field, rhodopsin-, or melanopsin-equated narrowband lights (${\lambda &#95;{\rm max}}:\;{462}$λ max :462, 499, 525 nm). Our data show that in scotopic illumination ($ - {5.1}$-5.1 to $ - {3.9}\;{\log}\;\unicode{x00B5} {\rm Watts}\cdot{\rm cm}^{ - 2}$-3.9logµWatts⋅cm -2 ), the perceptual brightness estimates of rhodopic irradiance-equated conditions are independent of their corresponding melanopic irradiance, whereas brightness estimates with melanopic irradiance-equated conditions increase with increasing rhodopic irradiance. In mesopic illumination ($ - {3.4}$-3.4 to $ - {1.9}\;{\log}\;\unicode{x00B5} {\rm Watts}\cdot{\rm cm}^{ - 2}$-1.9logµWatts⋅cm -2 ), the brightness estimates with both lighting conditions increase with increasing rhodopic or melanopic irradiances. Rhodopsin activation therefore entirely signals scotopic brightness perception and plateaus in mesopic illumination where intrinsic melanopsin contributions become first evident. We infer that all photoreceptor signals are transmitted to higher visual centers for representing scene brightness in scotopic and mesopic illumination through both conventional and melanopsin ganglion cell pathways.

Background: Melanopsin-expressing intrinsically photosensitive retinal ganglion cells (ipRGCs) signal the environmental light to mediate circadian photoentrainment and sleep-wake cycles. There is high prevalence of circadian and sleep disruption in people with Parkinson's disease, however the underlying mechanisms of these symptoms are not clear., Objective: Based on recent evidence of anatomical and functional loss of melanopsin ganglion cells in Parkinson's disease, we evaluate the link between melanopsin function, circadian, and sleep behavior., Methods: The pupil light reflex and melanopsin-mediated post-illumination pupil response were measured using chromatic pupillometry in 30 optimally medicated people with Parkinson's disease and 29 age-matched healthy controls. Circadian health was determined using dim light melatonin onset, sleep questionnaires, and actigraphy. Ophthalmic examination quantified eye health and optical coherence tomography measured retinal thickness., Results: The melanopsin-mediated post-illumination pupil response amplitudes were significantly reduced in Parkinson's disease (p < 0.0001) and correlated with poor sleep quality (r2 = 33; p < 0.001) and nerve fiber layer thinning (r2 = 0.40; p < 0.001). People with Parkinson's disease had significantly poorer sleep quality with higher subjective sleep scores (p < 0.05) and earlier melatonin onset (p = 0.01). Pupil light (outer retinal) response metrics, daily light exposure and outer retinal thickness were similar between the groups (p > 0.05)., Conclusion: Our evidence-based data identify a mechanism through which inner retinal ipRGC dysfunction contributes to sleep disruption in Parkinson's disease in the presence of normal outer retinal (rod-cone photoreceptor) function. Our findings provide a rationale for designing new treatment approaches in Parkinson's disease through melanopsin photoreceptor-targeted light therapies for improving sleep-wake cycles.

The white noise electroretinogram (wnERG) provides a measure of the impulse response function under conditions of retinal equilibrium; it is yet to be determined how the electrical response generated by melanopsin ganglion cell photoreception is expressed in the impulse response. To this end, we recorded the human wnERG to continuous temporal white noise (TWN) stimuli that were melanopsin-directed (rod and cone silent) or cone-directed (rod and melanopsin silent). The impulse response of the electroretinogram was derived by cross-correlating the TWN stimulus with the wnERG response. We observed that the LMS-cone directed wnERG contained the expected N1 wave (24.1 ± 2.4 ms; mean ± SEM) and P1 wave (49.7 ± 1.8 ms). Melanopsin-directed stimuli produced a unique wnERG with a slower negative deflection (N m ) at 62.9 ± 3.3 ms followed by a positive deflection (P m ) at 126.3 ± 5.1 ms. Additional experiments indicated this melanopsin-directed wnERG response was not due to cone intrusion. The N m and N m P m amplitudes increased with illuminance (32,000-80,000 Td; no rod intrusion) and melanopsin contrast (10-36% Michelson contrast). As there are known pathways connecting melanopsin cells to the outer retina, we then measured the wnERG to combined melanopsin and cone-directed stimuli to quantify melanopsin interactions with cone signalling. With the combined stimuli, the N1P1 amplitudes were suppressed by ~59%, which may be a result of a destructive interference between the positive (P1) and negative (N m ) waves generated by the cone and melanopsin pathways. We conclude that the human wnERG to melanopsin-directed stimuli may reflect the combined response of intra-retinal melanopsin pathways, independent of rod and cone photoreception., (Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Purpose: The photoreceptor classes driving the flicker pupil light response (fPLR) to monochromatic sinusoidal temporal modulation are largely unknown. Here, we determine the photoreceptor inputs to the fPLR., Methods: The 0.5-Hz fPLR was measured in healthy observers using a Maxwellian view (41° diameter) pupillometer at five narrowband wavelengths (short: 409 nm; intermediate: 462, 507, 530 nm; and long: 592 nm) over ∼10 log units of irradiance spanning scotopic to photopic levels (5.6 to 15.6 log quanta·cm -2 ·s -1 ; -6.9 to 3.6 log cd·m -2 ). The relative photoreceptor contributions to the fPLR were then derived from these amplitude-irradiance functions using a criterion fPLR., Results: The fPLR amplitude is small (≤ 3.9 ± 3.1%; mean ± SEM) below 8.0 log quanta·cm -2 ·s -1 then increases with retinal irradiance in accordance with a Hill function that asymptotes between 13.0 to 15.0 log quanta·cm -2 ·s -1 (wavelength dependent). The Hill slope is steepest for the intermediate wavelengths. Further increases in irradiance (>15.0 log quanta·cm -2 ·s -1 ) produce a distinct suppression of the fPLR for the intermediate wavelengths. The fPLR phase delay shows a linear decrease with increasing irradiance. The spectral sensitivity of the fPLR is dominated by inner retinal melanopsin ganglion cell and outer retinal rod photoreceptor inputs to the afferent pupil control pathway; the relative melanopsin : rhodopsin weighting decreases with the transition from photopic to scotopic lighting., Conclusions: The fPLR can be used as a marker of melanopsin and rod interactions during the flicker stimulation and to quantify their contributions to the post-illumination pupil response (PIPR)., Translational Relevance: These irradiance and wavelength responses will be useful in standardizing the measurements of the fPLR using chromatic pupillometry., (Copyright 2019 The Authors.)

The precise control of visual sensitivity to variations in external lighting is critical for optimising human visual function in a changing environment. In photopic illumination, the cone photoreceptors and their post-receptoral pathways have a primary role in regulating these adjustments; it is not fully understood how a small population of melanopsin-expressing, intrinsically photosensitive retinal ganglion cells (ipRGCs) can interact with the three cone photoreceptor classes to modulate human visual function. Here we investigated interactions between these inner and outer retinal photoreceptor classes in participants with trichromatic colour vision under conditions that independently controlled the excitations of ipRGCs, cones and rods in the retina. In the peripheral retina, we show that interaction between melanopsin- and cone-directed signals affect conscious, image-forming vision. The interaction patterns are inconsistent with any potential effects arising from artefacts due to open-field and penumbral-cone contrasts, or rod intrusion. For cone signals mediated via each of the three primary visual pathways, melanopsin activation enhances contrast sensitivity. The contrast response functions indicate this enhancement is a more generalised facilitation effect that onsets at ∼9% melanopsin contrast. The implication for human vision is that the contrast sensitivity of cone-mediated visual processes can be modulated by the level of melanopsin excitation in the stimulus light., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: Retinal photoreceptors provide the main stage in the mammalian eye for regulating the retinal illumination through changes in pupil diameter, with a small population of melanopsin-expressing intrinsically photosensitive retinal ganglion cells (ipRGCs) forming the primary afferent pathway for this response. The purpose of this study is to determine how melanopsin interacts with the three cone photoreceptor classes in the human eye to modulate the light-adapted pupil response. Methods: We investigated the independent and combined contributions of the inner and outer retinal photoreceptor inputs to the afferent pupil pathway in participants with trichromatic color vision using a method to independently control the excitations of ipRGCs, cones and rods in the retina. Results: We show that melanopsin-directed stimuli cause a transient pupil constriction generated by cones in the shadow of retinal blood vessels; desensitizing these penumbral cone signals uncovers a signature melanopsin pupil response that includes a longer latency (292 ms) and slower time (4.1x) and velocity (7.7x) to constriction than for cone-directed stimuli, and which remains sustained post-stimulus offset. Compared to melanopsin-mediated pupil responses, the cone photoreceptor-initiated pupil responses are more transient with faster constriction latencies, higher velocities and a secondary constriction at light offset. The combined pupil responses reveal that melanopsin signals are additive with the cone signals. Conclusions: The visual system uses the L-, M-, and S-cone photoreceptor inputs to the afferent pupil pathway to accomplish the tonic modulations of pupil size to changes in image contrast. The inner retinal melanopsin-expressing ipRGCs mediate the longer-term, sustained pupil constriction to set the light-adapted pupil diameter during extended light exposures.

Purpose: Light transmitted by retinal photoreceptors provides the input for circadian photoentrainment. In diabetes, there is a high prevalence of circadian and sleep disruption but the underlying causes are not well understood. Patients with diabetes can exhibit dysfunctional photoreceptors but their role in circadian health is not known. Here we quantify photoreceptor function and contributions to circadian health and sleep in patients with diabetes without diabetic retinopathy and healthy controls., Methods: Rod, cone, and melanopsin function was derived using chromatic pupillometry in 47 participants including 23 patients with type 2 diabetes and 24 age-matched healthy controls after an ophthalmic examination including retinal thickness assessment using optical coherence tomography. Circadian health was determined using dim light melatonin onset (DLMO) and sleep questionnaires; light exposure was measured using actigraphy., Results: Compared with the control group, the patients with diabetes had a significantly earlier DLMO (1 hour) (P = 0.008), higher subjective sleep scores (P < 0.05), a reduction in pupil constriction amplitude for red stimuli (P = 0.039) and for the early postillumination pupil response (PIPR) for blue (P = 0.024) stimuli. There were no between-group differences in the light exposure pattern, activity levels, and intrinsic melanopsin-mediated PIPR amplitude (P > 0.05). A significant correlation was evident between outer retinal thickness and DLMO (r = -0.65, P = 0.03) and the pupil constriction amplitude (r = 0.63, P = 0.03); patients with thinner retina had earlier DLMO and lower pupil amplitudes., Conclusions: We infer that the observed changes in circadian function in patients with no diabetic retinopathy are due to structural and functional outer retinal rod photoreceptor deficits at early stage of diabetic eye disease.

The number of research groups studying the pupil is increasing, as is the number of publications. Consequently, new standards in pupillography are needed to formalize the methodology including recording conditions, stimulus characteristics, as well as suitable parameters of evaluation. Since the description of intrinsically photosensitive retinal ganglion cells (ipRGCs) there has been an increased interest and broader application of pupillography in ophthalmology as well as other fields including psychology and chronobiology. Color pupillography plays an important role not only in research but also in clinical observational and therapy studies like gene therapy of hereditary retinal degenerations and psychopathology. Stimuli can vary in size, brightness, duration, and wavelength. Stimulus paradigms determine whether rhodopsin-driven rod responses, opsin-driven cone responses, or melanopsin-driven ipRGC responses are primarily elicited. Background illumination, adaptation state, and instruction for the participants will furthermore influence the results. This standard recommends a minimum set of variables to be used for pupillography and specified in the publication methodologies. Initiated at the 32nd International Pupil Colloquium 2017 in Morges, Switzerland, the aim of this manuscript is to outline standards in pupillography based on current knowledge and experience of pupil experts in order to achieve greater comparability of pupillographic studies. Such standards will particularly facilitate the proper application of pupillography by researchers new to the field. First we describe general standards, followed by specific suggestions concerning the demands of different targets of pupil research: the afferent and efferent reflex arc, pharmacology, psychology, sleepiness-related research and animal studies.

Our analytical description of full-field brightness perception data [J. Opt. Soc. Am. A35, B19 (2018)JOAOD60740-323210.1364/JOSAA.35.000B19] with contributions from cone luminance and melanopsin expressing intrinsically photosensitive retinal ganglion cells has been extended [J. Opt. Soc. Am. A35, 1780 (2018)JOAOD60740-323210.1364/JOSAA.35.001780] to include S-cones through a blue-yellow opponent channel. We welcome this reanalysis and provide a few remarks on the approach.

Background: Melanopsin-expressing intrinsically photosensitive Retinal Ganglion Cells (ipRGCs) signal non-imaging forming effects of environmental light for circadian phoentrainment, the pupil light reflex, and mood regulation. In seasonal affective disorder, ipRGC dysfunction is thought to cause abberant transmission of the external illumination for photoentrainment. It is not known if patients with non-seasonal depression have abnormal melanospin mediated signaling and/or irregular environmental light exposure. Methods: Twenty-one adults who live in a sub-tropical region, including eight patients with non-seasonal depression and thirteen age-matched healthy controls were recruited. The Mini International Neuropsychiatry Interview diagnosed the presence of a major depressive disorder. Light exposure was determined using actigraphy over a 2 week period. The melanopsin mediated post-illumination pupil response (PIPR) and outer retinal inputs to ipRGCs (transient pupil response and maximum pupil constriction amplitude) were measured in response to 1 s, short and long wavelength light with high and low melanopsin excitation. Results: The mean daylight exposure as a function of clock hours and total light exposure duration (mins) to illumination levels commonly recommended for depression therapy were not significantly different between groups. Out of 84 pupil measurements (42 each in the depression and control groups), the melanopsin-mediated PIPR amplitude, transient pupil response, and pupil constriction amplitude were not significantly different between groups. Conclusions: This report provides initial evidence of normal melanopsin function and environmental light exposures in patients with pre-dominately mid and moderate non-seasonal depression in a subtropical location in the southern hemisphere.

Parkinson's disease (PD) is characterised by non-motor symptoms including sleep and circadian disruption. Melanopsin-expressing intrinsically photosensitive Retinal Ganglion Cells (ipRGC) transmit light signals to brain areas controlling circadian rhythms and the pupil light reflex. To determine if non-motor symptoms observed in PD are linked to ipRGC dysfunction, we evaluated melanopsin and rod/cone contributions to the pupil response in medicated participants with PD (n = 17) and controls (n = 12). Autonomic tone was evaluated by measuring pupillary unrest in darkness. In the PD group, there is evidence for an attenuated post-illumination pupil response (PIPR) amplitude and reduced pupil constriction amplitude, and PIPR amplitudes did not correlate with measures of sleep quality, retinal nerve fibre layer thickness, disease severity, or medication dosage. Both groups exhibited similar pupillary unrest. We show that melanopsin- and the rod/cone-photoreceptor contributions to the pupil control pathway are impaired in people with early-stage PD who have no clinically observable ophthalmic abnormalities. Given that ipRGCs project to brain targets involved in arousal, sleep and circadian rhythms, ipRGC dysfunction may underpin some of the non-motor symptoms observed in PD.

We determined how extrinsic white noise correlating with cone inputs to the three primary visual pathways affects both rod-pathway temporal contrast sensitivity and the impulse response function. A four-primary photostimulator provided independent control of rod and cone photoreceptor excitations under mesopic illumination (20 photopic Td). We show that rod-pathway temporal contrast sensitivity uniformly decreases across all temporal frequencies in the presence of cone noise correlating with the inferred magnocellular, parvocellular, or koniocellular pathways. The rod-pathway temporal impulse response functions derived using the Stork-Falk procedure (with a minimum phase assumption) had lower amplitudes in the pathway-specific cone noise. Therefore, cone noise impairs rod-pathway temporal contrast sensitivity without delaying rod-pathway signal transmission.

This study investigated how invisible extrinsic temporal white noise that correlates with the activity of one of the three [magnocellular (MC), parvocellular (PC), or koniocellular (KC)] post-receptoral pathways alters mesopic rod signaling. A four-primary photostimulator provided independent control of the rod and three cone photoreceptor excitations. The rod contributions to the three post-receptoral pathways were estimated by perceptually matching a 20% contrast rod pulse by independently varying the LMS (MC pathway), +L-M (PC pathway), and S-cone (KC pathway) excitations. We show that extrinsic cone noise caused a predominant decrease in the overall magnitude and ratio of the rod contributions to each pathway. Thus, the relative cone activity in the post-receptoral pathways determines the relative mesopic rod inputs to each pathway.

The visual consequences of melanopsin photoreception in humans are not well understood. Here we studied melanopsin photoreception using a technique of photoreceptor silent substitution with five calibrated spectral lights after minimising the effects of individual differences in optical pre-receptoral filtering and desensitising penumbral cones in the shadow of retinal blood vessels. We demonstrate that putative melanopsin-mediated image-forming vision corresponds to an opponent S-OFF L + M-ON response property, with an average temporal resolution up to approximately 5 Hz, and >10x higher thresholds than red-green colour vision. With a capacity for signalling colour and integrating slowly changing lights, melanopsin-expressing intrinsically photosensitive retinal ganglion cells maybe the fifth photoreceptor type for peripheral vision.

Various in vitro culture systems have been used to investigate the pathogenesis of age-related macular degeneration (AMD). However, many still rely on oversimplified monolayer culture models. AMD is a complex disease, associated with the pathological changes to multiple structural components such as the Bruch's membrane, retinal pigment epithelium (RPE), and choroidal endothelial cells. This study aims to construct a novel 3D coculture model using the polycaprolactone (PCL)-gelatin electrospun scaffold, with human RPE cells (hRPE) and primate choroidal cells (RF-6A). Results from this study show that PCL-gelatin scaffolds have a highly porous ultrastructure that supports the attachment, proliferation, differentiation, and migration of the hRPEs and choroidal endothelial cells. It is also demonstrated that the PCL-gelatin 3D coculture model may be useful in exploring the molecular interplay between the hPRE and the choroidal endothelial cells, and their effects on growth factor modulation, which may be important in the pathogenesis of AMD., (© 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Purpose: We introduce a method for determining the impulse response function (IRF) of the ERG derived from responses to temporal white noise (TWN) stimuli., Methods: This white noise ERG (wnERG) was recorded in participants with normal trichromatic vision to full-field (Ganzfeld) and 39.3° diameter focal stimuli at mesopic and photopic mean luminances and at different TWN contrasts. The IRF was obtained by cross-correlating the TWN stimulus with the wnERG., Results: We show that wnERG recordings are highly repeatable, with good signal-to-noise ratio, and do not lead to blink artifacts. The wnERG resembles a flash ERG waveform with an initial negativity (N1) followed by a positivity (P1), with amplitudes that are linearly related to stimulus contrast. These N1 and N1-P1 components showed commonalties in implicit times with the a- and b-waves of flash ERGs. There was a clear transition from rod- to cone-driven wnERGs at ∼1 photopic cd.m -2 . We infer that oscillatory potentials found with the flash ERG, but not the wnERG, may reflect retinal nonlinearities due to the compression of energy into a short time period during a stimulus flash., Conclusion: The wnERG provides a new approach to study the physiology of the retina using a stimulation method with adaptation and contrast conditions similar to natural scenes to allow for independent variation of stimulus strength and mean luminance, which is not possible with the conventional flash ERG., Translational Relevance: The white noise ERG methodology will be of benefit for clinical studies and animal models in the evaluation of hypotheses related to cellular redundancy to understand the effects of disease on specific visual pathways.

Purpose: Melanopsin expressing intrinsically photosensitive retinal ganglion cells (ipRGC) input to multiple brain regions including those for pupil control, circadian rhythms, sleep and mood regulation. Here we measured ipRGC function and its relationship to sleep quality and depression in patients with advanced AMD., Methods: The melanopsin-mediated post-illumination pupil response (PIPR) was measured in 53 patients with advanced AMD (age 78.8 ± 8.8 years) and in 20 healthy controls (age 72.5 ± 3.3 years). Sleep quality and efficiency was assessed using the Pittsburgh Sleep Quality Index (PSQI). Risk of depression was determined using the Center for Epidemiologic Studies Depression questionnaire., Results: The group with AMD showed significantly reduced pupil constrictions (P = 0.039); PIPR amplitudes (P = 0.003); global sleep scores (P = 0.01); and higher levels of depression (P < 0.001) than the control group. There was a significant correlation between the PIPR amplitude and global sleep score in the AMD group (P = 0.01). The amplitude of PIPR significantly correlated with sleep efficiency (P = 0.008; regression, P = 0.01, R2 = 0.13), but not sleep quality (P = 0.23) in the AMD group. There was no correlation between PIPR and depression scores., Conclusions: Intrinsically photosensitive RGC dysfunction in advanced AMD contributes to the observed reduction in sleep efficiency. The correlation between the melanopsin-mediated PIPR and sleep may indicate reduced photic input to the suprachiasmatic nucleus and ventrolateral preoptic area due to ipRGC dysfunction in AMD.

Current hydration assessments involve biological fluids that are either compromised in dehydrated individuals or require laboratory equipment, making timely results unfeasible. The eye has been proposed as a potential site to provide a field-based hydration measure. The present study evaluated the efficacy and sensitivity of intraocular pressure (IOP) to assess hydration status. Twelve healthy males undertook two 150 min walking trials in 40°C 20% relative humidity. One trial matched fluid intake to body mass loss (control, CON) and the other had fluid restricted (dehydrated, DEH). IOP (rebound tonometry) and hydration status (nude body mass and serum osmolality) were determined every 30 min. Body mass and serum osmolality were significantly ( p < 0.05) different between trials at all-time points following baseline. Body mass losses reached 2.5 ± 0.2% and serum osmolality 299 ± 5 mOsmol.kg -1 in DEH. A significant trial by time interaction was observed for IOP ( p = 0.042), indicating that over the duration of the trials IOP declined to a greater extent in the DEH compared with the CON trial. Compared with baseline measurements IOP was reduced during DEH (150 min: -2.7 ± 1.9 mm Hg; p < 0.05) but remained stable in CON (150 min: -0.3 ± 2.4 mm Hg). However, using an IOP value of 13.2 mm Hg to predict a 2% body mass loss resulted in only 57% of the data being correctly classified (sensitivity 55% and specificity 57%). The use of ΔIOP (-2.4 mm Hg) marginally improved the predictive ability with 77% of the data correctly classified (sensitivity: 55%; specificity: 81%). The present study provides evidence that the large inter-individual variability in baseline IOP and in the IOP response to progressive dehydration, prevents the use of IOP as an acute single assessment marker of hydration status.

Purpose: To determine whether decreasing illumination of the Pelli-Robson contrast sensitivity (CS) chart and MP-1 microperimeter to low mesopic conditions is more sensitive to vision changes occurring with healthy ageing and in early and intermediate age-related macular degeneration (AMD) and whether these mesopic tests can differentiate visual function between healthy older participants with and without AMD risk genotypes., Methods: Retinal sensitivity was measured in 98 healthy participants (19-85 years) and 21 AMD (AREDS Grade 2/3) patients (73.9 ± 6.5 years) using the Pelli-Robson CS chart and MP-1 microperimeter under low mesopic and standard illumination. The effect of ageing and AMD on retinal sensitivity was estimated using regression analysis. Healthy older participants (>50 years; n = 24) were genotyped for AMD risk genes CFH and/or ARMS2 and retinal sensitivity was compared between genotypes., Results: With healthy ageing, photopic and mesopic Pelli-Robson CS showed a similar decline (-0.004 log CS/year). In AMD, photopic CS showed a similar decline to healthy ageing (-0.004 log CS/year) while mesopic CS was significantly reduced (-0.007 log CS/year). Both standard and low mesopic microperimetry showed a significant decline (-0.51 and -0.73% contrast/year) with healthy ageing and greater decline (-0.73 and -0.99% contrast/year) with AMD onset. Pelli-Robson CS and microperimetry sensitivity did not differ between AMD risk genotypes in healthy participants., Conclusions: Mesopic Pelli-Robson CS detects functional deficits before photopic CS in early and intermediate AMD that can be differentiated from ageing. This test can be easily administered in clinical practice and may provide a means for early detection of retinal dysfunction., (© 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

Purpose: We determine the effect of short-term light adaptation on the pupil light reflex and the melanopsin mediated post-illumination pupil response (PIPR). Inner and outer retinal photoreceptor contributions to the dark-adapted pupil response were estimated., Methods: In Experiment A, light adaptation was studied using short wavelength lights ranging from subthreshold to suprathreshold irradiances for melanopsin signaling that were presented before (5-60 seconds) and after (30 seconds) a melanopsin-exciting stimulus pulse. We quantified the pupil constriction and the poststimulus response amplitudes during dark (PIPR) and light (poststimulus pupil response, PSPR) adaptation. In Experiment B, colored prestimulus adapting lights were univariant for melanopsin or rod excitation., Results: Increasing the prestimulus duration and irradiance of adapting lights increased the pupil constriction amplitude when normalized to the dark-adapted baseline but reduced its amplitude when normalized to the light-adapted baseline. Light adaptation at irradiances suprathreshold for melanopsin activation increased the PIPR amplitude, with larger changes at longer adaptation durations, whereas the PSPR amplitude became more attenuated with increasing irradiances, independent of duration. Rod versus melanospin univariant adaptation did not alter the constriction amplitude but increased the PIPR amplitude in the rod condition. Correlations between millimeter pupil constriction and PIPR amplitudes were eliminated when normalized to the baseline diameter., Conclusions: The findings have implications for standardizing light adaptation paradigms and the choice of pupil metrics in both laboratory and clinical settings. Light and dark adaptation have opposite effects on the pupil metrics, which should be normalized to baseline to minimize significant correlations between constriction and PIPR amplitudes.

It is difficult to detect visual function deficits in patients at risk for glaucoma (glaucoma suspects) and at early disease stages with conventional ophthalmic tests such as perimetry. To this end, we introduce a novel quadrant field measure of the melanopsin retinal ganglion cell mediated pupil light response corresponding with typical glaucomatous arcuate visual field defects. The melanopsin-mediated post-illumination pupil response (PIPR) was measured in 46 patients with different stages of glaucoma including glaucoma suspects and compared to a healthy group of 21 participants with no disease. We demonstrate that the superonasal quadrant PIPR differentiated glaucoma suspects and early glaucoma patients from controls with fair (AUC = 0.74) and excellent (AUC = 0.94) diagnostic accuracy, respectively. The superonasal PIPR provides a linear functional correlate of structural retinal nerve fibre thinning in glaucoma suspects and early glaucoma patients. This first report that quadrant PIPR stimulation detects melanopsin dysfunction in patients with early glaucoma and at pre-perimetric stages may have future implications in treatment decisions of glaucoma suspects.

Melanopsin expressing intrinsically photosensitive Retinal Ganglion Cells (ipRGCs) entirely control the post-illumination pupil response (PIPR) from 6 s post-stimulus to the plateau during redilation after light offset. However, the photoreceptor contributions to the early redilation phase of the PIPR (< 6 s post-stimulus) have not been reported. Here, we evaluated the photoreceptor contributions to the early phase PIPR (0.6 s to 5.0 s) by measuring the spectral sensitivity of the criterion PIPR amplitude in response to 1 s light pulses at five narrowband stimulus wavelengths (409, 464, 508, 531 and 592 nm). The retinal irradiance producing a criterion PIPR was normalised to the peak and fitted by either a single photopigment nomogram or the combined melanopsin and rhodopsin spectral nomograms with the +L+M cone photopic luminous efficiency (Vλ) function. We show that the PIPR spectral sensitivity at times ≥ 1.7 s after light offset is best described by the melanopsin nomogram. At times < 1.7 s, the peak PIPR sensitivity shifts to longer wavelengths (range: 482 to 498 nm) and is best described by the combined photoreceptor nomogram, with major contributions from melanopsin and rhodopsin. This first report of melanopsin and rhodopsin contributions to the early phase PIPR is in line with the electrophysiological findings of ipRGC and rod signalling after the cessation of light stimuli and provides a cut-off time for isolating photoreceptor specific function in healthy and diseased eyes., Competing Interests: The authors have declared that no competing interests exist.

Intrinsically photosensitive retinal ganglion cells (ipRGCs) regulate pupil size by integrating extrinsic rod and cone signals with intrinsic melanopsin-mediated phototransduction. Light adapted pupil diameter is determined by the corneal flux density (CFD), and for central visual field stimulation the melanopsin-mediated post-illumination pupil response (PIPR) follows this same CFD relationship. Rods, cones, and ipRGCs vary in size, density, and distribution across the retina, but how these differences affect the amplitude and timing of the extrinsic and intrinsic pupil light reflex in the central and peripheral retina is unknown. We determined the relationship between stimulus area and photon flux with stimuli constant for CFD, irradiance, or area at central (0°) and peripheral (20°) eccentricities with high and low melanopsin excitation. We show that the pupil constriction amplitude was similar at both eccentricities and the time to minimum diameter increased as melanopsin excitation increased. In contrast, the peripheral PIPR follows a CFD relationship but with lower amplitude compared with that at the fovea. This indicates differences in the spatial and temporal characteristics of extrinsic and intrinsic ipRGC inputs to the pupil control pathway for the central and peripheral retina. The eccentricity-dependent change in PIPR amplitude may be analogous to the hill of vision observed in visual perimetry; such knowledge is an important precursor to the development of pupil perimetry paradigms to measure the PIPR in select regions of the visual field.

We determined how rod signaling at mesopic light levels is altered by extrinsic temporal white noise that is correlated or uncorrelated with the activity of one (magnocellular, parvocellular, or koniocellular) postreceptoral pathway. Rod and cone photoreceptor excitations were independently controlled using a four-primary photostimulator. Psychometric (Weibull) functions were measured for incremental rod pulses (50 to 250 ms) in the presence (or absence; control) of perceptually invisible subthreshold extrinsic noise. Uncorrelated (rod) noise facilitates rod detection. Correlated postreceptoral pathway noise produces differential changes in rod detection thresholds and decreases the slope of the psychometric functions. We demonstrate that invisible extrinsic noise changes rod-signaling characteristics within the three retinogeniculate pathways at mesopic illumination depending on the temporal profile of the rod stimulus and the extrinsic noise type.

Melanopsin containing intrinsically photosensitive Retinal Ganglion cells (ipRGCs) mediate the pupil light reflex (PLR) during light onset and at light offset (the post-illumination pupil response, PIPR). Recent evidence shows that the PLR and PIPR can provide non-invasive, objective markers of age-related retinal and optic nerve disease; however there is no consensus on the effects of healthy ageing or refractive error on the ipRGC mediated pupil function. Here we isolated melanopsin contributions to the pupil control pathway in 59 human participants with no ocular pathology across a range of ages and refractive errors. We show that there is no effect of age or refractive error on ipRGC inputs to the human pupil control pathway. The stability of the ipRGC mediated pupil response across the human lifespan provides a functional correlate of their robustness observed during ageing in rodent models.

Purpose: To determine whether melanopsin-expressing intrinsically photosensitive retinal ganglion cell (ipRGC) inputs to the pupil light reflex (PLR) are affected in early age-related macular degeneration (AMD)., Methods: The PLR was measured in 40 participants (20 early AMD and 20 age-matched controls) using a custom-built Maxwellian view pupillometer. Sinusoidal stimuli (0.5 Hz, 11.9 seconds duration, 35.6° diameter) were presented to the study eye and the consensual pupil response was measured to lights with high melanopsin excitation (464 nm [blue]) and with low melanopsin excitation (638 nm [red]) that biased activation to the outer retina. Two melanopsin PLR metrics were quantified: the phase amplitude percentage (PAP) during the sinusoidal stimulus presentation and the post-illumination pupil response (PIPR). The PLR during stimulus presentation was analyzed using latency to constriction, the transient pupil response and maximum pupil constriction metrics. Diagnostic accuracy was evaluated using receiver operating characteristic (ROC) curves., Results: The blue PIPR was significantly less sustained in the early AMD group (P < 0.001). The red PIPR was not significantly different between groups (P > 0.05). The PAP and blue stimulus constriction amplitude were significantly lower in the early AMD group (P < 0.05). There was no significant difference between groups in the latency or transient amplitude for both stimuli (P > 0.05). ROC analysis showed excellent diagnostic accuracy for the blue PIPR metrics (area under the curve > 0.9)., Conclusions: This is the initial report that the melanopsin-controlled PIPR is dysfunctional in early AMD. The noninvasive, objective measurement of the ipRGC controlled PIPR has excellent diagnostic accuracy for early AMD.

Purpose: To develop a signal processing paradigm for extracting ERG responses to temporal sinusoidal modulation with contrasts ranging from below perceptual threshold to suprathreshold contrasts and estimate the magnitude of intrinsic noise in ERG signals at different stimulus contrasts., Methods: Photopic test stimuli were generated using a 4-primary Maxwellian view optical system. The 4-primary lights were sinusoidally temporally modulated in-phase (36 Hz; 2.5-50% Michelson contrast). The stimuli were presented in 1-s epochs separated by a 1-ms blank interval and repeated 160 times (160.160-s duration) during the recording of the continuous flicker ERG from the right eye using DTL fibre electrodes. After artefact rejection, the ERG signal was extracted using Fourier transforms in each of the 1-s epochs where a stimulus was presented. The signal processing allows for computation of the intrinsic noise distribution in addition to the signal-to-noise (SNR) ratio., Results: We provide the initial report that the ERG intrinsic noise distribution is independent of stimulus contrast, whereas SNR decreases linearly with decreasing contrast until the noise limit at ~2.5%. The 1-ms blank intervals between epochs de-correlated the ERG signal at the line frequency (50 Hz) and thus increased the SNR of the averaged response. We confirm that response amplitude increases linearly with stimulus contrast. The phase response shows a shallow positive relationship with stimulus contrast., Conclusions: This new technique will enable recording of intrinsic noise in ERG signals above and below perceptual visual threshold and is suitable for measurement of continuous rod and cone ERGs across a range of temporal frequencies, and post-receptoral processing in the primary retinogeniculate pathways at low stimulus contrasts. The intrinsic noise distribution may have application as a biomarker for detecting changes in disease progression or treatment efficacy.

Purpose: The post-illumination pupil response (PIPR) has been quantified using four metrics, but the spectral sensitivity of only one is known; here we determine the other three. To optimize the human PIPR measurement, we determine the protocol producing the largest PIPR, the duration of the PIPR, and the metric(s) with the lowest coefficient of variation., Methods: The consensual pupil light reflex (PLR) was measured with a Maxwellian view pupillometer. Experiment 1: Spectral sensitivity of four PIPR metrics (plateau, 6 seconds, area under curve early and late recovery) was determined from a criterion PIPR to a 1-second pulse and fitted with vitamin A1 nomogram (λ(max) = 482 nm). Experiment 2: The PLR was measured as a function of three stimulus durations (1 second, 10 seconds, 30 seconds), five irradiances spanning low to high melanopsin excitation levels (retinal irradiance: 9.8-14.8 log quanta.cm(-2).s(-1)), and two wavelengths, one with high (465 nm) and one with low (637 nm) melanopsin excitation. Intra- and interindividual coefficients of variation (CV) were calculated., Results: The melanopsin (opn4) photopigment nomogram adequately describes the spectral sensitivity of all four PIPR metrics. The PIPR amplitude was largest with 1-second short-wavelength pulses (≥ 12.8 log quanta.cm(-2).s(-1)). The plateau and 6-second PIPR showed the least intra- and interindividual CV (≤ 0.2). The maximum duration of the sustained PIPR was 83.0 ± 48.0 seconds (mean ± SD) for 1-second pulses and 180.1 ± 106.2 seconds for 30-second pulses (465 nm; 14.8 log quanta.cm(-2).s(-1))., Conclusions: All current PIPR metrics provide a direct measure of the intrinsic melanopsin photoresponse. To measure progressive changes in melanopsin function in disease, we recommend that the PIPR be measured using short-duration pulses (e.g., ≤ 1 second) with high melanopsin excitation and analyzed with plateau and/or 6-second metrics. Our PIPR duration data provide a baseline for the selection of interstimulus intervals between consecutive pupil testing sequences.

Rods, cones and melanopsin containing intrinsically photosensitive retinal ganglion cells (ipRGCs) operate in concert to regulate pupil diameter. The temporal properties of intrinsic ipRGC signalling are distinct to those of rods and cones, including longer latencies and sustained signalling after light offset. We examined whether the melanopsin mediated post-illumination pupil response (PIPR) and pupil constriction were dependent upon the inter-stimulus interval (ISI) between successive light pulses and the temporal frequency of sinusoidal light stimuli. Melanopsin excitation was altered by variation of stimulus wavelength (464 nm and 638 nm lights) and irradiance (11.4 and 15.2 log photons cm(-2) s(-1)). We found that 6s PIPR amplitude was independent of ISI and temporal frequency for all melanopsin excitation levels, indicating complete summation. In contrast to the PIPR, the maximum pupil constriction increased with increasing ISI with high and low melanopsin excitation, but time to minimum diameter was slower with high melanopsin excitation only. This melanopsin response to briefly presented pulses (16 and 100 ms) slows the temporal response of the maximum pupil constriction. We also demonstrate that high melanopsin excitation attenuates the phasic peak-trough pupil amplitude compared to conditions with low melanopsin excitation, indicating an interaction between inner and outer retinal inputs to the pupil light reflex. We infer that outer retina summation is important for rapidly controlling pupil diameter in response to short timescale fluctuations in illumination and may occur at two potential sites, one that is presynaptic to extrinsic photoreceptor input to ipRGCs, or another within the pupil control pathway if ipRGCs have differential temporal tuning to extrinsic and intrinsic signalling., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Background: Serum lutein (L) and zeaxanthin (Z) positively correlate with macular pigment optical density (MPOD); hence, the latter is a valuable indirect tool for measuring L and Z content in the macula. L and Z have been attributed antioxidant capacity and protection from certain retinal diseases but their uptake within the eye is thought to depend on genetic, age, and environmental factors. In particular, gene variants within beta-carotene monooxygenase (BCMO1) are thought to modulate MPOD in the macula., Objectives: To determine the effect of BCMO1 single nucleotide polymorphisms (SNPs) rs11645428, rs6420424, and rs6564851 on MPOD in a cohort of young healthy participants of Caucasian origin with normal ocular health., Design: In this cohort study, MPOD was assessed in 46 healthy participants (22 male and 24 female) with a mean age of 23.8 ± 4.0 years (range 19-33). The three SNPs, rs11645428, rs6420424, rs6564851 that have established associations with MPOD were determined using MassEXTEND (hME) Sequenom assay. One-way analysis of variance was performed on groups segregated into homozygous and heterozygous BCMO1 genotypes. Correlations between body mass index (BMI), iris color, gender, central retinal thickness (CRT), diet, and MPOD were investigated., Results: Macular pigment optical density neither significantly varied with BCMO1 rs11645428 (F 2,41 = 0.70, p = 0.503), rs6420424 (F 2,41 = 0.21, p = 0.801) nor rs6464851 homozygous or heterozygous genotypes (F 2,41 = 0,13, p = 0.88), in this young healthy cohort. The combination of these three SNPs into triple genotypes based on plasma conversion efficiency did not affect MPOD (F 2,41 = 0.07, p = 0.9). There was a significant negative correlation with MPOD and CRT (r = -0.39, p = 0.01) but no significant correlation between BMI, iris color, gender, and MPOD., Conclusion: Our results indicate that macular pigment deposition within the central retina is not dependent on BCMO1 gene variants in young healthy people. We propose that MPOD is saturated in younger persons and/or other gene variant combinations determine its deposition.