Jean-François Le Gargasson

Is there a systematic location for the pseudo-fovea in patients with central scotoma?

The retinal location of preferential fixations of twenty-four patients with central scotoma were studied when reading digits projected onto their retina with a scanning laser ophthalmoscope. In the majority of cases the fixation was located on the left part, or the inferior part of the visual field relative to the central scotoma. The fact that the inferior visual field is used is coherent with the notion that the lower visual field is important for locomotion. However the preferential use of the left field appears contradictory with data showing superiority of visual faculties in the right visual field. This result may possibly be explained in relation to the need for left-to-right readers to monitor where their eyes have landed relative to the word previously fixated on the left.

Eye fixations near corners : evidence for a centre of gravity calculation based on contrast, rather than luminance or curvature

Subjects scanned line drawings of polygons in order to count the number of corners. The positions their eyes fixated were studied as a function of the size of the angle and whether the apex of the angle was present or absent. The results showed that the eyes tended to land at a position near the centre of gravity of the corner configurations. The observed landing positions were coherent with the hypothesis that the centre of gravity was calculated within an attentional spotlight centered on the apex of the corners, and that the calculation was based not on the total luminance distribution, nor on the distribution of energy in a neurophysiologically motivated curvature detector, but simply on the basis of a contrast detector.

Scanning laser ophthalmoscope imaging of fluorescein-labelled blood cells

Abstract• Purpose: To demonstrate the feasibility of a technique for the visualization by scanning laser ophthalmoscope (SLO) of fluores cein-labelled autologous leukocytes and platelets in retinal vessels. • Method: Individual blood samples from rats and rabbits were centrifuged to isolate platelets and leukocytes, then passively labelled with fluorescein and reinjected into the same animal. An SLO was used to visualize and record cell displacement in the retinal circulation. Labelled platelets were analysed by flow cytometry. • Results: By SLO, platelets appeared as a heterogeneous particle flow, and individual leukocytes appearing as brighter spots could easily be traced. Flow cytometry showed that after labelling platelets were well individualized and their size was slightly increased. • Conclusion: Circulating blood cells can be visualized in retinal vessels by a simple method consisting of passive labelling of autologous platelets and leukocytes by fluorescein. No platelet toxicity was detected. This method could be applied to the study of blood cell movement in human retinal vascular diseases.

Contribution of scanning laser ophthalmoscopy to the functional investigation of subjects with macular holes

A study was designed to validate a functional investigation performed with the scanning laser ophthalmoscope before surgery for macular holes in 12 eyes: The assessment included fundus examination, a functional examination resulting in evaluation of the preferred retinal lows, visual acuity and recording of visual evoked potentials. The preferred retinal locus was evaluated by presenting a small square area, and visual acuity was determined by means of calibrated figures. The visual evoked potentials were evoked by three alternating checkerboards (check size, 30′, 2 Hz) centered over the hole and seen at an angle of 6.5 × 6.5°, 2.5 × 2.5° and 6.5 × 6.5° with central exclusion of 2.5 × 2.5°. The appearance of the fundus visualized by scanning laser ophthalmoscopy consisted of a clear central disk corresponding to the hole, surrounded by a very dark ring, associated with a second, less dark ring with unclear margins. Fixation was unstable in one case with a visual acuity of 20/70. In 11 cases, fixation was localized to the superior retina with a visual acuity superior to 20/70. The visual evoked potentials evoked by 6.5 × 6.5° were discernible in all 12 eyes; visual evoked potential by annular stimuli were discernible in 11 cases. The 2.5 × 2.5° stimulus evoked no response in eight cases, proving the area of the hole was nonfunctional. A response was recorded in the four other cases, where the dimension of the holes was less than 2°. The results of this scanning laser ophthalmoscopic assessment demonstrated a precise evaluation of the residual macular function in the cases of full-thickness macular holes.

ERGs in female carriers of incomplete congenital stationary night blindness (I-CSNB). A family report.

ERG findings in five sisters are reported. By pedigree analysis, four of the five must be obligate carriers for I-CSNB since their sons were affected (impaired night vision, reduced visual acuity, variable ametropia, congenital nystagmus and ERG with both scotopic and photopic b-wave reduced amplitude). The fifth was childless at the time of examination and her ERG analysis was normal. Three of the four obligate carriers showed significant reduction in the sum of the OPs amplitude as previously reported as being an electrophysiological signs in female carriers: two without alteration in other ERG components and the third with association with a flicker ERG amplitude significantly increased. The fourth female carrier showed a normal sum of the OPs amplitude whereas the other b-wave ERG or flicker amplitudes were significantly decreased. These last two ERG results suggest a possible modifications of synaptic transmission at a post-receptoral site (outer plexiform layer or involvement of the bipolar pathways) in these two carriers.

Adding the third dimension on adaptive optics retina imager thanks to full-field optical coherence tomography

Retinal pathologies, like ARMD or glaucoma, need to be early detected, requiring imaging instruments with resolution at a cellular scale. However, in vivo retinal cells studies and early diagnoses are severely limited by the lack of resolution on eye-fundus images from classical ophthalmologic instruments. We built a 2D retina imager using Adaptive Optics to improve lateral resolution. This imager is currently used in clinical environment. We are currently developing a time domain full-field optical coherence tomograph. The first step was to conceive the images reconstruction algorithms and validation was realized on non-biological samples. Ex vivo retina are currently being imaged. The final step will consist in coupling both setups to acquire high resolution retina cross-sections.

First Adaptive Optics Images with the Upgraded Quinze-Vingts Hospital Retinal Imager

In a retinal imaging instrument, the ocular aberrations are time-varying, leading to images degradation. Adaptive Optics improves resolution. We describe here several modifications made on our system and their impact in terms of image quality.