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OCR for page 23
PHOTORECEPTOR PROPERTIES
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INTRODUCTION
Eliot L. Berson
Night blindness disorders represent a significant cause of visual
loss to people all over the world. The incidence of these conditions,
sometimes grouped under the heading of retinitis pigmentosa, has been
estimated to be 1 in 3,500 births in the United States. Affected pa-
tients can be asymptomatic and have normal visual acuity and yet have
considerable compromise in visual function due to abnormalities in dark
adaptation and loss of midperipheral visual field. These patients can
perform visual tasks under bright daylight conditions but fall to per-
form the same task under starlight or moonlight conditions and, in some
cases, under dim daylight conditions as well. This variability in per-
formance, depending on the conditions of illumination, poses hazards to
those affected as well as to those with whom they work. Some can have
20/20 vision but are legally blind due to the profound loss of their
peripheral visual field with consequent "tunnel vision." Most of these
disorders occur as a consequence of malfunction and loss of rod and cone
photoreceptors.
Considerable progress has been made in our understanding of normal
photoreceptor function, and this has provided us with a framework for
understanding the pathophysiology of different types of retinal dis-
eases associated with night blindness. Sensitive tests of retinal
function have made it possible to diagnose these conditions in their
earliest stages, sometimes many years before the patient is symptomatic
or changes can be seen on routine ocular examination. Two rare heredi-
tary diseases associated with night blindness and retinitis pigmentosa
are treatable if detected in the early stages. Electrooptical techno1-
ogy has resulted in development of the night vision pocketscope that
can be used to alleviate the symptom of night blindness.
The papers in this section provide examples of the wide range of
approaches that are being used to understand normal and abnormal pho-
-toreceptor function. These include psychophysics, electrophysiology,
biochemistry, electron microscopy, and molecular genetics. Current
knowledge of the mechanism of visual excitation is reviewed, as is our
understanding of how conditions of illumination affect visual function.
The disorders themselves are considered in the context of early diagno-
sis and some aspects of pathogenesis and management. It is hoped that
these papers will encourage the continued examination of methods for
assessing these patients and further research on causes and possible
treatments.
25
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PHOTOTRANSDUCTION AND DARE NOT SE IN
l
ROD PHOTORECEPTORS
David R. Copenhagen and Tom Reuter
A study of night vision necessarily confines itself to an examina-
tion of seeing mediated by rods and the rod visual pathways. In the
rod system, high spatial and temporal resolution and color vision are
sacrificed for an extremely high sensitivity to very dim lights. Under
optimal conditions, fewer than 100 photons striking the eye are suffi-
cient for rod-mediated vision. In equivalent terms, the dimmest detec-
table visual stimulus corresponds to the light from a candle placed
some 17 miles away. Certainly, there are mechanisms to enhance visual
sensitivity as the signals travel along the rod pathways to cortical
centers in the brain. However, the rod photoreceptors themselves are
responsible for much of the high sensitivity of rod-mediated vision.
The conversion of each photon absorption by a rod into an electrical
signal is a high-gain biochemical process. This paper discusses cur-
rent hypotheses related to how the rod photoreceptors transduce light
into electrical energy and how they achieve their high sensitivity.
One must keep in mind, however, that high gain alone does not
guarantee optimum detection of a dim light. Seeing dim objects also
involves an optimization of the signals with respect to the noise.
This paper also addresses the origin of biological noise sources in
the retina that limit night vision.
TRANSDUCTION OF LIGHT IN THE RODS
Structure of a Typical Rod
The rods of vertebrates are cylindrical in shape and are perhaps
the most structurally specialized class of neurons in the nervous
system. See Figure 1 for a schematic drawing of a typical rod photo-
receptor. In-depth reviews of rod transduction have recently been
published (Korenbrot, 1985; Schwartz, 1985; Stryer, 1986~. The outer
segments of the rods are embedded in the retinal pigment epithelium at
the most distal margin of the retina. These outer segments function as
the sole lock s for transduction. The inner segments of the rods are
connected via a ciliary bridge to the outer segments. The inner segment
of the rod contains m itochondr ia, Golgi apparatus, rough endoplasmic
reticulum and, in many poikilotherms including reptiles and amphibians,
26
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27
Retinal Pigment Epithelium
-
Outer
Segment
Inner
Segment
Rh G . PDE t~
~ . -
Light ~ ~ GMP
chat
/
\
.
,. . )
cGMP
~ ~ I
4 Dark
Current
NatI,/
¢~ C>,/
Synaptic / O 1°
Tern~inal ~ Oo fig
_
Horizontal
Cells
K+
Bipolar
Cells
FIGURE 1 Schematic diagram of rod and mechanisms under ying the light
responses. Abbreviations: Rh, rhodopsin; PLE, phosphodiesterase; GAP,
guanosine monophosphate; cGhiP, cycl ic GAP .
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28
a store of glycogen. The inner segment is the site of cellular metabo-
lism and protein synthesis. The synaptic terminal, at the proximal end
of the inner segment, is the site specialized for communication with
the second-order cells. Here, synaptic transmitter molecules are pack-
aged within vesicles and secreted into the thin cleft separating the
rods from the horizontal and bipolar cells, the neurons immediately
postsynaptic to the rods.
The outer segment consists of a plasma membrane which forms an
envelope around a stack of pancake-like disks. These disks float
inside the outer segment and are structurally and electrically iso-
lated from the plasma membrane. They do appear to be tethered by
slender strands that reach from the edges of the disks to the inside
wall of the plasma membrane (Roof et al., 19821. The membrane of each
disk, which is probably more correctly visualized as a flattened bal-
loon, contains the photopigment rhodopsin. The absorption of incident
photons by rhodopsin is the initial step in transduction. A total of
10 -10 of these protein molecules (240,000 molecular weight) are em-
bedded in the membranes of the ~103 stacked disks. The wavelength at
which rhodopsin exhibits its peak absorption ranges from 500 to 525 nm,
depending on the species--this peak wavelength confers on the rod system
an optimal sensitivity to lights in the green section of the visible
spectrum.
New disks are generated continuously at the base of the outer seg-
ment, while the older disks are shed continuously from the tip of the
outer segment where they are broken down by macrophagic and lysosomal
degradation In the pigmented epithelium. Disk shedding f rom rods ap-
pears to be circadian, with a peak of activity at the onset of morning
light. A typical disk has a lifetime of about 10 days.
Electron microscopic studies of disk membranes reveal 60-~-diameter
bumps on the intradisk surface at densities of 30,000/pm2. These bumps
correspond to the rhodopsin molecules. Examination of the extradisk
side of the disk membrane shows large particles projecting above the
surface and randomly distributed with a density of 2,000/m. These
particles are believed to be the G protein, which is activated by
bleached rhodopsin and is involved in the regulation of phosphocies-
terase (PDE) (see below).
Electrical Properties of the Rod in Darkness and in Light
The generation of the electrical signal in the rods results from
closure of specific ion channels located within the plasma membrane
envelope of the rod's outer segment. Before covering the specific
hypothesis linking the absorption of rhodopsin to the closure of these
channels, it would be good to review the quiescent properties of the
dark-adapted rod. In darkness, the rod is principally permeable to
Na+ and K+ ions and moderately permeable to C1 and Cam. The trans-
membrane potential in the dark is typically about -40 mV. The K and
C1- permeability is conf ined primarily to the inner segment, while the
flat permeabili ty is loca ~ ized to channels in the plasma membrane of the
outer segment. Calcium ions can flow through channels in the inner and
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29
outer segments. Due to the spatial separation of these selectively
permeable ionic channels, a net positive current flows extracellularly
along the outside of the rod from the inner segment to the outer seg-
ment, enters the rod through the Na+-selective (and probably C1 - and
Ca+~-selective) channels of the outer segment, and returns to the inner
segment through the ciliary bridge. This ionic current is termed the
dark current. The ionic gradients across the rod membrane that serve
as batteries for the ion flow are maintained by an ouabain-sensitive,
ATP-dependent Na+/K+ exchange pump in the inner segment membrane. This
pump clears Na+ from the intracellular cytosol and pumps Kay into the
interior of the rod from the extracellular space. The magnitude of the
dark current is species dependent and ranges between 10 x ~o~12 and
70 x 10 12 A. Monkey rods have dark currents of 12 pA (Baylor et al.,
1984), while tiger salamander rods exhibit dark currents of 55 pA; The
Na+ influx into the outer segment during darkness is about 10 Na
ions/rod/s in toad and frog rods. On the assumption that each of these
Na+ channels has a conductance of about 60 x 10-15 Q. that the membrane
potential is -40 mV, and that the reversal potential for Nat ions is 0
my, this would indicate that the 20-pA dark current is conducted through
about 5 x 103 open ionic channels in the plasma membrane of the outer
segment.
The absorption of an individual photon by a single rhocopsin mole-
cule causes an isomerization of the rhodopsin molecule from a cis to a
bans configuration. This single isomerization in a rod's outer seg-
ment initiates ~ cascade of events that results in the closure of 2-4
percent of the channels conducting the dark current (Baylor et al.,
1979b). In toad rods, the single photon signal represents the cessa-
tion of 1 pA of the dark current or about 4 percent of the total. This
single-photon response corresponds to the cessation of 106 to 107 Na+
ions/e resulting from the simultaneous closing of about 200 ionic
c hannel s .
B iochemical L ink between Photon Absorption and Channel Closings
Given the ultrastructural picture of the rod and the need to explain
the amplif ication f rom the single-photon absorption to the closure of
200 channels, two requirements for transduction are evident: ( 1) there
must be one or more processes which amplify the effects of a single pho-
toninitiated rhodopsin isomerization. The transformation of a single
molecule cannot easily explain how 200 spatially separate channels can
be modulated; and (2) there must be an internal, diffusible transmitter
linking the photon absorption by rhodopsin on the disk membrane with
the closing of channels in the electrically isolated plasma membrane.
Intense research into the mechanisms mediating the generation of
the electrical signal has been going on for the last 20 or more years.
Originally, Ca++ was hypothesized as the internal transmitter
(Yoshikami and Hagins, 1973~. Stores of Ca++ believed to be seques-
tered within disks, were thought to be released on ~somerization of the
rhodopsin. Many hundreds or thousands of Ca++ ions were thought to
diffuse into the plasma membrane and subsequently block the ionic
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30
channels carrying the dark current. Recent experiments with C a++ buf-
fers injected into outer segments (Matthews et al., 1985) and a lack of
correspondence between Ca++ fluxes and the time course of the electri-
cal response seriously undermine the validity of the Ca++ hypothesis
(Gold, 1985~.
Recent evidence indicates that the monophosphonucleotide cyclic
guanosine monophosphate (cGMP) may be the internal transmitter. On
this idea, cGMP levels are believed to be relatively high inside the
outer segment in the dark. The presence or binding of cGMP to the
cytosolic surface of the ionic channels of the plasma membrane is
believed to hold these channels open to current flow. On photoiso-
merization, the bleached rhodopsin is thought to activate a G protein
Lasso called transducing, which in turn activates PDE molecules. The
activation of PDE hydrolyzes cGMP to GMP, thereby reducing the intra-
cellular concentrations of cGMP. This decrease causes the ionic chan-
nels to close and thus suppress some of the dark current. Several
recent results support this hypothesis. These include the demonstra-
tion that cGMP can act on conductances in the plasma membrane (Fesenko,
1985; Nakatani and Yau, 1985), that cam injected into the outer seg-
ment increases the dark current, and that the injection of PDE evokes a
change in the rod's dark current (and membrane potential) which mimics
light. Thus, cGMP is a satisfactory candidate for an internal trans-
mitter.
The amplification afforded by this process can be seen in an exam-
ination of the number of intermediate molecules activated by each step.
Under optimum conditions rhodopsin can activate 104 G prote~ns/s. One
G protein can, in turn, under optimum conditions, activate 500 PDE mole-
cules/s. The details of the reactions w' thin the cells themselves are
still unclear, but it is known that in rods, one photoactivated rhodop-
sin molecule can destroy 105 cGM~ molecules/s.
Once the channels are closed by the reduction of cGMP, the cessa-
tion of dark current causes the transmembrane potential to become more
negative thyperpolarize). This hyperpolarization modulates the release
of synaptic transmitter molecules from the synaptic terminal. This
change in transmitter release signals the photon absorption to the
second-order neurons in the rod pathways. These changes are relayed by
similar modulatory schemes from neuron to neuron up to the higher vis-
ual centers.
SIGNAL DETECTION AND DARK NOISE IN THE UTICA
As discussed above, a reasonable hypothesis exists for the trans-
duction mechanism. Further studies are required for validation. Ir-
respective of which mechanisms may be proven to underlie transduction,
however, there are many additional aspects of visual processing that
one must consider to understand the limits of night vision. The high-
gain mechanisms of the rod are not sufficient by themselves to ensure
that a photon or a group of photons get "seen." To illustrate this
point, one car, visualize the problem of trying to listen to one con-
~-ersation across a crowded rood f illed with many other conversations.
OCR for page 31
31
Being able to increase the gain on a microphone (unless it is a airec-
tional one) will amplify the conversation of interest and all the other
conversations which for these purposes could be considered noise. So
detection of a selected conversation or a dim light is a signal-to-noise
task, whereby a signal of potential interest must be extracted from on-
going noise. In the following sections, noise sources that limit detec-
tion of dim lights by the retina are discussed. At the levels of light
used for night vision, there appear to be two main noise sources that
limit detection: (1) random fluctuations in the stimulus itself, and
(2) biological noise in the retina.
Photon Noise
Light, being composed of independent photons, is random in nature
and therefore inherently noisy. If one considers a brief flash of
light, the randomness of the photon fluxes is evident. For a series of
identical flashes, there will be a mean number of photons per flash (m).
In any one flash there may be fewer or more photons than the mean. The
statistical variation of the photon actually delivered per flash follows
a Poisson distribution in which the probability of obtaining photons is
related to the mean by:
P(x = n, = beam mn'/n,
Where P (x = n) is the probability that each flash will contain exactl y
n photons, g iven that the mean number is m. I t can be shown that the
variance of the number of flashes is equal to the mean for such a dis-
tribution and the standard deviation (~) is equal to the square root of
the mean.
For dim lights delivering an average of 1,000 photons per flash
to the rods of the eye, the standard deviation of the photon count is
31. 6. For a much dimmer light delivering 10 photons, the standard
deviation is 3.16 photons. This points out an important limitation in
vision. Namely, the variance/mean ratio increases for dimmer lights.
For very dim lights there is a large percentage of uncertainty as to
how many photons are delivered per flash. For brighter lights, e.s.,
where 104 photons are incident on the cornea, the ratio of the standard
deviation or variance to the mean is much less. Hence, the photon noise
is less prevalent.
Hecht et al. (1942), in their classical experiments measuring the
absolute dark-adapted sensitivity of human vision, found close agreement
between the randomness of seeing, as would be predicted by photon noise,
and the estimated number of photons reaching the roast Their results
implicitly assumed that vision at absolute threshold was limited strict-
ly by photon noise.
Barlow ( 1956) disputed the photon noise assumption and postulated
that a second sou rce of noise imposed severe limitations on the relia-
bility with which very dim 'ights could be detected. Barlow's (1956)
assertion rested on results of some of his own experiments and a recal-
culation of the number of photons that actually struck the retina in
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32
experiments similar to those of Hecht et al. (1942~. Barlow called this
second noise source dark light and likened it to spontaneous photon-like
events in the dark. That is, on a random basis the retina would wrongly
register the arrival of a photon. The task of detecting an actual dim
light was complicated by these spontaneous dark events.
In an attempt to substantiate or rule out the Barlow (1956) hypothe-
sis that these dark events limited detection in the retina, an endeavor
was made to record threshold responses from ganglion cells in the retina
of a rod-dominated animal and test whether the detection of dim lights
was indeed influenced or limited by dark events. Recording was done
extracellularly from ganglion cells in the retina of Bufo marines. The
retinas of these animals can be maintained for several hours in an open
eyecup preparation under an atmosphere of pure, moistened O2. This pre-
paration offers several advantages. Since the anterior portion of the
eye can be dissected away, light calibration is made easier. Further-
more, intracellular recordings can be made of the light responses in
the rods and other cells distal to the ganglion cells.
Figure 2 shows typical data from ~ ganglion cell in Bufo marinus
retina. Very dim flashes were presented multiple times at intensities
below, at, or above those which elicited an action potential, the
a)
c
o
Q
~ 0.8
c:
=
o
._
ct
-
-
._
ce
Q
1 .0
0.6-
0.4-
0.2
__-~' ~
.... X_
· /
. /X
. f.'
:~.
X
- ~I I ~
-oo 0.5 1.0 1.5
Log Intensity
FIGURE 2 Frequency of response functions for a ganglion cell. Abscissa
plots the log (mean) flash intensity where 1. a = lo flash-indu~ed ~so-
merizations within the recpetive field. The ordinate shows the fraction
of flashes elicting an action potential in the ganglion cell with 2 s
following the flash. Ten flashes (at interstimulus intervals of 30 s)
were resented at each intensity. The dotted and solid continuous curves
plot, as a function of mean intensity, the probability that the number
of events, X, exceed a criterion value, c. The steeper dotted curve,
the abscissa values denote flash-induced isomerizations. The flatter
curves assume that the number of events is comprised of photon-elicited
events plus dark events. The solid curve is plotted assuming that the
rate of dark events was 0.06/rod and s. The shallowest dotted curve
shows the curve assuming there were 0.24 dark events/rod and s.
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33
threshold response, in the ganglion cell. The ordinate plots the per-
centage of flashes causing a response at each respective intensity.
The steeper dotted line plots the predicted frequency of response func-
tion on the assumption that the threshold responses were responding
only to the photons in the light stimulus. This curve is a cumulative
Poisson distribution (Barlow, 1964~. The actual data points fell along
a shallower curve. Following the example of Barlow (1964), it was
assumed that there is a continuous rate of ongoing photon-like events
indistinguishable from the photon events. By altering the presumed
rate of these events, the best curve was fitted to the data. For
Figure 2, the best fit was obtained for a dark rate equivalent to 0.05
dark events/rod and s. These data and the results from other cells
indicate that threshold detection is not limited strictly by photon
noise and that a second source of noise exists which can be attributed
to spontaneous dark events in the rods.
If there were dark events in the rods, one might expect to find
evidence in horizontal cells for fluctuations caused by these dark
events. Figure 3 shows intracellular recordings from a horizontal cell
in Bufo marines retina. The membrane potential is seen to fluctuate in
darkness, and the magnitude of the fluctuations is increased by the
background light which produces 0.58 photoisomerizations/rod and s.
Figure 3B is a power spectral density curve calculated by a fast
Fourier transform (FFT) method. This shows the power inherent in the
fluctuations as a function of frequency. Both the background and dark
curves display a prominent low-frequency component (<1 Hz). A differ-
ence spectrum (background-dark) is shown in Figure 3C. This difference
spectrum shows the power added by the background light. Also shown
~ pluses) is the power spectral density of very dim flash responses in
the same celle The overlap of the difference spectrum and the flash
spectrum strongly suggest that the background fluctuations are com-
prised of many single-photon events which sum linearly together.
Having established the likelihood that the background fluctuations
originated with photon events, the key question then becomes whether
the fluctuations in the dark originate with the photon-like dark events.
Since the low-frequency components of both power spectral density curves
overlap with a vertical scaling (Figure 3B), it is reasonable to assume
that the dark fluctuations are caused by photon-like events occurring
at a frequency substantially less than the 0.58 photoisomerizations/rod
and s evoked by the background light. A comparison of the total vari-
ance (area under the curve) of the low-f requency components indicates
that the dark fluctuations would result from a spontaneous dark rate of
0.02 photoisomerization-like events rod and s. This rate of dark events
compares favorably with the rate deduced from the frequency of response
curves obtained from the ganglion cells.
Within the last several years, the technology of recording currents
flowing into and out of individual neurons has evolved. Baylor and
colleagues, by using suction-type microelectrodes, recorded the dark
currents of individual rods (Baylor et al., 1979a, 1979b, 1984~. They
found a stereotyped response to light flashes that elicited single pho-
toisomerizations. When the rods were kept in absolute darkness for per-
iods of several minutes, spontaneous photon-like responses were observed
OCR for page 70
- 5
70
,
w
mu
-
w
u,
-
lo
.
TESt - `~, as
BAt!GROUBO : 491 .R
DURATION ~ 200 RSEt
DItAY: 400 RSEt
~ Be
A/
- 1 ~1
i f
. ~1 1 1 1 I I
-A S -` -I -2 -1 0
IOC BAt`GROUBD INlENSlT' IRE: 1.0 ERC/SEC'DECREE SQUARED)
~ Off
it.
FIGURE 9 Threshold just before and just after extinction of a back-
ground field. The difference between the two is attributed to noise
under steady illumination. Source: Krauskopf and Reeves (1984~.
SOME PRACTICAL CONSIDERATIONS
Limits of Sensitivity
Whatever the reason, the human visual system falls short of sev-
eral ideals. This leaves room for enhancement of visual performance
through various aids. Telescopes and microscopes are classic examples.
Knowing how the eye compares with various instruments intended to do
similar tasks may help to determine the best combination of eye and
instrument, and knowing the specific ways in which human performance
deviates from an ideal may help to design aids that will bring the
entire system closer to the ideal. It was argued above that even when
the eye is at its best, it adds noise to that which inevitably accost
panics the signal, and that in a variety of tasks human observers do
about 10 times worse than an ideal quantum detector. This suggests
that the signal-to-noise ratio can be increased by amplifying the stim-
ulus, noise and all, for it would reduce the relative contribution of
the noi se that is intr insic to the visual system. This is no secret
to those who have worked with image intensif iers. According to the
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71
measurements of van Meeteren (1978), improvements of quantum eff ciency
by image intensifiers are typically 100 to 1.
Binocular Vision
Same military applications require monocular viewing, as in
sighting through optical devices and heads-up displays. Evidence
presented above suggests that vision is likely to be best if light
adaptation of the nonviewing eye is maintained.
Transient Visual Adaptation
The brief period of reduced sensitivity lasting about a second
following large changes of illumination, referred to as transient
visual adaptation and sometimes as neural adaptation, is of con-
siderable practical importance. Therefore, it has been treated
extensively in the illumination engineering literature (cf. Kaufman
and Christensen, 1972) and so needs no further treatment here.
Screening Procedures
Human Factors and Testing
Some of the issues relating to screening for night vision are
not specific to vision and can be handled by specialists in testing
or human factors or by reference to data in the literature on human
factors, such as the text by Bailey (1982) or the reference works of
Van Cott and Kinkade (1972) or Woodson (1981~.
Duplicity
A long-standing dogma of visual science is that the rod and cone
systems form not one but two largely independent visual systems, each
specialized to function under different conditions, but sharing the
same retina and visual pathway. As the specialized functions of the
cone system demand a high density of receptors, the small part of the
retina const ituting the fovea is 9 iven over entirely to the cone sys-
tem, and a ref ined eye movement mechanism has evolved the capability
to bring this part of the retina to coincide with interesting parts of
the retinal image. However, the proportion of the retina numer ically
dominated by cones is exaggerated by our subjective experience and
actually occupies less than 0.02 percent of the retina. As the two
systems are specialized to operate under different levels of illumina-
tion, one system tends to lie dormant while the other system is doing
the work of vision, and so perhaps to save resources, both use the
same pathway to the brain and the same neural machinery to process the
information that their separate receptor systems gather. As the same
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72
optic nerve fibers carry the information for both systems, except in
the fovea, the signals from the two systems are bound to interact under
some circumstances, yet under most conditions the systems operate with
astonishing independence.
Several practical implications follow. Insofar as the systems
have different functions, and to the extent that they compete for
space and access to the brain, testing one will tell little about the
other, and performance that depends more on one system could even vary
inversely with that which depends more on the other system. Other fac-
tors, such as optical quality of the eye, affect one system more than
the other, and so would tend to make performance that depends more on
one system somewhat independent of performance that depends more on
the other systems Conversely, insofar as the same central mechanisms
are used by both systems, measures that depend primarily on central
processing are likely to correlate well with one another. My own
impression is that cone sensitivity, as reflected by the level of
the cone plateau of dark adaptation curves, is more variable than
rod sensitivity, as reflected by the dark-adapted absolute threshold.
Equivalent Backgrounds
One of the significant findings about light and dark adaptation is
that the state of the visual system under an enormous range of condi-
tions can be characterized by a single parameter referred to as the
equivalent background (Crawford, 19471. Hence, to measure an indi-
vidual's adaptive state, there is seldom a need to test with more than
one kind of test probe. Crawford successfully generalized his finding
from the simple geometric shapes of the laboratory to natural objects,
such as a zeppelin over Hamburg, a small boat in a harbor, and a dis-
tant house on the horizon.
SUMMARY
Through a consideration of human performance at the absolute
threshold for detecting light, I have tried to illustrate the value
of comparing human performance with ideal systems and to stress the
limits on vision attributable to noise. I have pointed to the many
different sites at which adaptation to changing illumination occurs
and estimated the magnitude of each under different illumination.
Finally, I have discussed ways of reducing the limits that intrinsic
noise places on visual performance and the implications that the
mechanisms of visual adaptation might have for night vision screening
procedures.
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73
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GENERAL DISCUSSION
BERSON: Does anyone feel that normal rod function would be enhanced
by taking vitamin A every day?
PITTS: The work that has been done on this shows that if a person
has sufficient amounts of vitamin A, additional amounts of vitamin A
are not going to help them. But we do know that if vitamin A is not in
their diets, they're going to get an elevated threshold.
A. MENENDEZ: I 'm with Technology Incorporated. It has come to our
attention that the Air Force Office of Scientific Research is inter-
ested in funding ways to improve normal vision through pharamacolog ical
research--"super-vision," as we call it. That raises the question of
whether normal vision is limited not so much by the physiological prom
cess as by the actual quantum nature of light. If we believe in the
doctrine of quantum limitation, then it seems that normal vision could
not be improved and that the limiting factor is the physics of the light
involved. I think that's related to the question of vitamin A in a
general sense.
BERSON: Dr. Copenhagen, would you like to comment on that? Do you
think we have the most visually efficient system we could possibly have?
COPENHAGEN: I would think selective evolutionary pressures would
make it optimal. There is some dispute still over whether we are
photon-limited at the absolute threshold. But the point is that you
cannot get any better from the physics of the light. That's what the
ideal observer can do. So you can build no machine that's better than
that. There's no drug that you can take that's going to somehow change
the physical properties of light. That's as far as we can go. So if
that's super-vision, that would be the definition of super-vision.
MACLEOD: I'd like to mention one interesting experiment concerned
with super-vision and dietary vitamin A deprivation. One way to improve
vision--even if the vision system is currently quantum-limited--is to
absorb more quanta. I understand that during the war an effort was
made to develop super-vision in the infrared by substituting vitamin A2
for vitamin Al in the diet, which should give a redward shift in the
visual pigment absorption spectra. Experiments were done in Britain
during World War II, but the project turned out to be infeasible with
humans because it was difficult to induce sufficient vitamin A depriva-
tion without endangering the general health of the observer. The ex-
periment, however, has been made successfully using rats (S. Yoshikami,
J . Pearlman, and F . Crescitelli, Vision Research 9: 633-646, 1969) .
76
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77
MAKOUS: I do want to add one thing to that. When we talk about
"optimum," it depends on what "optimum" you're talking about. At abso-
lute threshold, detecting quanta is certainly what the organism needs
to do, but at high levels of illumination, it is more important to make
discriminations of fine differences in the environment than simply to
detect quanta. It is important to keep in mind what "optimum" you're
comparing performance against.
JOHNSON: I'd like to introduce the subject of individual differ-
ences, particularly with regard to the ideal observer and the limiting
factors on vision. There are considerable individual differences in
the normal population. I was wondering if any of you would like to
comment upon these individual differences. I'd also like to ask how
the various clinical and psychological measures of photopic and sco-
topic visual function compare in terms of the individual variations.
What kind of correlations do you find among the various tests in normal
individuals?
MAKOUS: Crawford measured dark adaptation among 26 nonclinical
subjects and found that the standard deviation of their time to a given
point in dark adaptation was about 60 percent of the mean, which I would
consider substantial variation among a nonclinical population. Another
issue has to do with the relationship between cone dark adaptation and
rod dark adaptation, but I don't have any data on it. I expect from our
research that rod adaptation wouldn't tell you much about cone sensitiv-
ity, or rate of cone dark adaptation or vice versa. They are factors
that would tend to make the two systems competitive, and other factors
would lead to independence of the two estimates.
MASSOF: I want to respond to Chris's fJohnson] question on individ-
ual differences. We've been doing studies with the electroretinogram
[ERG] in normals to look at sources of variability. If you look across
normal observers with the electroretinogram and look at a number of dif-
ferent intensities so you're varying the amplitude across observers, the
standard deviation of the between-observer distribution is a constant
proportion of the mean amplitude. And the proportionality constant, the
coefficient of variation, is 18 percent. So what that means is that
across the normal population you expect to see a standard deviation of
approximately 18 percent on the amplitude of the electroretinogram, on
the dark-adapted eye. However, the within-observer coefficient of var~-
ation is approximately 11 percent. So a large portion of the between-
observer variability can be attributed to within-observer variability.
The cetween-eye variables' coefficient of variation--recording the res-
ponses of both eyes to the same flash--is about 3 percent.
FISHMAN: Regarding visual f ield reproducibility, we have had the
opportunity to look at it in the same individual repeated three times
over a per lad of approximately 3 weeks. The visual field reproducibil-
ity can be extremely poor, particularly in patients with ocular disease.
In some patients with retinitis pigmentosa, the visual field area can
vary by as much as 50 percent on short-term retest.
BERSON: We found that the intervisit variation for 24 patients
with retinitis pigmentosa was such that one had to have a change of
greater than 33 percent in the ERG response to a single flash of white
light to be certain with 99 percent confidence that the change had
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78
really occurred. We have not done intervisit variability of normals.
But we have done yearly follow-ups of normals and find that they are
not varying too much.
MASSOF: I'd like to add to your comment, Jerry [Fishman], that
the ERG numbers I'm using apply to Ganzfeld stimulation, so you're
integrating over the entire retina. To talk about individual dark
adaptation curves or individual measures of points, you have to add to
that sampling errors and inhomogeneity of thresholds in terms of dis-
tribution of sensitivity across the retina, so you would expect varia-
bility to be higher.
HARVEY: There really Is more to vision than detecting light. A lot
of the uses that people want to optimize are not detecting small spots
for which the ideal observer can be fairly well defined. So in tasks
that require pattern observation there really is not a good theory of
an ideal observer. It is really difficult to know whether there is not
some sort of observable physical limit on an ideal observer for identi-
fying or recognizing the target, rather than just detecting it. And
since there are at least two psychological processes that go on, one
involving sensory representations and the other involving decision, it
would seem to me to be an open question whether you could have training
strategies or some sort of intervention strategy that would lead to a
substantive improvement. This is a possibility that should not be
ruled out on theoretical grounds alone.
MAKOUS: I'd like to comment on that. Bill Geisler has recently
published two papers for which he's described an ideal observer for
more complex tasks such as localization and Vernier acuity.
I'd like to add a comment about dark adaptation, ERG variability,
and psychophysical var lability. Of course, the ERG is of enormous
value in clinical evaluations, but it' s hard to go directly f rom the
variability of an ERG to variability of a psychophysical process such
as afar k adaptation.
MASSOF: I'd like to add to what Walt [Makous] just said. The ERG
numbers I just gave you apply to the amplitude of the ERG, which is of
course in all cases a suprathreshold stimulus. The other way you can
look at the ERG is to take an intensity ser. ies. I f you plot amplitude
versus log intensity and then look at the half-saturation constant, the
variability across observers on that half-saturation constant is
comparable to what you would get psychophysical.
MACLEOD: I'd like to raise a question about the reproducibility of
the course of dark adaptation for a given observer. I am very struck
that in the lab when we try to measure dark adaptation curves of normal
individuals, they are really disappointing in their reproducibility.
Other psychophysical functions reproduce very well. Dark adaptation
curves reproduce very poorly by comparison. There must be an underlying
reason for that, in terms of a fluctuation over time and the dynamics
of a given individual's dark adaptation process. I think it would be
very interesting to try to do some analytical work on the systemic fac-
tors that underlie this fluctuation with time in a given individual's
dark adaptation characteristics, whether it's related to eating pat-
terns, caffeine, or diurnal rhythms and body temperature, and in the
latter case, whether sensitivity is optimal during the night phase or
during the daytime phase when body temperature is higher.
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79
MONACO: I'd like to digress to what General Doppelt said and what
I interpreted as him asking: What are the kinds of tests that are cur-
rently available--diagnost~c tests, screening tests--that will answer
some of the questions that the military has about operating under re-
duced levels of illumination.
FISHMAN: I'm not clear whether to make the screening procedures
more efficient so that you could administer them to the 750,000 recruits
that need to be screened for night-blinding disorders or whether you
want to qualitatively improve the tests to discern the difference be-
tween ~better" and "best" for a group of normal recruits, so that some
could be optimized for night vision tasks while the rest would be deter-
mined as adequate to perform the majority of night vision tasks. If the
latter case is the goal, I think that's very difficult because I don't
know how to solve it with any clinical techniques that are currently
available; in other words, how to discern the individual that would be
superlative at a potentially critical task done under dim illumination
as opposed to other individuals that would be considered "good."
TREDICI: That's one of the reasons we set up this conference.
Yes, we need to know the true pathologic ones and separate those out at
the very beginning. We do have methods for that, which you've all done.
The other aspect, I understand, would be difficult.
BERSON: I'd like to make one comment: The family history and a
history of symptoms of cliff faulty with adaptation are, o' course,
important in deciding which individuals should have an ERG to see if
they have retinitis pigmentosa. I would also like to suggest for your
consideration that the optics of the patient--the pair of glasses that
they're wearing--should be a red flag, particularly if there's astig-
matism. We analyzed the patients with ret~nitis pigmentosa and their
normal relatives -with 20/20 to find out if the refractive errors in the
retinitis pigmentosa patients differed from those in their normal rela-
tives. We found that astigmatism of two or more diopters in the less
astigmatic eye was seen in a sample of approximately 10 percent of 160
patients who had retinitis pigmentosa. When we compared this to the
normal relatives, we found that only 1 to 2 percent of normal relatives
had this refractive error and 20/20. I'm confining my remarks now to
patients who have 20/20, for if their acuity is reduced, which is more
often the case when they come to our hospital, that's a separate issue.
If you want to obtain a higher yield of people who might have retinitis
pigmentosa, we would suggest ERG testing of individuals who have two or
more diopters of astigmatism. We suspect that the yield per examination
of patients with retinitis pigmentosa would be greater for those with
this refractive error.
JOHNSON: Just a comment relative to rapid screen tests. Everybody
wants a quick test that will give them all the answers. With a quick
test you have very limited information. Since very little is presently
known about the relative parameters of night vision for job performance,
I think that a quick screening test is a bit preliminary. In order to
establish a relationship between task performance and visual parameters,
a great deal of work must be done. Only after these relationships have
been established and the visual parameters have been fully characterized
should a rapid screening test be contemplated.
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BERSON: I'd like to state that most of the disease states are
symmetrical in both eyes. In terms of economy of time and effort, a
patient can be dilated and dark-adapted in the waiting room with a
patch over one eye and can do other tasks with the other eye, whether
it's questionnaires or whatever. The patient can be led into the room
to record a dark adaptation threshold, then have an ERG lens placed on
the topically anesthetized cornea, have a few flashes of light adminis-
tered, thus doing a very comprehensive and definitive examination in 10
or 15 minutes. So I think screening programs could be very definitive
and run in a short period of time. The advantage of doing the testing
this way also is that if the person is normal by ERG testing, our avail-
able evidence is that they're not going to develop these diseases later.
If you're going to pass someone, it would be helpful to know that they
are going to be normal for the next 20 years. Therefore, it seems if
you have a high-risk individual--high astigmatism, symptoms of night
blindness or difficulty with adaptation, positive family history of
retinitis pigmentosa--I would do ERG testing even though it may take an
extra few minutes. I think this will be cost-effective in the end.
Representative terms from entire chapter:
dark adaptation