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Ophthalmological assessment of cannabis-induced persisting perception disorder: Is there a direct retinal effect?

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Abstract

Purpose

Cannabis is a psychotomimetic agent that induces impairment of sensory perception. We present detailed clinical and electrophysiological data of patients with hallucinogen persisting perception disorder (HPPD) after marijuana consumption.

Methods

A HPPD patient and four heavy cannabis smokers with no visual disturbances (controls) underwent complete ophthalmological examination including psychophysical tests (visual acuity, color vision, visual field, and dark adaptation) and detailed electrophysiological examinations, including extended Ganzfeld ERG, multifocal ERG, and electrooculography (EOG). Furthermore, electrically evoked phosphene thresholds (EPTs) were measured to further evaluate retinal function.

Results

Ophthalmological and most electrophysiological examinations were within normal limits for the HPPD patient and for all control subjects. Interestingly, EOG results of the HPPD patient showed a slightly reduced fast oscillation ratio, diminished standing potentials of the slow oscillations, and a light peak within normal range resulting in higher Arden ratios. The EPTs of the patient were reduced, in particular for pulses with long durations (50 ms) causing visual sensations even at lowest possible currents of the neurostimulator. The control subjects did not reveal such alterations.

Conclusions

Our findings suggest a direct effect of cannabinoids on the retina and retinal pigment epithelium function, which may be involved in disturbances of the visual function experienced after drug consumption. The observations presented here may contribute to the elucidation of the detailed mechanism. Furthermore, EOG and EPT measurements may be useful tools to demonstrate long-term retinal alterations in cannabis-induced HPPD in patients.

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Acknowledgments

We are grateful to the subjects for their participation and thank the technicians Ulrike Fuchs and Gudrun Haerer for performing excellent examinations.

Conflict of interest

The authors have no commercial interests in the subject of the manuscript or in entities discussed in the manuscript.

Author information

Authors and Affiliations

  1. Institute for Ophthalmic Research, University of Tübingen, Schleichstr 12-16, 72076, Tübingen, Germany

    Ditta Zobor, Torsten Strasser, Gergely Zobor & Eberhart Zrenner

  2. Department of General Psychiatry, University of Tübingen, Tübingen, Germany

    Franziska Schober & Anil Batra

  3. Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of São Paulo, Ribeirão Preto, Brazil

    Andre Messias

  4. Experimental Ophthalmology, Department of Ophthalmology, Charité University Medicine Berlin, Berlin, Germany

    Olaf Strauss

  5. Werner Reichardt Center for Integrative Neuroscience (CIN), University of Tübingen, Tübingen, Germany

    Eberhart Zrenner

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  1. Ditta Zobor
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Correspondence to Ditta Zobor.

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Zobor, D., Strasser, T., Zobor, G. et al. Ophthalmological assessment of cannabis-induced persisting perception disorder: Is there a direct retinal effect?. Doc Ophthalmol 130, 121–130 (2015). https://doi.org/10.1007/s10633-015-9481-2

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  • DOI: https://doi.org/10.1007/s10633-015-9481-2

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