The optometry group IMMAD LLC, Impairment Measurement Marijuana and Driving, presented their groundbreaking cannabis retinal research at the New England Association of Forensic Scientists conference. The work was presented by Holly Hailher, Trevor Koppy and Denise Valenti, OD, FAAO. The research was funded in part by the National Institute of Justice.
Inhaled marijuana causes a dysfunction of the dopaminergic dependent intrinsically photosensitive retinal ganglion cells (ipRGC). There are cannabinoid receptors in all layers of the retina (Straiker, Maguire et al.). Acute use of marijuana depletes the retina of dopamine (Mikulskaya and Martin 2018, Polli, Schwan et al. 2021) and reductions in dopamine result in dysfunction and impairment of retinal processing, particularly in what is historically referred to the magnocellular visual pathway.
Based on functional measures using temporal striped squares of variable contrast (similar to the FDT10 visual field) the regional dysfunction with acute marijuana use is demonstrated to have a relationship to subclasses of retinal ganglion cells, the melanopsin-expressing intrinsically photosensitive retinal ganglion cells (ipRGC). The ipRGC innervates those brain regions that influence subconscious visual behaviors (Beier, 2022 #617). A subcategory of these ipRGC contributes to vision related functions such as contrast, depth and motion (Chen, 2011 #610)
Yet another category of ipRGC control sustained pupil response (Chen, 2011 #610)(Traustason, 2016 #618). This sustained pupil constriction response referred to the post illumination pupil response (PIPR) is impaired with acute inhaled marijuana use. The mechanism of the dilated pupil, impaired constriction response was unknown prior to this research. The phenomenon of dilated pupils has long been associated with marijuana impaired driving and is a part of a specialized law enforcement Drug Recognition Expert evaluation (Porath-Waller, 2010 #198). Law enforcement refer to the abnormal pupil as rebound pupil. The normal, unimpaired PIPR is driven predominately by blue light (470) (Kankipati, 2010 #602) with red light having a weaker ipsilateral response. Marijuana impaired PIPR with rebound dilation is identified using light sources that have limited yellow, and denser blue wavelengths (https://www.neafs.org/neafs-annual-meeting).
Read about Dr. Valenti’s research that may one day lead to technology to detect driver’s impairment.
References
Adams, A., B. Brown, G. Haegerstrom-Portnoy, M. Flom and R. Jones (1976). “Evidence for acute effects of alcohol and marijuana on color discrimination.” Perception & Psychophysics 20(2): 119-124.
Adams, A. J., B. Brown, M. C. Flom, R. T. Jones and A. Jampolsky (1975). “Alcohol and marijuana effects on static visual acuity.” Am J Optom Physiol Opt 52(11): 729-735.
Adams, A. J., B. Brown, G. Haegerstrom-Portnoy, M. C. Flom and R. T. Jones “Marijuana, alcohol, and combined drug effects on the time course of glare recovery.” Psychopharmacology (Berl). 1978 Jan 31;56(1):81-6.
Beier, C., U. Bocchero, L. Levy, Z. Zhang, N. Jin, S. C. Massey, C. P. Ribelayga, K. Martemyanov, S. Hattar and J. Pahlberg (2022). “Divergent outer retinal circuits drive image and non-image visual behaviors.” Cell Rep 39(13): 111003.
Beier, C., Z. Zhang, M. Yurgel and S. Hattar (2021). “Projections of ipRGCs and conventional RGCs to retinorecipient brain nuclei.” J Comp Neurol 529(8): 1863-1875.
Brown, B., A. J. Adams, G. Haegerstrom-Portnoy, R. T. Jones and M. C. Flom (1977). “Pupil size after use of marijuana and alcohol.” Am J Ophthalmol 83(3): 350-354.
Chakraborty, R., M. J. Collins, H. Kricancic, D. Moderiano, B. Davis, D. Alonso-Caneiro, F. Yi and K. Baskaran (2022). “The intrinsically photosensitive retinal ganglion cell (ipRGC) mediated pupil response in young adult humans with refractive errors.” J Optom 15(2): 112-121.
Flom, M. C., A. J. Adams and R. T. Jones (1975). “Marijuana smoking and reduced pressure in human eyes: drug action or epiphenomenon?” Invest Ophthalmol 14(1): 52-55.
Flom, M. C., B. Brown, A. J. Adams and R. T. Jones (1976). “Alcohol and marijuana effects on ocular tracking.” Am J Optom Physiol Opt 53(12): 764-773.
Hannibal, J., L. Kankipati, C. E. Strang, B. B. Peterson, D. Dacey and P. D. Gamlin (2014). “Central projections of intrinsically photosensitive retinal ganglion cells in the macaque monkey.” J Comp Neurol 522(10): 2231-2248.
Kankipati, L., C. A. Girkin and P. D. Gamlin (2010). “Post-illumination pupil response in subjects without ocular disease.” Invest Ophthalmol Vis Sci 51(5): 2764-2769.
Liao, H. W., X. Ren, B. B. Peterson, D. W. Marshak, K. W. Yau, P. D. Gamlin and D. M. Dacey (2016). “Melanopsin-expressing ganglion cells on macaque and human retinas form two morphologically distinct populations.” J Comp Neurol 524(14): 2845-2872.
Mikulskaya, E. and F. H. Martin (2018). “Contrast sensitivity and motion discrimination in cannabis users.” Psychopharmacology (Berl) 235(8): 2459-2469.
Nasir-Ahmad, S., S. C. S. Lee, P. R. Martin and U. Grünert (2019). “Melanopsin-expressing ganglion cells in human retina: Morphology, distribution, and synaptic connections.” J Comp Neurol 527(1): 312-327.
Polli, L., R. Schwan, E. Albuisson, L. Malbos, K. Angioi-Duprez, V. Laprevote and T. Schwitzer (2021). “Oscillatory potentials abnormalities in regular cannabis users: Amacrine cells dysfunction as a marker of central dopaminergic modulation.” Prog Neuropsychopharmacol Biol Psychiatry 108: 110083.
Straiker, A. J., G. Maguire, K. Mackie and J. Lindsey “Localization of cannabinoid CB1 receptors in the human anterior eye and retina.” Invest Ophthalmol Vis Sci. 1999 Sep;40(10):2442-8.
Traustason, S., A. E. Brondsted, B. Sander and H. Lund-Andersen (2016). “Pupillary response to direct and consensual chromatic light stimuli.” Acta Ophthalmol 94(1): 65-69.
