Treatment with the ketogenic diet rescues photoreceptor cell survival in the arRP preclinical mouse. (a) Histological analysis of the retinas of Pde6ɑD670G mice on normal chow diet (gray) compared to Pde6ɑD670G mice provided the ketogenic diet (green) shows a significant increase in the thickness of the outer nuclear layer (ONL) by number of photoreceptor cell nuclei in mice treated with the ketogenic diet at one month of age, one-week post-dietary treatment. Results are displayed as a morphometric quantification (spider graph) of ONL layer thickness superior (left) and inferior (right) to the optic nerve head (ONH). Wild-type mice have an ONL thickness of approximately 10 nuclei. ***p < 0.001 [Student's t-test]. N = 8 eyes each group, with multiple ONL thickness counts per eye as described in Methods. Error bars = SEM. (b) Representative traces of the scotopic 0.1 (flash strength in cd·s·m−2) dim-light rod-specific electroretinography (ERG; left) shows no significant difference in the rod photoreceptor cell response in Pde6ɑD670G mice treated with the ketogenic diet (green) in comparison to untreated Pde6ɑD670G mice (gray) at one month of age. Representative traces of the scotopic 1.0 (flash strength in cd·s·m−2) global electroretinography (ERG; left) shows some rescue of the global visual response in Pde6ɑD670G mice treated with the ketogenic diet (green) in comparison to wild-type controls (black) and untreated Pde6ɑD670G mice (gray) at one month of age. Quantification of ERGs from a cohort of mice shows no significant visual rescue of (c) the rod photoreceptor cell response, (d) the maximum scotopic a-wave response, or (e) the maximum scotopic b-wave response in mice treated with the ketogenic diet (green) in comparison with wild-type controls (black) or untreated Pde6ɑD670G mice (gray) at one month of age, although there was a trend toward an increased a- and b-wave maximal response. N = 5 WT, 6 arRP, 6 arRP + ketogenic diet mice.