Abstract

Open angle glaucoma (OAG) is increasingly being viewed as an age-related neurodegenerative condition that may occur in individuals who are innately susceptible to global (autonomic) neural injury. Recent data support the plausibility of auditory neural impairment in a proportion of individuals with OAG, with results showing a key disruption to processing temporal properties of sound. This study tested the hypothesis that temporal processing deficits consistent with central (cortical) processing abnormalities are present in both the visual and auditory domains in individuals with glaucoma. A series of tasks designed to test progressively more complex aspects of temporal processing were conducted in 25 OAG individuals and 25 age- and sex-matched controls. For audition, baseline measurement of hearing sensitivity was followed by functional assessment of amplitude modulation detection, frequency discrimination at two reference levels, and speech perception. For vision, measures of foveal temporal contrast detection at two flicker rates, speed discrimination at two reference velocities, and coherent global motion detection were assessed. A significant proportion of the OAG cohort displayed an impairment in auditory low-frequency discrimination, speech perception, visual speed discrimination for slow velocities and/or visual global motion detection, compared to controls (36%, 25%, 39%, and 34% respectively, were outside the 90th percentile of control performance; P < 0.05). A subgroup of individuals with OAG displayed impaired auditory temporal processing concurrent with signs of visual temporal processing impairment. These temporal processing deficits were in the presence of normal sound detection and normal central luminance increment thresholds.

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