Abstract

SynopsisBoth optimal stereoacuity and integration time to achieve that are impaired in patients with intermittent exotropia. The deterioration of stereoacuity is more revealing since it correlates well with exotropia control score.BackgroundDespite the periodic misalignment of two eyes, some intermittent exotropia (IXT) patients exhibit normal stereoacuity, particularly when evaluated with static tests. It is not clear if the temporal integration process of stereopsis is altered in IXT patients, thus warranting further research.MethodsIXT patients (n = 29) and age-matched normal controls (n = 36) were recruited. Static stereopsis was measured with the Titmus stereoacuity test. In computer-generated random dots tests, stereoacuity was measured with a stimuli presentation duration varying from 100 to 1,200 ms. And the relationship between stereoacuity and stimuli duration was fitted into a quadratic model. Optimal stereoacuity was achieved when fitted curve flattened and the critical integration time was the duration needed to achieve optimal stereoacuity.ResultsIXT patients were not found to differ significantly from control subjects under the Titmus test, while the Random Dots stereotest showed significantly worse optimal stereoacuity and significantly longer critical integration time. Multiple regression analysis showed that age (R = −4.83; P = 0.04) had statistically significant negative correlation on the critical integration time, age (R = −6.45; P = 0.047) and exotropia control scores (R = 60.71; P = 0.007) had statistically significant effects on optimal stereoacuity.ConclusionThe temporal integration for stereopsis is impaired in IXT patients, requiring longer critical integration time to achieve elevated optimal stereoacuity.

Highlights

  • Despite the periodic misalignment of two eyes, some intermittent exotropia (IXT) patients exhibit normal stereoacuity, when evaluated with static tests. It is not clear if the temporal integration process of stereopsis is altered in IXT patients, warranting further research

  • Multiple regression analysis showed that age (R = −4.83; P = 0.04) had statistically significant negative correlation on the critical integration time, age (R = −6.45; P = 0.047) and exotropia control scores (R = 60.71; P = 0.007) had statistically significant effects on optimal stereoacuity

  • The temporal integration for stereopsis is impaired in IXT patients, requiring longer critical integration time to achieve elevated optimal stereoacuity

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Summary

Introduction

Stereopsis is the finest form of binocular visual processing, in which the image disparity between two eyes is extracted to achieve depth perception (Blake and Wilson, 2011). Intermittent exotropia is a condition in which one or two eyes occasionally deviate outward. During misalignment, decorrelated binocular inputs impair the normal development of binocular vision. IXT patients show an understandably wide range of binocular deficits, from having no binocular fusion to normal stereopsis (Lee et al, 2014). Despite the periodic misalignment of two eyes, some intermittent exotropia (IXT) patients exhibit normal stereoacuity, when evaluated with static tests. It is not clear if the temporal integration process of stereopsis is altered in IXT patients, warranting further research

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