Amblyopic Participants Research Articles

Decreased scene-selective activity within the posterior intraparietal cortex in amblyopic adults.

Amblyopia is a developmental disorder associated with reduced performance in visually guided tasks, including binocular navigation within natural environments. To help understand the underlying neurological disorder, we used fMRI to test the impact of amblyopia on the functional organization of scene-selective cortical areas, including the posterior intraparietal gyrus scene-selective (PIGS) area, a recently discovered region that responds selectively to ego-motion within naturalistic environments (Kennedy et al., 2024). Nineteen amblyopic adults (10 female) and thirty age-matched controls (12 female) participated in this study. Amblyopic participants spanned a wide range of amblyopia severity, based on their interocular visual acuity difference and stereoacuity. The visual function questionnaire (VFQ-39) was used to assess the participants perception of their visual capabilities. Compared to controls, we found weaker scene-selective activity within the PIGS area in amblyopic individuals. By contrast, the level of scene-selective activity across the occipital place area (OPA), parahippocampal place area (PPA), and retrosplenial cortex (RSC)) remained comparable between amblyopic and control participants. The subjects scores on general vision (VFQ-39 subscale) correlated with the level of scene-selective activity in PIGS. These results provide novel and direct evidence for amblyopia-related changes in scene-processing networks, thus enabling future studies to potentially link these changes across the spectrum of documented disabilities in amblyopia.

Visual Tracking in Amblyopia: A Continuous Psychophysical Approach.

This study aimed to explore the underlying mechanisms of the observed visuomotor deficit in amblyopia. Twenty-four amblyopic (25.8 ± 3.8years; 15 males) and 22 normal participants (25.8 ± 2.1years; 8 males) took part in the study. The participants were instructed to continuously track a randomly moving Gaussian target on a computer screen using a mouse. In experiment 1, the participants performed the tracking task at six different target sizes. In experiments 2 and 3, they were asked to track a target with the contrast adjusted to individual's threshold. The tracking performance was represented by the kernel function calculated as the cross-correlation between the target and mouse displacements. The peak, latency, and width of the kernel were extracted and compared between the two groups. In experiment 1, target size had a significant effect on the kernel peak (F(1.649, 46.170) = 200.958, P = 4.420 × 10-22). At the smallest target size, the peak in the amblyopic group was significantly lower than that in the normal group (0.089 ± 0.023 vs. 0.107 ± 0.020, t(28) = -2.390, P = 0.024) and correlated with the contrast sensitivity function (r = 0.739, P = 0.002) in the amblyopic eyes. In experiments 2 and 3, with equally visible stimuli, there were still differences in the kernel between the two groups (all Ps < 0.05). When stimulus visibility was compensated, amblyopic participants still showed significantly poorer tracking performance.

Amblyopic stereo vision is efficient but noisy

People with amblyopia demonstrate a reduced ability to judge depth using stereopsis. Our understanding of this deficit is limited, as standard clinical stereo tests may not be suited to give a quantitative account of the residual stereo ability in amblyopia. In this study we used a stereo test designed specifically for that purpose. Participants identified the location of a disparity-defined odd-one-out target within a random-dot display. We tested 29 amblyopic (3 strabismic, 17 anisometropic, 9 mixed) participants and 17 control participants. We obtained stereoacuity thresholds from 59% of our amblyopic participants. There was a factor of two difference between the median stereoacuity of our amblyopic (103 arcsec) and control (56 arcsec) groups. We used the equivalent noise method to evaluate the role of equivalent internal noise and processing efficiency in amblyopic stereopsis. Using the linear amplifier model (LAM), we determined the threshold difference was due to a greater equivalent internal noise in the amblyopic group (238 vs 135 arcsec), with no significant difference in processing efficiency. A multiple linear regression determined 56% of the stereoacuity variance within the amblyopic group was predicted by the two LAM parameters, with equivalent internal noise predicting 46% alone. Analysis of control group data aligned with our previous work, finding that trade-offs between equivalent internal noise and efficiency play a greater role. Our results allow a better understanding of what is limiting amblyopic performance in our task. We find this to be a reduced quality of disparity signals in the input to the task-specific processing.

Characterizing amblyopic perception under non-rivalrous viewing conditions

Current assessments of interocular interactions in amblyopia often use rivalrous stimuli, with conflicting stimuli in each eye, which does not reflect vision under typical circumstances. Here we measure interocular interactions in observers with amblyopia, strabismus with equal vision, and controls using a non-rivalrous stimulus. Observers used a joystick to continuously report the perceived binocular contrast of dichoptic grating stimuli, identical except that the stimulus was contrast-modulated independently in each eye over time. Consistent with previous studies, a model predicting the time-course of perceived contrast found increased amblyopic eye attenuation, and reduced contrast normalization of the fellow eye by the amblyopic eye, in amblyopic participants compared to controls. However, these suppressive interocular effects were weaker than those found in previous studies, suggesting that rivalrous stimuli may overestimate the effects of amblyopia on interocular interactions during naturalistic viewing conditions.

Binocular Integration of Perceptually Suppressed Visual Information in Amblyopia.

PurposeThe purpose of this study was to assess whether motion information from suppressed amblyopic eyes can influence visual perception.MethodsParticipants with normal vision (n = 20) and with amblyopia (n = 20; 11 anisometropic and 9 strabismic/mixed) viewed dichoptic, orthogonal drifting gratings through a mirror stereoscope. Participants continuously reported form and motion percepts as gratings rivaled for 60 seconds. Responses were binned into categories ranging from binocular integration to complete suppression. Periods when the grating presented to the nondominant/amblyopic eye was suppressed were analyzed further to determine the extent of binocular integration of motion.ResultsIndividuals with amblyopia experienced longer periods of non-preferred eye suppression than controls. When the non-preferred eye grating was suppressed, binocular integration of motion occurred 48.1 ± 6.2% and 31.2 ± 5.8% of the time in control and amblyopic participants, respectively. Periods of motion integration from the suppressed eye were significantly non-zero for both groups.ConclusionsVisual information seen only by a suppressed amblyopic eye can be binocularly integrated and influence the overall visual percept. These findings reveal that visual information subjected to interocular suppression can still contribute to binocular vision and suggest the use of appropriate optical correction for the amblyopic eye to improve image quality for binocular combination.

Influence of prior and visual information on eye movements in amblyopic children.

This study analyzed the characteristics of pursuit and assessed the influence of prior and visual information on eye velocity and saccades in amblyopic and control children, in comparison to adults. Eye movements of 41 children (21 amblyopes and 20 controls) were compared to eye movements of 55 adults (18 amblyopes and 37 controls). Participants were asked to pursue a target moving at a constant velocity. The target was either a 'standard' target, with a uniform color intensity, or a 'noisy' target, with blurry edges, to mimic the blurriness of an amblyopic eye. Analysis of pursuit patterns showed that the onset was delayed, and the gain was decreased in control children with a noisy target in comparison to amblyopic or control children with a standard target. Furthermore, a significant effect of prior and visual information on pursuit velocity and saccades was found across all participants. Moreover, the modulation of the effect of visual information on the pursuit velocity by group, that is amblyopes or controls with a standard target, and controls with a noisy target, was more limited in children. In other words, the effect of visual information was higher in control adults with a standard target compared to control children with the same target. However, in the case of a blurry target, either in control participants with a noisy target or in amblyopic participants with a standard target, the effect of visual information was larger in children.

White matter microstructural alterations in amblyopic adults revealed by diffusion spectrum imaging with systematic tract-based automatic analysis.

Background/aimWe investigated the microstructural changes in white matter of adults with amblyopia using diffusion spectrum imaging with systematic tract-based automatic analysis of the whole brain.MethodsTen adults with amblyopia (six women and four men, 33.6±10.6 years old on average) and 20 age- and sex-matched normal-sighted controls were enrolled. The mean generalised fractional anisotropy (GFA) was measured in 76 white matter tracts and compared between the experimental and control groups using a threshold-free cluster-weighted method and t-test. A 2-percentile cut-off was used to identify segments with the greatest differences between the two groups.ResultsParticipants with amblyopia had significantly lower GFA values than the controls in 11 segments located in nine white matter tracts, which included the following: left arcuate fasciculus, left frontal aslant tract, left fornix and left inferior fronto-occipital fasciculus of the association fibres; left thalamic radiations of the auditory nerve and bilateral optic radiations of the projection fibres; and genu and middle temporal gyrus of the callosal fibres. Amblyopic participants had statistically higher GFA values in the bilateral uncinate fasciculus than those of the controls.ConclusionThis preliminary study using whole-brain tractographic analysis of white matter reveals association between abnormal early visual processing and alterations in brain architecture, which may be related to various higher-level deficits, such as audiovisual integration and hand−eye coordination in patients with amblyopia.

Spatial summation across the visual field in strabismic and anisometropic amblyopia

Ricco’s area (the largest area of visual space in which stimulus area and intensity are inversely proportional at threshold) has previously been hypothesised to be a result of centre/surround antagonism in retinal ganglion cell receptive fields, but recent evidence suggests a sizeable cortical contribution. Here, Ricco’s area was measured in amblyopia, a condition in which retinal receptive fields are normal, to better understand its physiological basis. Spatial summation functions were determined at 12 visual field locations in both eyes of 14 amblyopic adults and 15 normal-sighted controls. Ricco’s area was significantly larger in amblyopic eyes than in fellow non-amblyopic eyes. Compared to the size of Ricco’s area in control eyes, Ricco’s area measured significantly larger in amblyopic eyes. Additionally, Ricco’s area in the fellow, non-amblyopic eye of amblyopic participants measured significantly smaller than in control eyes. Compared to controls, Ricco’s area was larger in amblyopic eyes and smaller in fellow non-amblyopic eyes. Amblyopia type, binocularity, and inter-ocular difference in visual acuity were significantly associated with inter-ocular differences in Ricco’s area in amblyopes. The physiological basis for Ricco’s area is unlikely to be confined to the retina, but more likely representative of spatial summation at multiple sites along the visual pathway.

The Prevalence of Amblyopia and Its Determinants in a Population-based Study

ABSTRACTPurpose: To determine the prevalence of amblyopia and its determinants in a population-based study in Mashhad County, Iran.Methods: This cross-sectional, population-based study was conducted on the population of Mashhad County aged >1 year using randomized stratified cluster sampling. Examinations were performed after selection of the participants and their free transportation to the sampling site. The examinations included the measurement of uncorrected and corrected visual acuity, cycloplegic and non-cycloplegic refraction, cover testing, slit-lamp biomicroscopy, and ophthalmoscopy. In this study, amblyopia was defined as best corrected visual acuity (BCVA) of 20/30 or less or 2-line interocular optotype acuity differences with no pathology.Results: After considering the exclusion criteria, the data of 2739 individuals, 65.6% of whom were women, were analyzed. The mean age of the participants was 29.5±17.5 years. The prevalence of amblyopia was 4.6% (95% CI: 3.77%-5.43%) in the total population. The lowest prevalence was 2.24% in the age group 5-15 years (95% CI: 0.99%-3.48%) and the highest prevalence was 7.14% in the age group 55-65 years (95% CI: 2.64%-11.56%). Anisometropic amblyopia was observed in 45.24% of the amblyopic participants. Isometropic, mixed (strabismic/anisometropic), and strabismic amblyopia were other common causes of amblyopia, with a prevalence of 24.6%, 16.67%, and 13.49% in amblyopic patients, respectively. The odds ratio (OR) of having amblyopia for each 1-year increase in age was 1.02 (95% CI: 1.01-1.03). Amblyopia was less common in people with better socioeconomic status.Conclusion: This study showed the prevalence of amblyopia in all age groups in a population-based study for the first time. The findings of this study regarding the relatively high prevalence of amblyopia in the older population and its lower prevalence in young people indicate attention to amblyopia in recent years.

Latent binocular function in amblyopia

Recently, psychophysical studies have shown that humans with amblyopia do have binocular function that is not normally revealed due to dominant suppressive interactions under normal viewing conditions. Here we use magnetoencephalography (MEG) combined with dichoptic visual stimulation to investigate the underlying binocular function in humans with amblyopia for stimuli that, because of their temporal properties, would be expected to bypass suppressive effects and to reveal any underlying binocular function.We recorded contrast response functions in visual cortical area V1 of amblyopes and normal observers using a steady state visually evoked responses (SSVER) protocol. We used stimuli that were frequency-tagged at 4Hz and 6Hz that allowed identification of the responses from each eye and were of a sufficiently high temporal frequency (>3Hz) to bypass suppression. To characterize binocular function, we compared dichoptic masking between the two eyes in normal and amblyopic participants as well as interocular phase differences in the two groups.We observed that the primary visual cortex responds less to the stimulation of the amblyopic eye compared to the fellow eye. The pattern of interaction in the amblyopic visual system however was not significantly different between the amblyopic and fellow eyes. However, the amblyopic suppressive interactions were lower than those observed in the binocular system of our normal observers. Furthermore, we identified an interocular processing delay of approximately 20ms in our amblyopic group.To conclude, when suppression is greatly reduced, such as the case with our stimulation above 3Hz, the amblyopic visual system exhibits a lack of binocular interactions.

Dichoptic training in adults with amblyopia: Additional stereoacuity gains over monocular training

Dichoptic training is a recent focus of research on perceptual learning in adults with amblyopia, but whether and how dichoptic training is superior to traditional monocular training is unclear. Here we investigated whether dichoptic training could further boost visual acuity and stereoacuity in monocularly well-trained adult amblyopic participants. During dichoptic training the participants used the amblyopic eye to practice a contrast discrimination task, while a band-filtered noise masker was simultaneously presented in the non-amblyopic fellow eye. Dichoptic learning was indexed by the increase of maximal tolerable noise contrast for successful contrast discrimination in the amblyopic eye. The results showed that practice tripled maximal tolerable noise contrast in 13 monocularly well-trained amblyopic participants. Moreover, the training further improved stereoacuity by 27% beyond the 55% gain from previous monocular training, but unchanged visual acuity of the amblyopic eyes. Therefore our dichoptic training method may produce extra gains of stereoacuity, but not visual acuity, in adults with amblyopia after monocular training.

Developmental Trajectory of McGurk Effect Susceptibility in Children and Adults With Amblyopia.

The McGurk effect is an audiovisual illusion that involves the concurrent presentation of a phoneme (auditory syllable) and an incongruent viseme (visual syllable). Adults with amblyopia show less susceptibility to this illusion than visually normal controls, even when viewing binocularly. The present study investigated the developmental trajectory of McGurk effect susceptibility in adults, older children (10-17 years), and younger children (4-9 years) with amblyopia. A total of 62 participants with amblyopia (22 adults, 12 older children, 28 younger children) and 66 visually normal controls (25 adults, 17 older children, 24 younger children) viewed videos that combined phonemes and visemes, and were asked to report what they heard. Videos with congruent (auditory and visual matching) and incongruent (auditory and visual not matching) stimuli were presented. Incorrect responses on incongruent trials correspond to high McGurk effect susceptibility, indicating that the viseme influenced the phoneme. Participants with amblyopia (28.0% ± 3.3%) demonstrated a less consistent McGurk effect than visually normal controls (15.2% ± 2.3%) across all age groups (P = 0.0024). Effect susceptibility increased with age (P = 0.0003) for amblyopic participants and controls. Both groups showed a similar response pattern to different speakers and syllables, but amblyopic participants invariably demonstrated a less consistent effect. Amblyopia is associated with reduced McGurk effect susceptibility in children and adults. Our findings indicate that the differences do not simply indicate delayed development in children with amblyopia; rather, they represent permanent alterations that persist into adulthood.

Grey and white matter changes in children with monocular amblyopia: voxel-based morphometry and diffusion tensor imaging study

AimsTo investigate the potential morphological alterations of grey and white matter in monocular amblyopic children using voxel-based morphometry (VBM) and diffusion tensor imaging (DTI).MethodsA total of 20 monocular amblyopic children...

Bilateral Changes in Foveal Structure in Individuals with Amblyopia

To examine foveal structure in amblyopia using spectral-domain optical coherence tomography (SD-OCT). Prospective, cross-sectional study. Two subject groups were recruited to the study: 85 amblyopes (34 adults, 51 children) and 110 visually normal controls (44 adults, 66 children). A detailed eye examination, including an SD-OCT scan, was performed in all participants. A total of 390 eyes of 195 subjects were imaged using a 3-dimensional (3D) macula scan covering a nominal 6 × 6-mm area with a resolution of 256 × 256 (65,536 axial scans). Data from the B-scans bisecting the fovea both horizontally and vertically were fitted with a mathematical model of the fovea to determine a range of foveal parameters. Foveal thickness, foveal pit depth, and foveal pit slope. Bilateral differences between the eyes of amblyopes compared with visually normal controls were found. The difference between foveal structure in amblyopic participants relative to structure in subjects with normal vision persisted even when variables such as age, ethnicity, axial length, and sex were taken into account. Amblyopes showed increased foveal thickness (+8.31 μm; P = 0.006) and a reduction in pit depth in the horizontal meridian (-10.06 μm; P = 0.005) but not in the vertical meridian (P = 0.082) when compared with subjects with normal vision. Foveal pit slopes were found to be approximately 1 degree flatter in the nasal (P = 0.033) and temporal (P = 0.014) meridians in amblyopes, but differences between amblyopes and controls in the superior (P = 0.061) and inferior (P = 0.087) meridians did not reach statistical significance. No statistically significant interocular differences were found in the foveal structure between amblyopic and fellow eyes. Differences were found in the foveal structure in both eyes of amblyopes compared with subjects with normal vision. These differences consisted of increased foveal thickness, reduced pit depth when measured along the horizontal meridian, and flattening of the nasal and temporal sides of the foveal pit.

Colour vision in adult amblyopia

AbstractPurpose Amblyopia is a disorder of visual processing. There is evidence that the parvocellular pathway, which prefers chromatic stimuli, is selectively damaged in amblyopia. Consistent with this hypothesis, previous studies have demonstrated that patients with amblyopia show poorer performance on colour vision tests.Methods Ten adult amblyopic subjects (3 strabismic, 5 anisometropic and 3 mixed) were tested using the Farnsworth Munsell 100 Hue (FM100Hue)colour vision test. In separate testing sessions, positive spherical lenses were used to induce blur in the fellow eye (FFE)to match the near acuity of the amblyopic eye (AME). The test (all boxes)was performed under five conditions(randomised): AME,FFE,binocularly (BIN),FFE with blur and BIN with the FFE blurred. Age matched controls were included to assess the effect of defocus in normal subjects, with blur placed in front of the non‐dominant eye to induce mild, moderate or severe blur.Results Amblyopic participants performed well in the FM100Hue test, with scores falling within normal age means in 9/11 subjects (in the AME). Strabismic amblyopes had a more pronounced deficit in error scores. Across all amblyopic subjects, performance was significantly beter under BIN conditions (p=0.023). Induced blur in controls only affected error scores under the severe blur condition, and had litle effect in amblyopic participants.Conclusion This study has shown that amblyopes perform well in this commonly performed colour vision test, and demonstrated improved test performance under binocular conditions. The low spatial frequency of the stimuli may allow for extensive pooling of chromatic information therefore allowing performance of this test to be robust to a parvocellular dysfunction.

A Compact Clinical Instrument for Quantifying Suppression

We describe a compact and convenient clinical apparatus for the measurement of suppression based on a previously reported laboratory-based approach. In addition, we report and validate a novel, rapid psychophysical method for measuring suppression using this apparatus, which makes the technique more applicable to clinical practice. By using a Z800 dual pro head-mounted display driven by a MAC laptop, we provide dichoptic stimulation. Global motion stimuli composed of arrays of moving dots are presented to each eye. One set of dots move in a coherent direction (termed signal) whereas another set of dots move in a random direction (termed noise). To quantify performance, we measure the signal/noise ratio corresponding to a direction-discrimination threshold. Suppression is quantified by assessing the extent to which it matters which eye sees the signal and which eye sees the noise. A space-saving, head-mounted display using current video technology offers an ideal solution for clinical practice. In addition, our optimized psychophysical method provided results that were in agreement with those produced using the original technique. We made measures of suppression on a group of nine adult amblyopic participants using this apparatus with both the original and new psychophysical paradigms. All participants had measurable suppression ranging from mild to severe. The two different psychophysical methods gave a strong correlation for the strength of suppression (rho = -0.83, p = 0.006). Combining the new apparatus and new psychophysical method creates a convenient and rapid technique for parametric measurement of interocular suppression. In addition, this apparatus constitutes the ideal platform for suppressors to combine information between their eyes in a similar way to binocularly normal people. This provides a convenient way for clinicians to implement the newly proposed binocular treatment of amblyopia that is based on antisuppression training.

QCSF in Clinical Application: Efficient Characterization and Classification of Contrast Sensitivity Functions in Amblyopia

The qCSF method is a novel procedure for rapid measurement of spatial contrast sensitivity functions (CSFs). It combines Bayesian adaptive inference with a trial-to-trial information gain strategy, to directly estimate four parameters defining the observer's CSF. In the present study, the suitability of the qCSF method for clinical application was examined. The qCSF method was applied to rapidly assess spatial CSFs in 10 normal and 8 amblyopic participants. The qCSF was evaluated for accuracy, precision, test-retest reliability, suitability of CSF model assumptions, and accuracy of amblyopia screening. qCSF estimates obtained with as few as 50 trials matched those obtained with 300 Ψ trials. The precision of qCSF estimates obtained with 120 and 130 trials, in normal subjects and amblyopes, matched the precision of 300 Ψ trials. For both groups and both methods, test-retest sensitivity estimates were well matched (all R > 0.94). The qCSF model assumptions were valid for 8 of 10 normal participants and all amblyopic participants. Measures of the area under log CSF (AULCSF) and the cutoff spatial frequency (cutSF) were lower in the amblyopia group; these differences were captured within 50 qCSF trials. Amblyopia was detected at an approximately 80% correct rate in 50 trials, when a logistic regression model was used with AULCSF and cutSF as predictors. The qCSF method is sufficiently rapid, accurate, and precise in measuring CSFs in normal and amblyopic persons. It has great potential for clinical practice.