Contrast Sensitivity Deficits Research Articles

Vision in Alzheimer's disease.

In order to assess vision in Alzheimer's disease (AD) and related disorders, gerontologists must use tests that make minimal cognitive demands on the subject. Using such tests, we have found a pattern of deficits in color discrimination, stereoacuity, contrast sensitivity, and backward masking that differs from that seen in healthy elderly individuals. Impaired vision predicts deficient performance of subjects with AD on numerous tests of cognition, underscoring the importance of understanding visual changes in this population.

Visual evoked potentials and eye movements in myasthenia gravis

Diabetic retinopathy is a common complication of diabetes mellitus. Diabetic patients experience functional deficits in dark adaptation, contrast sensitivity, and color perception before microvascular pathologies become apparent. Herein, we evaluated early changes in neural retinal function and in retinoid metabolism in the eye in diabetes. Streptozotocin-induced diabetic rats showed decreased a- and b-wave amplitudes of scotopic and photopic electroretinography responses 4 months after diabetes induction compared to nondiabetic controls. Although Western blot analysis revealed no difference in opsin expression, rhodopsin content was decreased in diabetic retinas, as shown by a difference in absorbance. Consistently, levels of 11-cis-retinal, the chromophore for visual pigments, were significantly lower in diabetic retinas compared to those in controls, suggesting a retinoid deficiency. Among visual cycle proteins, interphotoreceptor retinoid-binding protein and stimulated by retinoic acid 6 protein showed significantly lower levels in diabetic rats than those in nondiabetic controls. Similarly, serum levels of retinol-binding protein 4 and retinoids were significantly lower in diabetic rats. Overall, these results suggest that retinoid metabolism in the eye is impaired in type 1 diabetes, which leads to deficient generation of visual pigments and neural retinal dysfunction in early diabetes.

Vision in Aging and Dementia

This study was designed to determine the extent of visual deficits in Alzheimer's disease (AD) patients relative to normal aging changes and to patients with other types of dementia. Four groups of subjects were tested: patients with probable AD (N = 10), patients with other dementias (N = 10), age-matched controls (N = 11), and young controls (N = 10). Color vision was assessed with the L'Anthony D-15 desaturated color test, contrast sensitivity with the Pelli-Robson chart, and stereoacuity with the RAN-DOT test. Visual changes were found in AD patients that can be accounted for by age-related deficits (color vision), deficits found in other types of dementia (stereoacuity), and deficits specific to AD (low spatial frequency contrast sensitivity). We conclude that AD patients show a variety of visual deficits. With our tests, only deficits in contrast sensitivity were specific to AD.

The effects of V4 and middle temporal (MT) area lesions on visual performance in the rhesus monkey.

The effects of V4, MT, and combined V4 + MT lesions were assessed on a broad range of visual capacities that included measures of contrast sensitivity, wavelength and brightness discrimination, form vision, pattern vision, motion and flicker perception, stereopsis, and the selection of stimuli that were less prominent than those with which they appeared in stimulus arrays. The major deficit observed was a loss in the ability, after V4 lesions, to select such less prominent stimuli; this was the case irrespective of the manner in which the stimulus arrays were made visible, using either luminance, chrominance, motion, or stereoscopic depth as surface media. In addition, V4 lesions yielded mild deficits in color, brightness, and form vision whereas MT lesions yielded mild to moderate deficits in motion and flicker perception. Both lesions produced mild deficits in contrast sensitivity, shape-from-motion perception, and yielded increased reaction times on many of the tasks. The impairment resulting from combined V4 and MT lesions was not greater than the sum of the deficits of either lesion. None of the lesions produced significant deficits in stereopsis. The findings suggest that (1) area V4 is part of a neural system that is involved in extracting stimuli from the visual scene that elicit less neural activity early in the visual system than do other stimuli with which they appear and (2) several other extrastriate regions and more than just two major cortical processing streams contribute to the processing of basic visual functions in the extrastriate cortex.

The spatial localization deficit in amblyopia

There have now been numerous reports of a spatial localization deficit in amblyopia but none so far have tackled (1) the relationship between the contrast sensitivity and spatial localization deficits and (2) whether the spatial localization deficit is best described in units of visual angle or in terms of the underlying filter size. These issues are germane because they lie at the very heart of our understanding of the underlying deficit in amblyopia. To answer these questions we use spatially bandpass stimuli so that we can readily compare detection and localization for the same stimuli at each of a number of spatial scales. For some amblyopes (all strabismics and a minority of anisometropes) the contrast sensitivity defect neither underlies nor covaries with the spatial localization deficit. In the majority of anisometropic amblyopes, the contrast sensitivity loss is a complete description. The spatial localization deficit in amblyopia is of two independent kinds; positional inaccuracy and positional distortion. The positional inaccuracy deficit which can occur in varying degrees in both strabismic and anisometropic amblyopia, affects all spatial scales equally and therefore is best thought of in terms of a constant fraction of the underlying filter size in the space-frequency plane. The positional distortion deficit which can also occur to varying degrees in both strabismic and anisometropic forms can not be easily understood within this metric at least for strabismics.

Visual Dysfunction among Former Microelectronics Assembly Workers

Although known neurotoxins with potential ophthalmotoxic properties are commonly used in microelectronics assembly, there has been no systematic study of visual disturbances among past or present workers in this industry. The objective of the present study was to compare visual functions, using a matched-pair design, between former workers from a microelectronics plant and a local reference population. From an initial population of 180 former workers and 157 potential referents, 54 pairs were matched for age (+/- 3 y), education (+/- 2 y), sex, ethnic origin, and number of children. Near and far visual acuity, chromatic discrimination, and near contrast sensitivity were assessed monocularly. Paired comparisons (Signed-rank Wilcoxon test) revealed that the former microelectronics workers had significantly lower contrast sensitivity, particularly in the intermediate frequencies, independently of near visual acuity loss. There were no differences for far visual acuity in both eyes. Even though near visual acuity and color vision were compromised among the former workers, the differences were only significant for one eye, as was the prevalence of acquired dyschromatopsia (chi-square for matched pairs, p less than .001). These findings suggest a pattern of contrast sensitivity deficits consistent with impairment to foveal and/or neuro-optic pathways among these former microelectronics workers. Exposure to ophthalmotoxic chemicals is proposed as the most probable risk factor.

Disruption of binocularly correlated signals alters the postnatal development of spatial properties in cat striate cortical neurons

1. Extracellular single-cell recording techniques were employed to investigate the effects of ocular misalignment on the postnatal development of the spatial response properties of striate cortical neurons. The primary objective of the study was to gain insight into the neural basis of strabismic amblyopia. 2. Two basic rearing strategies were used to study specific aspects of experimental strabismus in developing kittens. In one group, strabismus was optically induced by fitting kittens with goggles that held a 15-diopter base-in prism in front of one eye (MP) or both eyes (BP) between the ages of 4 wk and 4 mo. In the second group, a unilateral esotropia was surgically induced at 3 wks of age either by the simple resection of the lateral rectus muscle tendon (tenotomy) or by a more drastic procedure that involved removing sections of the lateral rectus and superior oblique muscles (myectomy). In addition, the eyelids of the nondeviating eyes of these kittens were sutured closed (ESO/MD). The first rearing paradigm isolated the effects of conflicting visual inputs on neural development, whereas the second procedure isolated the effects of anomalous ocular motility by producing a misalignment without putting the deviated eye at a competitive disadvantage. 3. The recording experiments were conducted when the animals were greater than or equal to 9 mo of age. A total of 445 striate cortical neurons were isolated and quantitatively studied in 17 cats (3 MPs, 3 BPs, 5 ESO/MDs, 3 goggle-reared controls, and 3 normals). In addition, we analyzed the distribution of preferred stimulus orientations of 1,205 single units that had been studied qualitatively in our previous investigation of 42 kittens reared with optically induced strabismus. 4. As expected, the proportion of binocularly driven units was reduced in both MP and BP cats. The great majority of units in ESO/MD animals were exclusively driven or highly dominated by the open deviating eye. 5. Prism-reared animals showed physiological deficits in spatial resolution, contrast sensitivity, contrast gain, and peak firing rate. These effects were manifest in both eyes, although there was always an interocular asymmetry in the deficits observed in the two eyes. In MP animals, the units dominated by the treated eye, which was contralateral to the recording hemisphere, were on the average more severely affected. The interocular asymmetry was smaller in BP cats; however, two of the three BP animals also showed a greater deficit in those units dominated by the contralateral eye.(ABSTRACT TRUNCATED AT 400 WORDS)

Contact lens anterior surface pH

Recent reports of CO 2 accumulation under hydrogel lenses, paired with the detection of a decrease in stromal pH following contact lens wear, have highlighted the potential for tear pH assessment as a clinical tool. The in situ anterior hydrogel lens surface pH was measured with a flat-surfaced, self-referenced pH electrode in order to indirectly evaluate fluid exchange between the precorneal tear film and hydrogel lenses. Volunteer human subjects were fitted with moderate water content (58%), disposable extended wear hydrogel lenses. Measurements were recorded from the lens in its packaged state (pH 6.99), from the lens in situ 5 minutes after initial lens application (pH 7.17), 24 hours later (pH 7.34), and at the end of 7 days continuous contact lens wear (pH 7.43). Possible cornea-tear film-hydrogel lens interactions could explain certain hydrogel lens-associated contrast sensitivity deficits and transient endothelial changes.

Visual contrast sensitivity in drug-induced Parkinsonism.

The influence of stimulus orientation on contrast sensitivity function was studied in 10 patients with drug-induced Parkinsonism. Nine of the 10 patients had at least one eye with contrast sensitivity deficit for vertical and/or horizontal stimuli. Only generalised contrast sensitivity loss, observed in two eyes, was stimulus orientation independent. All spatial frequency-selective contrast deficits in 15 eyes were orientation dependent. The striking similarity between the pattern of contrast sensitivity loss in drug-induced Parkinsonism and that in idiopathic Parkinson's disease, suggests that generalised dopaminergic deficiency, from whatever cause, affects visual function in an analogous way.

The effects of reverse monocular deprivation in monkeys. I. Psychophysical experiments.

Monkeys had one eye closed at about 30 days of age for 14, 30, 60, or 90 days, then opened, and the fellow eye closed for another 120 days. The animals then had at least 10 months of binocular visual experience before behavioral training and testing were begun. All subjects were used in a series of psychophysical investigations during the next two years. The results of the behavioral studies indicated that the initially deprived eyes (IDE) of the two monkeys that were subjected to initial deprivation periods of 14 or 30 days recovered normal or near-normal spatial contrast sensitivity. In contrast, the two animals which underwent longer periods of initial deprivation showed incomplete recovery, especially for high spatial frequency stimuli. All of the monkeys exhibited a reduction in spatial contrast sensitivity for their reverse deprived eyes (RDE); the earlier the onset of the reverse-deprivation procedures (i.e., the shorter the initial period of deprivation), the greater the deficit in the RDE's spatial contrast sensitivity. Measurements of temporal contrast sensitivity showed that all of the subjects' IDEs had normal or near-normal sensitivity levels. However, the reverse-deprivation procedures initiated at 90 days of age or earlier produced a frequency-dependent reduction in the RDE's temporal modulation sensitivity. The measures of increment-threshold spectral sensitivity revealed that only the RDE of the monkey that had the shortest initial deprivation period had an abnormal spectral sensitivity function. The results demonstrate that many of the severe behavioral deficits produced by early monocular form deprivation can be recovered via reverse-deprivation procedures. However, depending upon the length of the initial deprivation period and the age at which the reversal procedure is initiated, the second deprivation period can also adversely affect the functional capacity of the RDE.

The Relationship between Hue Discrimination and Contrast Sensitivity Deficits in Patients with Diabetes Mellitus

In an attempt to elucidate more fully the pathophysiologic basis of early visual dysfunction in patients with diabetes mellitus, color vision (hue discrimination) and spatial resolution (contrast sensitivity) were tested in diabetic patients with little or no retinopathy (n = 57) and age-matched visual normals (n = 35). Some evidence of visual dysfunction was observed in 37.8% of the diabetics with no retinopathy and 60.0% of the diabetics with background retinopathy. Although significant hue discrimination and contrast sensitivity deficits were observed in both groups of diabetic patients, contrast sensitivity was abnormal more frequently than hue discrimination. However, only 5.4% of the diabetics with no retinopathy and 10.0% of the diabetics with background retinopathy exhibited both abnormal hue discrimination and abnormal contrast sensitivity. Contrary to previous reports, blue-yellow (B-Y) and red-green (R-G) hue discrimination deficits were observed with approximately equal frequency. In the diabetic group, contrast sensitivity was reduced at all spatial frequencies tested, but for individual diabetic patients, significant deficits were only evident for the mid-range spatial frequencies. Among diabetic patients, the hue discrimination deficits, but not the contrast sensitivity abnormalities, were correlated with the patients' hemoglobin A1 level. A negative correlation between contrast sensitivity at 6.0 cpd and the duration of diabetes also was observed.

Effect of stimulus orientation on contrast sensitivity in Parkinson's disease.

We studied the effect of stimulus orientation on contrast sensitivity function in 21 patients with Parkinson's disease and in 10 normal subjects. This was done by measuring contrast sensitivity over a range of spatial frequencies for vertical and horizontal sine wave grating stimuli. There was a great test-retest consistency in normal subjects and patients. Fifteen of the 21 patients showed contrast sensitivity deficit in at least one eye. Orientation-specific loss was demonstrated in 17 of the 25 "affected" eyes. The most frequent type of orientation-specific loss was a notch defect, which preferentially affected the middle spatial frequencies. We attribute orientation-specific and spatial frequency-selective loss in Parkinson's disease to a functional disruption of neurons on the visual cortex.

Assessment of Visual Impairment in Patients With Alzheimer's Disease

We examined five patients with Alzheimer's disease who complained of poor vision. Two patients had mild Alzheimer's disease; they complained of problems with reading and of "bumping into things," yet both had normal visual acuities. One patient with moderate Alzheimer's disease had abnormal eye movements, visual-evoked potentials, and contrast sensitivity. The other two patients had severe Alzheimer's disease. Despite difficulties in performing the examination, we were able to see moderate impairments in visual acuity and visual fields, as well as marked dyschromatopsia, severe deficits in contrast sensitivity, and markedly abnormal eye movements and visual-evoked potentials.

Deficits in Visual Function after Resolution of Optic Neuritis

A study was done to systematically characterize visual function in eyes with recovered optic neuritis. Thirty-five eyes from 27 patients, all of whom had recovered at least 20/30 Snellen acuity after resolution of the neuritis, were included. Minimum recovery period was 6 months. Abnormalities were found in color vision (57%), contrast sensitivity (72%), perimetry (26%), stereoacuity (80%), light brightness (89%), pupillary reaction (89%), and optic disc appearance (77%). Eighty-five percent of patients complained of at least some subjective disturbance in vision. Subjective visual complaints correlated better with deficits in contrast sensitivity than they did with the other measures. The results of the study indicate that deficits in visual function are common after resolution of optic neuritis.

Reduced visual acuity in both eyes of monocularly deprived kittens following a short or long period of reverse occlusion

While there can be substantial recovery of vision during reverse occlusion in the deprived eye of kittens that have been monocularly deprived from birth, in many situations this visual improvement does not appear to be retained following the introduction of binocular visual input. This study examines the consequences of periods of reverse occlusion whose onset and duration would be thought to maximize the opportunity for good and permanent recovery of vision in the initially deprived eye. Twenty kittens were monocularly deprived from near birth to either 4, 5, or 6 weeks of age and then reverse occluded for periods that were either very brief (9-18 d) or very long (9-12 weeks). In the former situation, binocular visual experience was introduced when the visual cortex was most susceptible to environmental modification, which would be thought to maximize the opportunity for the eventual development of good vision in both eyes. On the other hand, the long periods of reverse occlusion might be expected to lead to a permanent recovery of vision in only the initially deprived eye, since binocular visual input would have been introduced at a time when the cortex was no longer very plastic. Surprisingly, the end result of both these extreme regimens of reverse occlusion was the same, namely, a severe bilateral amblyopia in which the acuity of both eyes was permanently reduced to levels that were as low as 1/10, but more typically between 1/3 and 1/4 of normal values. Contrast sensitivity functions measured on 2 of the cats that received a brief period of reverse occlusion revealed deficits in contrast sensitivity of about an order of magnitude at all spatial frequencies. These observations have important implications for the nature of the physiological and anatomical changes that occur in the visual cortex during reverse occlusion.

Pattern and motion vision in cats with selective loss of cortical directional selectivity

Neurons in the visual cortex of cats reared in 8 Hz stroboscopic illumination show a profound loss of directional selectivity, but no detectable deficits in orientation selectivity, contrast sensitivity, and temporal frequency response, and only a slight reduction in spatial resolution. In the present study, spatial vision, temporal resolution, and a variety of motion detection and discrimination thresholds were examined behaviorally in such cats. These psychophysical measurements revealed nearly normal spatial and temporal vision, but severe abnormalities in visual discriminations based on differences in stimulus direction. Specifically, strobe-reared cats showed normal orientation discrimination and temporal frequency resolution, nearly normal contrast sensitivity at low spatial frequencies, and a slight reduction of sensitivity to high spatial frequencies. At high contrasts, the cats were able to discriminate opposite directions of motion over a wide range of visible speeds, and their performance was indistinguishable from that of normal cats. However, a comparison of contrast thresholds for detecting moving gratings and for discriminating their direction of motion revealed severe abnormalities in strobe-reared animals. At low spatial frequencies (0.28 cycles/deg), normal cats could discriminate the direction of grating motion at contrasts that were just barely visible, whereas the strobe-reared cats could detect the grating at contrasts similar to those required by normal cats, but required contrasts about 10 X the threshold to identify the direction of motion. Normal cats showed nearly identical contrast sensitivity for detecting and discriminating gratings of high spatial frequency at high temporal frequency (drift rates), but when the temporal frequency was low, their sensitivity for detection exceeded that for direction discrimination.(ABSTRACT TRUNCATED AT 250 WORDS)

Spatiotemporal responses of the visual system in demyelinating diseases.

Previous studies have shown that, in patients with lesions of the visual pathway, contrast sensitivity (CS) measured with stationary sine-wave gratings can demonstrate deficits, that is, anomalies in pattern detection. The purpose of this study was to investigate whether temporal processing can be affected in demyelinating lesions of the visual pathway. CS was measured for eight spatial frequencies (SF), using stationary and temporally modulated stimuli in a group of 10 patients with multiple sclerosis or optic neuritis. A control group was composed of 48 normal eyes. With stationary stimuli, CS losses were found in 17 eyes of patients; 11 of these eyes were 'unaffected'. The importance of the CS measurements in detecting early subclinical visual damage is emphasized. The effect of temporal modulation in patients with CS deficits was different from that observed in normals: CS deficits were modified by temporal variation in three distinct manners. In 7 eyes (type 1 effect), temporal modulation reduced the deficit at all SFs. In type 2 (5 eyes), the effect was reversed at low and high SFs: the deficit was reduced at low SFs (below 2-3 cycles/deg) and aggravated at high SFs. In type 3 (4 eyes), CS deficit was aggravated over most SFs. Thus these patients exhibited anomalies of the spatiotemporal responses which could not be predicted by the CS to stationary stimuli. Some theoretical models of spatiotemporal processing proposed in normal vision might account for our results. Possible explanations of these findings are proposed and discussed.

Is reduced vernier acuity in amblyopia due to position, contrast or fixation deficits?

Poor vernier acuity, exhibited by amblyopes, may reflect anomalies related to eccentric fixation, deficient position sensitivity, or reduced contour visibility. We have examined these factors by measuring contrast and vernier sensitivities with stimuli consisting of extended sinusoidal gratings of several spatial frequencies. Vernier thresholds were measured using both a classical single step position change and also a grating that was position-modulated sinusoidally along its entire length. For both types of target amblyopes exhibited deficient displacement sensitivity although accurate fixation was not strictly required. The vernier deficits were not critically dependent upon the type of displacement used, and the magnitudes of the vernier and contrast sensitivity deficits were closely related. Both were largest at high spatial frequencies, and those amblyopes with larger contrast sensitivity deficits also had larger vernier acuity deficiencies. Typically, contrast sensitivity and vernier acuity were normal, or nearly so, at very low spatial frequencies. Also, vernier acuities for the amblyopic and non-amblyopic eyes were approximately equal if grating contrast was set at some fixed multiple of detection threshold. We did not find a close relationship between the magnitude of the vernier deficit and reported perceptual distortions.

Temporal sensitivity in amblyopia: An explanation of conflicting reports

Although the spatial characteristics of contrast sensitivity in amblyopia are well established, it is still not clear how temporal vision is affected. A wide range of spatial stimuli have been used to measure flicker sensitivity in amblyopia and we have considered the possibility that reported inconsistancies in results are due to a confounding of spatial and temporal stimulus parameters. To address this question we have measured contrast sensitivity from a sample of eight strabismic/anisometropic amblyopes using (1) stationary sinusoidal gratings, (2) uniform field flicker and (3) counterphased flickering gratings. In each case the contrast sensitivity deficits were predictably determined by the spatial properties of the stimulus (spot size or spatial frequency), and the spatial characteristics of the amblyopia. Results are nearly independent of the temporal properties of the stimulus. Specifically, when the stimulus is sufficiently large, or consists of low spatial frequencies, no temporal deficits are found. We conclude that conflicts between previous reports are attributable primarily to differences in spatial characteristics of the stimuli used.

Is amblyopia spatial frequency or retinal locus specific?

The visual deficit associated with amblyopia is thought to be both spatial frequency and retinal locus dependent. However, most data that have been obtained can be accounted for by either of these factors or by a combination of both. We have tried to distinguish between these three possibilities by measuring contrast sensitivity at different retinal loci using discrete localized patches of grating. For five of nine amblyopes, we find the contrast sensitivity deficit to be constant across the retina for a given spatial frequency. In only two cases were there substantial changes as a function of retinal eccentricity. Therefore, most of our data suggest that the visual deficit in amblyopia is primarily spatial frequency and not retinal locus specific.