Measurement of suprathreshold binocular interactions in amblyopia.

McGill Vision Research, Department of Ophthalmology, McGill University, 687 Pine Ave W (H4-14), Montreal, Que., Canada PQ H3A 1A1.
Vision research (Impact Factor: 2.29). 09/2008; 48(28):2775-84. DOI: 10.1016/j.visres.2008.09.002
Source: PubMed

ABSTRACT It has been established that in amblyopia, information from the amblyopic eye (AME) is not combined with that from the fellow fixing eye (FFE) under conditions of binocular viewing. However, recent evidence suggests that mechanisms that combine information between the eyes are intact in amblyopia. The lack of binocular function is most likely due to the imbalanced inputs from the two eyes under binocular conditions [Baker, D. H., Meese, T. S., Mansouri, B., & Hess, R. F. (2007b). Binocular summation of contrast remains intact in strabismic amblyopia. Investigative Ophthalmology & Visual Science, 48(11), 5332-5338]. We have measured the extent to which the information presented to each eye needs to differ for binocular combination to occur and in doing so we quantify the influence of interocular suppression. We quantify these suppressive effects for suprathreshold processing of global stimuli for both motion and spatial tasks. The results confirm the general importance of these suppressive effects in rendering the structurally binocular visual system of a strabismic amblyope, functionally monocular.

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    ABSTRACT: To test the hypothesis that fixational stability of the amblyopic eye in strabismics will improve when viewing provides both bifoveal fixation and reduced inter-ocular suppression by reducing the contrast to the fellow eye. Seven strabismic amblyopes (Age: 29.2 ± 9 years; five esotropes and two exotropes) showing clinical characteristics of central suppression were recruited. Interocular suppression was measured by a global motion task. For each participant, a balance point was determined which defined contrast levels for each eye where binocular combination was optimal (interocular suppression minimal). When the balance point could not be determined, this participant was excluded. Bifoveal fixation was established by ocular alignment using a haploscope. Participants dichoptically viewed similar targets (a cross of 2.3° surrounded by a square of 11.3°) at 40 cm. Target contrasts presented to each eye were either high contrast (100% to both eyes) or balanced contrast (attenuated contrast in the fellow fixing eye). Fixation stability was measured over a 5 min period and quantified using bivariate contour ellipse areas in four different binocular conditions; unaligned/high contrast, unaligned/balance point, aligned/high contrast and aligned/balance point. Fixation stability was also measured in six control subjects (Age: 25.3 ± 4 years). Bifoveal fixation in the strabismics was transient (58.15 ± 15.7 s). Accordingly, fixational stability was analysed over the first 30 s using repeated measures anova. Post hoc analysis revealed that for the amblyopic subjects, the fixational stability of the amblyopic eye was significantly improved in aligned/high contrast (p = 0.01) and aligned/balance point (p < 0.01) conditions. Fixational stability of the fellow fixing eye was not different statistically across conditions. Bivariate contour ellipse areas of the amblyopic and fellow fixing eyes were therefore averaged for each amblyope in the four conditions and compared with normals. This averaged bivariate contour ellipse area was significantly greater (reduced fixational stability, p = 0.04) in amblyopes compared to controls except in the case of aligned and balanced contrast (aligned/balance point, p = 0.19). Fixation stability in the amblyopic eye appears to improve with bifoveal fixation and reduced interocular suppression. However, once initiated, bifoveal fixation is transient with the strabismic eye drifting away from foveal alignment, thereby increasing the angle of strabismus.
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    ABSTRACT: It is known that information from an amblyopic eye can be strongly suppressed when both eyes are open. The authors investigated the way in which suppression influences the relative perception of suprathreshold contrast and luminance between a person's eyes under dichoptic viewing conditions. Stimuli consisted of four patches of luminance or four patches containing gratings. Two patches were presented to each eye. Ten amblyopes with mild suppression (six strabismic, three anisometropic and strabismic, and one deprivation; mean age, 34.5 years) and three control observers with normal vision (mean age, 33.0 years) matched the appearance of the stimuli presented to each eye. The match involved manipulation of either luminance or contrast. Amblyopes with mild suppression decreased stimulus luminance in the fellow fixing eye or increased luminance in the amblyopic eye to achieve a match (mean matching luminance, 21.1 and 39.6 cd/m(2) for the fellow fixing eye and the amblyopic eye, respectively; standard luminance, 30 cd/m(2)). This interocular mismatch was also observed when luminance was variable and contrast was kept constant (mean matching luminance, 22.8 cd/m(2) for the fellow fixing eye). On the other hand, the amblyopic eye showed no loss of perceived contrast. There was little or no mismatch between the two eyes of control participants with normal binocular vision. Amblyopes have monocular deficits in contrast perception but dichoptic deficits in luminance perception, suggesting that suppression in its mild form involves luminance processing.
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