Temporal synchronization elicits enhancement of binocular vision functions

The Relationship Between Binocular Imbalance and Myopic Shift in Unoperated Eyes After Unilateral SMILE and tPRK

Purpose

The purpose of this study was to investigate the relationship between binocular imbalance and myopic shift in unoperated eyes after unilateral small incision lenticule extraction (SMILE) and transepithelial photorefractive keratectomy (tPRK) procedures.

Methods

This study included 51 participants who had undergone unilateral SMILE (n = 28) or tPRK (n = 23) for at least 3 months. The participants were categorized into stable and myopic shift groups based on the difference between preoperative and postoperative spherical equivalent refractive (SER) errors of unoperated eyes. Psychophysical tests were conducted only at the postoperative follow-up point. Spatial sensory eye dominance was determined by analyzing a binocular orientation combination task at spatial frequencies of 1 and 6 cycles per degree (c/d). A rotating cylinder generated a spontaneous Pulfrich phenomenon to determine the interocular delay at spatial frequencies of 0.95 and 2.95 c/d.

Results

The logrBP in the myopic shift group was significantly more negative than in the stable group at 1 c/d (P < 0.01) and 6 c/d (P < 0.01). And logrBP correlated with the difference between preoperative and postoperative SER of the unoperated eye at 1 c/d (rs = 0.513, P < 0.001) and 6 c/d (rs = 0.504, P < 0.001). In the myopic shift group, logrBP was more negative at 6 c/d than at 1 c/d (P = 0.013), but not in the stable group.

Conclusions

Patients who experience myopic shift in the unoperated eye after unilateral SMILE or tPRK tend to have stronger sensory eye dominance in that eye, with a more pronounced dominance at higher spatial frequencies.

Contextual Binocular Imbalance Impairs Local Stereopsis

Purpose

Binocular imbalance is known to inhibit stereopsis. This study investigates whether an imbalanced context around stereo stimuli also affects local stereopsis and explores the underlying mechanisms.

Methods

Three experiments were conducted with normally sighted participants. Experiment 1 measured local stereo detection thresholds under three context conditions: binocular balance (0.5 vs. 0.5 contrast), left-eye dominance (0.8 vs. 0.2 contrast), and right-eye dominance (0.2 vs. 0.8 contrast). Experiment 2 assessed the modulation of the imbalance effect by context-target collinearity. Experiment 3 examined the imbalance effect with binocular fusion and rivalry context stimuli.

Results

In experiment 1, the average stereo threshold was 62.4 arcsec in the binocular balance condition, elevated to 111.4 arcsec in the left-eye dominance (P = 0.003), and 114.7 arcsec in the right-eye dominance (P < 0.001), with no significant difference between the two imbalance conditions (P = 0.650). Experiment 2 showed that context-target collinearity modulated the imbalance effect, resulting in a smaller threshold elevation in the non-collinear condition (P = 0.011). Experiment 3 revealed significant main effects of imbalance (P = 0.031) and rivalry (P = 0.004), with no significant interaction (P = 0.966).

Conclusions

Contextual binocular imbalance inhibits local stereopsis, an effect modulated by collinearity and similarly observed in both binocular integrative and suppressive contexts. These findings suggest that lateral connectivity in the primary visual cortex (V1) plays a fundamental role in stereopsis generation, offering novel approaches for clinical interventions aimed at restoring binocular balance and stereopsis.

Effects of Monocular Flicker on Binocular Imbalance in Amblyopic and Nonamblyopic Adults

Purpose

This study aimed to evaluate the effects of monocular flicker stimulation on binocular imbalance in both amblyopic and nonamblyopic adults.

Methods

Seven amblyopic patients (28.3 ± 3.3 years; four females) and seven normally sighted participants (27.3 ± 4.1 years; five females) participated in the study. We used liquid crystal spectacles to create externally-generated monocular flicker (4, 7, 10, 15, or 20 Hz) and used the metric of log balance point (logBP) to determine whether imposed flicker could change the eyes' equilibrium interocular contrast ratio. Flicker was applied to either the fellow eye vs. the amblyopic eye or dominant eye (DE) vs. non-DE (non-DE) of amblyopic and nonamblyopic participants, respectively. We defined a logBP of 0 to indicate complete binocular balance and an increase in logBP relative to baseline to indicate a relative strengthening of the non-DE or amblyopic eye.

Results

Monocular flicker applied to the DE or fellow eye increased logBP, whereas when applied to the non-DE or amblyopic eye, reduced the logBP. These effects were more pronounced at low temporal frequencies than that at high temporal frequencies. The interaction between eye and temporal frequency was significant in both normals, F(4, 24) = 58.082, P < 0.001, η2 = 0.906, and amblyopes, F(1.923, 11.538) = 60.555, P < 0.001, η2 = 0.91.

Conclusions

Monocular flicker diminishes the contribution of the flickered eye in binocular combination, resulting in a relative dominance of the nonflickered eye in interocular interactions. Furthermore, a more pronounced temporally modulated effect was observed at lower temporal frequencies.

Measuring the Interocular Delay and its Link to Visual Acuity in Amblyopia

Purpose

Research on interocular synchronicity in amblyopia has demonstrated a deficit in synchronization (i.e., a neural processing delay) between the two eyes. Current methods for assessing interocular delay are either costly or ineffective for assessments in severe amblyopia. In this study, we adapted a novel protocol developed by Burge and Cormack based on continuous target tracking to measure the interocular delay on a wide range of amblyopes. Our main aims were to assess the accessibility of this protocol and to investigate the relationship between interocular delay and visual acuity.

Methods

This protocol, which consists of tracking a target undergoing random lateral motion with the mouse cursor, is performed both binocularly and monocularly. The processing speed of a given eye is computed by comparing the changes in velocity of the target and mouse via cross-correlation. The difference in processing speed between the eyes defines the interocular delay.

Results

Cross-correlations revealed that the amblyopic eye tends to be delayed in time compared with the fellow eye. Interocular delays fell in the range of 0.6 to 114.0 ms. The magnitude of the delay was positively correlated with differences in interocular visual acuity (R2 = 0.484; P = 0.0002).

Conclusions

These results demonstrate the accessibility of this new protocol and further support the link between interocular synchronicity and amblyopia. Furthermore, we determine that the interocular delay in amblyopia is best explained by a deficit in the temporal integration of the amblyopic eye.

Spatial frequency channels depend on stimulus bandwidth in normal and amblyopic vision: an exploratory factor analysis

The Contrast Sensitivity Function (CSF) is the measure of an observer's contrast sensitivity as a function of spatial frequency. It is a sensitive measure to assess visual function in fundamental and clinical settings. Human contrast sensitivity is subserved by different spatial frequency channels. Also, it is known that amblyopes have deficits in contrast sensitivity, particularly at high spatial frequencies. Therefore, the aim of this study was to assess whether the contrast sensitivity function is subtended by the same spatial frequency channels in control and amblyopic populations. To determine these spatial frequency channels, we performed an exploratory factor analysis on five datasets of contrasts sensitivity functions of amblyopic and control participants measured using either gratings or noise patches, taken from our previous studies. In the range of 0.25-10 c/d, we identified two spatial frequency channels. When the CSF was measured with noise patches, the spatial frequency channels presented very similar tuning in the amblyopic eye and the fellow eye and were also similar to what was observed in controls. The only major difference was that the weight attributed to the high frequency channel was reduced by approximately 50% in the amblyopic eye. However, when the CSF was measured using gratings, the spatial frequency channels of the amblyopic eye were tuned toward lower spatial frequencies. These findings suggest that there is no mechanistic deficit for contrast sensitivity in amblyopia and that amblyopic vision may just be subjected to excessive internal noise and attenuation at higher spatial frequencies, thereby supporting the use of therapeutic strategies that involve rebalancing contrast.

Perceptual learning based on a temporal stimulus enhances visual function in adult amblyopic subjects

Studies have shown that Perceptual Learning (PL) can lead to enhancement of spatial visual functions in amblyopic subjects. Here we aimed to determine whether a simple flickering stimulus can be utilized in PL to enhance temporal function performance and whether enhancement will transfer to spatial functions in amblyopic subjects. Six adult amblyopic and six normally sighted subjects underwent an evaluation of their performance of baseline psychophysics spatial functions (Visual acuity (VA), contrast sensitivity (CS), temporal functions (critical fusion frequency (CFF) test), as well as a static and flickering stereopsis test, and an electrophysiological evaluation (VEP). The subjects then underwent 5 training sessions (on average, a total of 150 min over 2.5 weeks), which included a task similar to the CFF test using the method of constant stimuli. After completing the training sessions, subjects repeated the initial performance evaluation tasks. All amblyopic subjects showed improved temporal visual performance (CFF) in the amblyopic eye (on average, 17%, p << 0.01) following temporal PL. Generalization to spatial, spatio-temporal, and binocular tasks was also found: VA increased by 0.12 logMAR (p = 0.004), CS in backward masking significantly increased (by up to 19%, p = 0.003), and flickering stereopsis increased by 85 arcsec (p = 0.048). These results were further electrophysiologically manifested by an increase in VEP amplitude (by 43%, p = 0.03), increased Signal-to-Noise ratio (SNR) (by 39%, p = 0.024) to levels not different from normally sighted subjects, along with an improvement in inter-ocular delay (by 5.8 ms, p = 0.003). In contrast, no significant effect of training was found in the normally sighted group. These results highlight the potential of PL based on a temporal stimulus to improve the temporal and spatial visual performance in amblyopes. Future work is needed to optimize this method for clinical applications.