Interindividual variation in human visual performance

The Central Role of the Individual in the History of Brains

Every species' brain, body and behavior is shaped by the contingencies of their evolutionary history; these exert pressures that change their developmental trajectories. There is, however, another set of contingencies that shape us and other animals: those that occurring during a lifetime. In this perspective piece, we show how these two histories are intertwined by focusing on the individual. We suggest that organisms--their brains and behaviors--are not solely the developmental products of genes and neural circuitry but individual centers of action unfolding in time. To unpack this idea, we first emphasize the importance of variation and the central role of the individual in biology. We then go over "errors in time" that we often make when comparing development across species. Next, we reveal how an individual's development is a process rather than a product by presenting a set of case studies. These show developmental trajectories as emerging in the contexts of the "the actual now" and "the presence of the past". Our consideration reveals that individuals are slippery-they are never static; they are a set of on-going, creative activities. In light of this, it seems that taking individual development seriously is essential if we aspire to make meaningful comparisons of neural circuits and behavior within and across species.

Vision screening and vocational aptitude: A factor analysis approach

For a good vision screening battery to quickly and accurately reflect the status of the human visual system it should be relevant, reliable, and streamlined. Because the early visual system has limited functional architecture, many simple measurements of the visual system may in fact be measuring the shared computations and parallel processes of other visual functions, making much of the measurement process redundant. This can make a screening battery repetitious and therefore inefficient. The purpose of this research is to investigate these redundancies in a large occupational screening dataset using factor analysis. 192 subjects participated in the Operational Based Vision Assessment (OBVA) Laboratory Automated Vision Testing (AVT) procedure. The AVT includes digital tests for visual acuity, luminance and cone contrast sensitivity, motion coherence, stereopsis, and binocular motor function. Psychometric thresholds and fusional ranges were collected from each subject and a factor analysis was utilized to investigate independent latent variables in the dataset. A promax rotation revealed 5 factors that explained 74% of the total variance: (1) medium and high spatial frequency vision, (2) stereoacuity and horizontal fusional range, (3) cone contrast sensitivity, (4) motion perception, and (5) low spatial frequency vision. Practically, these results suggest that the screening battery can be reduced to 5 independent measurements that capture much of the variance in the dataset. Furthermore, the factors predicted operational and vocational aptitude better than any single variable. More interestingly, these relationships also reiterate known computational processes within the human visual system, such as the parallel processing of low and high spatial frequency content.

A novel visual illusion paradigm provides evidence for a general factor of illusion sensitivity and personality correlates

Visual illusions are a gateway to understand how we construct our experience of reality. Unfortunately, important questions remain open, such as the hypothesis of a common factor underlying the sensitivity to different types of illusions, as well as of personality correlates of illusion sensitivity. In this study, we used a novel parametric framework for visual illusions to generate 10 different classic illusions (Delboeuf, Ebbinghaus, Rod and Frame, Vertical-Horizontal, Zöllner, White, Müller-Lyer, Ponzo, Poggendorff, Contrast) varying in strength, embedded in a perceptual discrimination task. We tested the objective effect of the illusions on errors and response times, and extracted participant-level performance scores (n=250) for each illusion. Our results provide evidence in favour of a general factor underlying the sensitivity to different illusions (labelled Factor i). Moreover, we report a positive link between illusion sensitivity and personality traits such as Agreeableness, Honesty-Humility, and negative relationships with Psychoticism, Antagonism, Disinhibition, and Negative Affect.

Individual differences in the perception of visual illusions are stable across eyes, time, and measurement methods

Vision scientists have tried to classify illusions for more than a century. For example, some studies suggested that there is a unique common factor for all visual illusions. Other studies proposed that there are several subclasses of illusions, such as illusions of linear extent or distortions. We previously observed strong within-illusion correlations but only weak between-illusion correlations, arguing in favor of an even higher multifactorial space with-more or less-each illusion making up its own factor. These mixed results are surprising. Here, we examined to what extent individual differences in the perception of visual illusions are stable across eyes, time, and measurement methods. First, we did not find any significant differences in the magnitudes of the seven illusions tested with monocular or binocular viewing conditions. In addition, illusion magnitudes were not significantly predicted by visual acuity. Second, we observed stable individual differences over time. Last, we compared two illusion measurements, namely an adjustment procedure and a method of constant stimuli, which both led to similar individual differences. Hence, it is unlikely that the individual differences in the perception of visual illusions arise from instability across eyes, time, and measurement methods.

Individual differences in the Müller-Lyer and Ponzo illusions are stable across different contexts

Vision scientists have attempted to classify visual illusions according to certain aspects, such as brightness or spatial features. For example, Piaget proposed that visual illusion magnitudes either decrease or increase with age. Subsequently, it was suggested that illusions are segregated according to their context: real-world contexts enhance and abstract contexts inhibit illusion magnitudes with age. We tested the effects of context on the Müller-Lyer and Ponzo illusions with a standard condition (no additional context), a line-drawing perspective condition, and a real-world perspective condition. A mixed-effects model analysis, based on data from 76 observers with ages ranging from 6 to 66 years, did not reveal any significant interaction between context and age. Although we found strong intra-illusion correlations for both illusions, we found only weak inter-illusion correlations, suggesting that the structure underlying these two spatial illusions includes several specific factors.

The factorial structure of individual differences in visual perception

Although at first glance the way we perceive the world is similar for most individuals and resembles a veridical interpretation of the environment, the persistent individual differences found in many perceptual processes continue to inspire and confuse researchers. Despite numerous attempts to map out the reliable factors and correlates of individual variance in perception, the factorial structure of vision has remained elusive. The current article reviews recent developments in the study of individual differences in perception with a focus on work that has applied latent variable techniques for analysing performance across multiple visual paradigms. As this overview reveals, studies that have attempted to answer the question whether one general or several specific factors best describe vision tend to reject the monolithic view. Some general notes are also provided regarding pitfalls that should be taken into account when designing such research in the future.

Dissociating task acquisition from expression during learning reveals latent knowledge

Performance on cognitive tasks during learning is used to measure knowledge, yet it remains controversial since such testing is susceptible to contextual factors. To what extent does performance during learning depend on the testing context, rather than underlying knowledge? We trained mice, rats and ferrets on a range of tasks to examine how testing context impacts the acquisition of knowledge versus its expression. We interleaved reinforced trials with probe trials in which we omitted reinforcement. Across tasks, each animal species performed remarkably better in probe trials during learning and inter-animal variability was strikingly reduced. Reinforcement feedback is thus critical for learning-related behavioral improvements but, paradoxically masks the expression of underlying knowledge. We capture these results with a network model in which learning occurs during reinforced trials while context modulates only the read-out parameters. Probing learning by omitting reinforcement thus uncovers latent knowledge and identifies context- not “smartness”- as the major source of individual variability.

Performance is generally used as a metric to assay whether an animal has learnt a particular perceptual task. Here the authors demonstrate that in the context of probe trials without the possibility of reward, animals perform the correct instrumental response suggesting a latent knowledge of the task much before it is manifest in their performance.

Can speed be judged independent of direction?

The ability to judge speed is a fundamental aspect of visual motion processing. Speed judgments are generally assumed to depend on signals in motion-sensitive, directionally selective, neurons in areas such as V1 and MT. Speed comparisons might therefore be expected to be most accurate when they use information within a common set of directionally tuned neurons. However, there does not appear to be any published evidence on how well speeds can be compared for movements in different directions. We tested speed discrimination judgments between pairs of random-dot stimuli presented side-by-side in a series of four experiments (n = 65). Participants judged which appeared faster of a reference stimulus moving along the cardinal or oblique axis and a comparison stimulus moving either in the same direction or in a different direction. The bias (point of subjective equality) and sensitivity (Weber fraction) were estimated from individual psychometric functions fitted for each condition. There was considerable between-participants variability in psychophysical estimates across conditions. Nonetheless, participants generally made more acute comparisons between stimuli moving in the same direction than those moving in different directions, at least for conditions with an upwards reference (∼20% difference in Weber fractions). We also showed evidence for an oblique effect in speed discrimination when comparing stimuli moving in the same direction, and a bias whereby oblique motion tended to be perceived as moving faster than cardinal motion. These results demonstrate interactions between speed and direction processing, thus informing our understanding of how they are represented in the brain.

The optimal experimental design for multiple alternatives perceptual search

Perceptual bias is inherent to all our senses, particularly in the form of visual illusions and aftereffects. However, many experiments measuring perceptual biases may be susceptible to nonperceptual factors, such as response bias and decision criteria. Here, we quantify how robust multiple alternative perceptual search (MAPS) is for disentangling estimates of perceptual biases from these confounding factors. First, our results show that while there are considerable response biases in our four-alternative forced-choice design, these are unrelated to perceptual biases estimates, and these response biases are not produced by the response modality (keyboard vs. mouse). We also show that perceptual bias estimates are reduced when feedback is given on each trial, likely due to feedback enabling observers to partially (and actively) correct for perceptual biases. However, this does not impact the reliability with which MAPS detects the presence of perceptual biases. Finally, our results show that MAPS can detect actual perceptual biases and is not a decisional bias towards choosing the target in the middle of the candidate stimulus distribution. In summary, researchers conducting a MAPS experiment should use a constant reference stimulus, but consider varying the mean of the candidate distribution. Ideally, they should not employ trial-wise feedback if the magnitude of perceptual biases is of interest.

How neuroscience can inform the study of individual differences in cognitive abilities

Theories of human mental abilities should be consistent with what is known in neuroscience. Currently, tests of human mental abilities are modeled by cognitive constructs such as attention, working memory, and speed of information processing. These constructs are in turn related to a single general ability. However, brains are very complex systems and whether most of the variability between the operations of different brains can be ascribed to a single factor is questionable. Research in neuroscience suggests that psychological processes such as perception, attention, decision, and executive control are emergent properties of interacting distributed networks. The modules that make up these networks use similar computational processes that involve multiple forms of neural plasticity, each having different time constants. Accordingly, these networks might best be characterized in terms of the information they process rather than in terms of abstract psychological processes such as working memory and executive control.

An exploratory factor analysis of visual performance in a large population

A factor analysis was performed on 25 visual and auditory performance measures from 1060 participants. The results revealed evidence both for a factor relating to general perceptual performance, and for eight independent factors that relate to particular perceptual skills. In an unrotated PCA, the general factor for perceptual performance accounted for 19.9% of the total variance in the 25 performance measures. Following varimax rotation, 8 consistent factors were identified, which appear to relate to (1) sensitivity to medium and high spatial frequencies, (2) auditory perceptual ability (3) oculomotor speed, (4) oculomotor control, (5) contrast sensitivity at low spatial frequencies, (6) stereo acuity, (7) letter recognition, and (8) flicker sensitivity. The results of a hierarchical cluster analysis were consistent with our rotated factor solution. We also report correlations between the eight performance factors and other (non-performance) measures of perception, demographic and anatomical measures, and questionnaire items probing other psychological variables.

Extending Levelt's Propositions to perceptual multistability involving interocular grouping

Levelt's Propositions are central to understanding a wide range of multistable perceptual phenomena, but it is unclear whether they extend to perceptual multistability involving interocular grouping. We presented split-grating stimuli with complementary halves of the same color (either red or green) to human subjects. The subjects reported four percepts in alternation: the two stimuli presented to each eye (half red and half green), as well as the two single color (all red or all green), interocularly grouped percepts. Increasing color saturation lead to increased reports of the single color percept in most subjects, indicating increased predominance of grouped percepts (Levelt's Proposition I). This increase in predominance was due to a decrease in the average dominance duration of single-eye percepts, with grouped percept dominance largely unaffected. This agrees with a generalization of Levelt's Proposition II, as the average dominance duration of the stronger (in this case single-eye) percept was primarily affected by changes in stimulus strength. Moreover, in agreement with Levelt's Proposition III the alternation rate between percepts increased as the difference in the strength of the percepts decreased.

Increased peak gamma frequency in individuals with higher levels of autistic traits

Individual differences in orientation discrimination threshold are related to both visually-induced peak gamma frequency and the presence of autistic traits. The relationship between peak gamma frequency and orientation discrimination thresholds may be due to both of these factors being mediated by levels of neural inhibition. No study has previously measured the relationship between peak gamma frequency and levels of autistic traits. Thus, this was the aim of the present study. We measured orientation discrimination thresholds and autistic traits in a neurotypical human sample (N = 33), and separately recorded electroencephalography to measure visually induced gamma activity. In line with our prediction, we found a significant relationship between peak gamma frequency and level of autistic traits. Consistent with previous work we also found significant relationships between orientation discrimination thresholds and level of autistic traits and between orientation discrimination thresholds and peak gamma frequency. Our results demonstrate that individuals with individuals with higher levels of autistic personality traits have a higher peak-gamma frequency and are better at discriminating between visual stimuli based on orientation. As both higher peak gamma frequency and lower orientation discrimination thresholds have been linked to higher levels of neural inhibition, this suggests that autistic traits co-occur with increased neural inhibition. This discovery is significant as it challenges the currently-held view that autism spectrum conditions are associated with increased neural excitation.

Motion perception correlates with volitional but not reflexive eye movements

Visually-driven actions and perception are traditionally ascribed to the dorsal and ventral visual streams of the cortical processing hierarchy. However, motion perception and the control of tracking eye movements both depend on sensory motion analysis by neurons in the dorsal stream, suggesting that the same sensory circuits may underlie both action and perception. Previous studies have suggested that multiple sensory modules may be responsible for the perception of low- and high-level motion, or the detection versus identification of motion direction. However, it remains unclear whether the sensory processing systems that contribute to direction perception and the control of eye movements have the same neuronal constraints. To address this, we examined inter-individual variability across 36 observers, using two tasks that simultaneously assessed the precision of eye movements and direction perception: in the smooth pursuit task, observers volitionally tracked a small moving target and reported its direction; in the ocular following task, observers reflexively tracked a large moving stimulus and reported its direction. We determined perceptual-oculomotor correlations across observers, defined as the correlation between each observer's mean perceptual precision and mean oculomotor precision. Across observers, we found that: (i) mean perceptual precision was correlated between the two tasks; (ii) mean oculomotor precision was correlated between the tasks, and (iii) oculomotor and perceptual precision were correlated for volitional smooth pursuit, but not reflexive ocular following. Collectively, these results demonstrate that sensory circuits with common neuronal constraints subserve motion perception and volitional, but not reflexive eye movements.

What is the primary cause of individual differences in contrast sensitivity?

One of the primary objectives of early visual processing is the detection of luminance variations, often termed image contrast. Normal observers can differ in this ability by at least a factor of 4, yet this variation is typically overlooked, and has never been convincingly explained. This study uses two techniques to investigate the main source of individual variations in contrast sensitivity. First, a noise masking experiment assessed whether differences were due to the observer's internal noise, or the efficiency with which they extracted information from the stimulus. Second, contrast discrimination functions from 18 previous studies were compared (pairwise, within studies) using a computational model to determine whether differences were due to internal noise or the low level gain properties of contrast transduction. Taken together, the evidence points to differences in contrast gain as being responsible for the majority of individual variation across the normal population. This result is compared with related findings in attention and amblyopia.

Variability in visual cortex size reflects tradeoff between local orientation sensitivity and global orientation modulation

The surface area of early visual cortices varies several fold across healthy adult humans and is genetically heritable. But the functional consequences of this anatomical variability are still largely unexplored. Here we show that interindividual variability in human visual cortical surface area reflects a tradeoff between sensitivity to visual details and susceptibility to visual context. Specifically, individuals with larger primary visual cortices can discriminate finer orientation differences, whereas individuals with smaller primary visual cortices experience stronger perceptual modulation by global orientation contexts. This anatomically correlated tradeoff between discrimination sensitivity and contextual modulation of orientation perception, however, does not generalize to contrast perception or luminance perception. Neural field simulations based on a scaling of intracortical circuits reproduce our empirical observations. Together our findings reveal a feature-specific shift in the scope of visual perception from context-oriented to detail-oriented with increased visual cortical surface area.

Association of common genetic variants in GPCPD1 with scaling of visual cortical surface area in humans

Visual cortical surface area varies two- to threefold between human individuals, is highly heritable, and has been correlated with visual acuity and visual perception. However, it is still largely unknown what specific genetic and environmental factors contribute to normal variation in the area of visual cortex. To identify SNPs associated with the proportional surface area of visual cortex, we performed a genome-wide association study followed by replication in two independent cohorts. We identified one SNP (rs6116869) that replicated in both cohorts and had genome-wide significant association (P(combined) = 3.2 × 10(-8)). Furthermore, a metaanalysis of imputed SNPs in this genomic region identified a more significantly associated SNP (rs238295; P = 6.5 × 10(-9)) that was in strong linkage disequilibrium with rs6116869. These SNPs are located within 4 kb of the 5' UTR of GPCPD1, glycerophosphocholine phosphodiesterase GDE1 homolog (Saccharomyces cerevisiae), which in humans, is more highly expressed in occipital cortex compared with the remainder of cortex than 99.9% of genes genome-wide. Based on these findings, we conclude that this common genetic variation contributes to the proportional area of human visual cortex. We suggest that identifying genes that contribute to normal cortical architecture provides a first step to understanding genetic mechanisms that underlie visual perception.

Individual variability in functional connectivity predicts performance of a perceptual task

People differ in their ability to perform novel perceptual tasks, both during initial exposure and in the rate of improvement with practice. It is also known that regions of the brain recruited by particular tasks change their activity during learning. Here we investigate neural signals predictive of individual variability in performance. We used resting-state functional MRI to assess functional connectivity before training on a novel visual discrimination task. Subsequent task performance was related to functional connectivity measures within portions of visual cortex and between visual cortex and prefrontal association areas. Our results indicate that individual differences in performing novel perceptual tasks can be related to individual differences in spontaneous cortical activity.

Physiological Signal Variability in hMT+ Reflects Performance on a Direction Discrimination Task

Our ability to perceive visual motion is critically dependent on the human motion complex (hMT+) in the dorsal visual stream. Extensive electrophysiological research in the monkey equivalent of this region has demonstrated how neuronal populations code for properties such as speed and direction, and that neurometric functions relate to psychometric functions within the individual monkey. In humans, the physiological correlates of inter-individual perceptual differences are still largely unknown. To address this question, we used functional magnetic resonance imaging (fMRI) while participants viewed translational motion in different directions, and we measured thresholds for direction discrimination of moving stimuli in a separate psychophysics experiment. After determining hMT+ in each participant with a functional localizer, we were able to decode the different directions of visual motion from it using pattern classification (PC). We also characterized the variability of fMRI signal in hMT+ during stimulus and rest periods with a generative model. Relating perceptual performance to physiology, individual direction discrimination thresholds were significantly correlated with the variability measure in hMT+, but not with PC accuracies. Individual differences in PC accuracy were driven by non-physiological sources of noise, such as head-movement, which makes this method a poor tool to investigate inter-individual differences. In contrast, variability analysis of the fMRI signal was robust to non-physiological noise, and variability characteristics in hMT+ correlated with psychophysical thresholds in the individual participants. Higher levels of fMRI signal variability compared to rest correlated with lower discrimination thresholds. This result is in line with theories on stochastic resonance in the context of neuronal populations, which suggest that endogenous or exogenous noise can increase the sensitivity of neuronal populations to incoming signals.

Visual advantage in deaf adults linked to retinal changes

The altered sensory experience of profound early onset deafness provokes sometimes large scale neural reorganisations. In particular, auditory-visual cross-modal plasticity occurs, wherein redundant auditory cortex becomes recruited to vision. However, the effect of human deafness on neural structures involved in visual processing prior to the visual cortex has never been investigated, either in humans or animals. We investigated neural changes at the retina and optic nerve head in profoundly deaf (N = 14) and hearing (N = 15) adults using Optical Coherence Tomography (OCT), an in-vivo light interference method of quantifying retinal micro-structure. We compared retinal changes with behavioural results from the same deaf and hearing adults, measuring sensitivity in the peripheral visual field using Goldmann perimetry. Deaf adults had significantly larger neural rim areas, within the optic nerve head in comparison to hearing controls suggesting greater retinal ganglion cell number. Deaf adults also demonstrated significantly larger visual field areas (indicating greater peripheral sensitivity) than controls. Furthermore, neural rim area was significantly correlated with visual field area in both deaf and hearing adults. Deaf adults also showed a significantly different pattern of retinal nerve fibre layer (RNFL) distribution compared to controls. Significant correlations between the depth of the RNFL at the inferior-nasal peripapillary retina and the corresponding far temporal and superior temporal visual field areas (sensitivity) were found. Our results show that cross-modal plasticity after early onset deafness may not be limited to the sensory cortices, noting specific retinal adaptations in early onset deaf adults which are significantly correlated with peripheral vision sensitivity.

Relating inter-individual differences in metacognitive performance on different perceptual tasks

Human behavior depends on the ability to effectively introspect about our performance. For simple perceptual decisions, this introspective or metacognitive ability varies substantially across individuals and is correlated with the structure of focal areas in prefrontal cortex. This raises the possibility that the ability to introspect about different perceptual decisions might be mediated by a common cognitive process. To test this hypothesis, we examined whether inter-individual differences in metacognitive ability were correlated across two different perceptual tasks where individuals made judgments about different and unrelated visual stimulus properties. We found that inter-individual differences were strongly correlated between the two tasks for metacognitive ability but not objective performance. Such stability of an individual’s metacognitive ability across different perceptual tasks indicates a general mechanism supporting metacognition independent of the specific task.

THE INHERITANCE OF COGNITIVE SKILLS: DOES GENOMIC IMPRINTING PLAY A ROLE?

Genomic imprinting refers to the differential expression of a gene based on parental origin. Animal and clinical studies have suggested that genomic imprinting is influential in brain development, with the maternal genome playing a disproportionate role in the development of the cortex. The present study investigated this phenomenon in a nonclinical human population, using intrafamilial correlations. Broadly consistent with predictions, it was found that abilities mediated by frontal, parietal, and temporal lobes, but not occipital lobes, were more closely correlated between children and mothers versus fathers. The implications of these findings for the prevailing theory of the evolution of genomic imprinting, and for the general study of genetics and behavior, are discussed.

Genetic dissection of the mouse brain using high-field magnetic resonance microscopy

Magnetic resonance (MR) imaging has demonstrated that variation in brain structure is associated with differences in behavior and disease state. However, it has rarely been practical to prospectively test causal models that link anatomical and functional differences in humans. In the present study we have combined classical mouse genetics with high-field MR to systematically explore and test such structure-functional relations across multiple brain regions. We segmented 33 regions in two parental strains-C57BL/6J (B) and DBA/2J (D)-and in nine BXD recombinant inbred strains. All strains have been studied extensively for more than 20 years using a battery of genetic, functional, anatomical, and behavioral assays. We compared levels of variation within and between strains and sexes, by region, and by system. Average within-strain variation had a coefficient of variation (CV) of 1.6% for the whole brain; while the CV ranged from 2.3 to 3.6% for olfactory bulbs, cortex and cerebellum, and up to approximately 18% for septum and laterodorsal thalamic nucleus. Variation among strain averages ranged from 6.7% for cerebellum, 7.6% for whole brain, 9.0% for cortex, up to approximately 26% for the ventricles, laterodorsal thalamic nucleus, and the interpeduncular nucleus. Heritabilities averaged 0.60+/-0.18. Sex differences were not significant with the possible (and unexpected) exception of the pons ( approximately 20% larger in males). A correlation matrix of regional volumes revealed high correlations among functionally related parts of the CNS (e.g., components of the limbic system), and several high correlations between regions that are not anatomically connected, but that may nonetheless be functionally or genetically coupled.

Cortical area size dictates performance at modality-specific behaviors

The mammalian neocortex is organized into unique areas that serve functions such as sensory perception and modality-specific behaviors. The sizes of primary cortical areas vary across species, and also within a species, raising the question of whether area size dictates behavioral performance. We show that adult mice genetically engineered to overexpress the transcription factor EMX2 in embryonic cortical progenitor cells, resulting in reductions in sizes of somatosensory and motor areas, exhibit significant deficiencies at tactile and motor behaviors. Even increasing the size of sensorimotor areas by decreasing cortical EMX2 levels can lead to diminished sensorimotor behaviors. Genetic crosses that retain ectopic Emx2 transgene expression subcortically but restore cortical Emx2 expression to wild-type levels also restore cortical areas to wild-type sizes and in parallel restore tactile and motor behaviors to wild-type performance. These findings show that area size can dictate performance at modality-specific behaviors and suggest that areas have an optimal size, influenced by parameters of its neural system, for maximum behavioral performance. This study underscores the importance of establishing during embryonic development appropriate levels of regulatory proteins that determine area sizes, thereby influencing behavior later in life.

OPTICAL COHERENCE TOMOGRAPHY IN UNILATERAL RESOLVED CENTRAL SEROUS CHORIORETINOPATHY

PURPOSE

To evaluate the correlation between optical coherence tomographic evaluations of foveal thickness and anatomical changes within the fovea and visual acuity in patients who have unilateral resolved central serous chorioretinopathy.

METHODS

A retrospective review of cases of unilateral resolved central serous chorioretinopathy imaged with high-resolution optical coherence tomography was performed. The foveal thickness of the involved eye was normalized by dividing its thickness by that of the uninvolved fellow eye. The best-corrected visual acuity of the involved eye was normalized as well. The normalized foveal thickness was compared with the normalized visual acuity. The anatomical findings of the fovea were compared with the visual acuity.

RESULTS

Twenty patients were evaluated (11 men and 9 women; age range, 31-66 years [mean, 46.8 years]). The mean foveal thickness was 135.8 mum in the involved eyes and 184.4 mum in the uninvolved eyes (P < 0.001). There was a correlation between the normalized foveal thickness and the normalized visual acuity (Spearman rho, 0.67; P = 0.001). The external limiting membrane was visible in 7 (35%) of the involved eyes compared with 19 uninvolved eyes (95%) (P < 0.001). In the involved eyes, those with a visible external limiting membrane had better visual acuity than did those that did not (P = 0.001). It was possible to visualize the boundary between the photoreceptor cell bodies and the outer segments in 8 (40%) of the involved eyes and in the 17 uninvolved eyes (85%) (P < 0.001). In the involved eyes, those with a visible boundary between the photoreceptor bodies and the outer segments had a better visual acuity than did those that did not (P = 0.019).

CONCLUSIONS

Patients with unilateral resolved central serous chorioretinopathy had a decrease in the central foveal thickness in the involved eyes, and there was a statistically significant correlation between the foveal thickness and the visual acuity, even in eyes with relatively good visual acuity. The inability to observe a discrete signal corresponding to the external limiting membrane layer was more common in involved eyes and was significantly associated with decreased visual acuity. This same relationship was seen with the ability to visualize the boundary between the photoreceptor bodies and the outer segments; this boundary was less commonly observed in involved eyes and was associated with decreased visual acuity. Resolved central serous chorioretinopathy causes a number of morphologic changes in the fovea that are associated with visual acuity.