Neural contribution to spatiotemporal contrast sensitivity decline in healthy ageing eyes

The importance of assessing vision in falls management: A narrative review

SIGNIFICANCE

A comprehensive falls assessment should include the assessment of key visual risk factors, namely, visual acuity, contrast sensitivity, and stereoacuity, to help prevent further falls in older adults. As a minimum, a thorough visual history and uniocular visual acuity assessment would allow appropriate onward referral for intervention.

PURPOSE

Falls prevention is a global public health challenge. The etiology of falls is often complex due to multiple interacting risk factors contributing to postural instability in older adults. Despite national recommendations, the assessment of visual function is often overlooked in falls management. This may be due to a lack of clear guidance on key visual functions that need assessing in this patient group, professional roles, and responsibilities. This review gives an overview of visual risk factors for falls in older adults without cognitive impairment. It focuses on visual functions that can be assessed practically using standard clinical procedures. Possible test selection for a falls clinic or inpatient setting is discussed to help inform the implementation of vision assessments in falls management.

METHODS

Literature searches were conducted on Web of Science (1898 to current), MEDLINE (1946 to present), and APA PsycInfo (1887 to present) using relevant search terms and Boolean operators related to visual functions and falls. Retrospective and prospective studies including randomized controlled trials, observational, cohort, case-control, and qualitative studies were included.

RESULTS

Visual functions decline with age due to the normal aging process and age-related pathologies. Despite considerable heterogeneity across studies, the evidence supports the association of falls with declines in visual functions, including visual acuity, binocular single vision, and the visual field, but most notably contrast sensitivity and stereopsis. Existing vision screening tools, which assess multiple visual functions, are reviewed in light of their usefulness in falls.

CONCLUSIONS

We recommend a vision assessment in the management of falls, which considers visual functions associated with falls, particularly contrast sensitivity and stereopsis. Existing vision screening tools could be adapted or developed for use in falls clinics or the inpatient setting. Eye health professionals should form part of falls multidisciplinary teams or offer training in assessing vision and help to develop intervention pathways for timely management of visual impairment.

Age and visual cortex inhibition: a TMS-MRS study

Paired-pulse transcranial magnetic stimulation is a valuable tool for investigating inhibitory mechanisms in motor cortex. We recently demonstrated its use in measuring cortical inhibition in visual cortex, using an approach in which participants trace the size of phosphenes elicited by stimulation to occipital cortex. Here, we investigate age-related differences in primary visual cortical inhibition and the relationship between primary visual cortical inhibition and local GABA+ in the same region, estimated using magnetic resonance spectroscopy. GABA+ was estimated in 28 young (18 to 28 years) and 47 older adults (65 to 84 years); a subset (19 young, 18 older) also completed a paired-pulse transcranial magnetic stimulation session, which assessed visual cortical inhibition. The paired-pulse transcranial magnetic stimulation measure of inhibition was significantly lower in older adults. Uncorrected GABA+ in primary visual cortex was also significantly lower in older adults, while measures of GABA+ that were corrected for the tissue composition of the magnetic resonance spectroscopy voxel were unchanged with age. Furthermore, paired-pulse transcranial magnetic stimulation-measured inhibition and magnetic resonance spectroscopy-measured tissue-corrected GABA+ were significantly positively correlated. These findings are consistent with an age-related decline in cortical inhibition in visual cortex and suggest paired-pulse transcranial magnetic stimulation effects in visual cortex are driven by GABAergic mechanisms, as has been demonstrated in motor cortex.

BCLA CLEAR Presbyopia: Evaluation and diagnosis

It is important to be able to measure the range of clear focus in clinical practice to advise on presbyopia correction techniques and to optimise the correction power. Both subjective and objective techniques are necessary: subjective techniques (such as patient reported outcome questionnaires and defocus curves) assess the impact of presbyopia on a patient and how the combination of residual objective accommodation and their natural DoF work for them; objective techniques (such as autorefraction, corneal topography and lens imaging) allow the clinician to understand how well a technique is working optically and whether it is the right choice or how adjustments can be made to optimise performance. Techniques to assess visual performance and adverse effects must be carefully conducted to gain a reliable end-point, considering the target size, contrast and illumination. Objective techniques are generally more reliable, can help to explain unexpected subjective results and imaging can be a powerful communication tool with patients. A clear diagnosis, excluding factors such as binocular vision issues or digital eye strain that can also cause similar symptoms, is critical for the patient to understand and adapt to presbyopia. Some corrective options are more permanent, such as implanted inlays / intraocular lenses or laser refractive surgery, so the optics can be trialled with contact lenses in advance (including differences between the eyes) to better communicate with the patient how the optics will work for them so they can make an informed choice.

A drift diffusion model analysis of age-related impact on multisensory decision-making processes

Older adults (OAs) are typically slower and/or less accurate in forming perceptual choices relative to younger adults. Despite perceptual deficits, OAs gain from integrating information across senses, yielding multisensory benefits. However, the cognitive processes underlying these seemingly discrepant ageing effects remain unclear. To address this knowledge gap, 212 participants (18-90 years old) performed an online object categorisation paradigm, whereby age-related differences in Reaction Times (RTs) and choice accuracy between audiovisual (AV), visual (V), and auditory (A) conditions could be assessed. Whereas OAs were slower and less accurate across sensory conditions, they exhibited greater RT decreases between AV and V conditions, showing a larger multisensory benefit towards decisional speed. Hierarchical Drift Diffusion Modelling (HDDM) was fitted to participants' behaviour to probe age-related impacts on the latent multisensory decision formation processes. For OAs, HDDM demonstrated slower evidence accumulation rates across sensory conditions coupled with increased response caution for AV trials of higher difficulty. Notably, for trials of lower difficulty we found multisensory benefits in evidence accumulation that increased with age, but not for trials of higher difficulty, in which increased response caution was instead evident. Together, our findings reconcile age-related impacts on multisensory decision-making, indicating greater multisensory evidence accumulation benefits with age underlying enhanced decisional speed.

Association between spill-related exposure to fine particulate matter and peripheral motor and sensory nerve function among oil spill response and cleanup workers following the Deepwater Horizon oil spill

BACKGROUND

Burning/flaring of oil/gas during the Deepwater Horizon oil spill response and cleanup (OSRC) generated high concentrations of fine particulate matter (PM2.5). Personnel working on the water during these activities may have inhaled combustion products. Neurologic effects of PM2.5 have been reported previously but few studies have examined lasting effects following disaster exposures. The association of brief, high exposures and adverse effects on sensory and motor nerve function in the years following exposure have not been examined for OSRC workers.

OBJECTIVES

We assessed the relationship between exposure to burning/flaring-related PM2.5 and measures of sensory and motor nerve function among OSRC workers.

METHODS

PM2.5 concentrations were estimated from Gaussian plume dispersion models and linked to self-reported work histories. Quantitative measures of sensory and motor nerve function were obtained 4-6 years after the disaster during a clinical exam restricted to those living close to two clinics in Mobile, AL or New Orleans, LA (n = 3401). We obtained covariate data from a baseline enrollment survey and a home visit, both in 2011-2013. The analytic sample included 1186 participants.

RESULTS

We did not find strong evidence of associations between exposure to PM2.5 and sensory or motor nerve function, although there was a suggestion of impairment based on single leg stance among individuals with high exposure to PM2.5. Results were generally consistent whether we examined average or cumulative maximum exposures or removed individuals with the highest crude oil exposures to account for co-pollutant confounding. There was no evidence of exposure-response trends.

IMPACT STATEMENT

Remediating environmental disasters is essential for long-term human and environmental health. During the Deepwater Horizon oil spill disaster, burning and flaring of oil and gas were used to remove these pollutants from the environment, but led to potentially high fine particulate matter exposures for spill response workers working on the water. We investigate the potential adverse effects of these exposures on peripheral nerve function; understanding the potential health harm of remediation tactics is necessary to inform future clean up approaches and protect human health.

Age-related fornix decline predicts conservative response strategy-based slowing in perceptual decision-making

Aging leads to response slowing but the underpinning cognitive and neural mechanisms remain elusive. We modelled older and younger adults' response times (RT) from a flanker task with a diffusion drift model (DDM) and employed diffusion-weighted magnetic resonance imaging and spectroscopy to study neurobiological predictors of DDM components (drift-rate, boundary separation, non-decision time). Microstructural indices were derived from white matter pathways involved in visuo-perceptual and attention processing [optic radiation, inferior and superior longitudinal fasciculi (ILF, SLF), fornix]. Estimates of metabolite concentrations [N-acetyl aspartate (NAA), glutamate (Glx), and γ-aminobutyric acid (GABA), creatine (Cr), choline (Cho), myoinositol (mI)] were measured from occipital (OCC), anterior cingulate (ACC) and posterior parietal cortices (PPC). Age-related increases in RT, boundary separation, and non-decision time were observed with response conservatism acounting for RT slowing. Aging was associated with reductions in white matter microstructure (lower fractional anisotropy and restricted signal fraction, larger diffusivities) and in metabolites (NAA in ACC and PPC, Glx in ACC). Regression analyses identified brain regions involved in top-down (fornix, SLF, ACC, PPC) and bottom-up (ILF, optic radiation OCC) processing as predictors for DDM parameters and RT. Fornix FA was the strongest predictor for increases in boundary separation (beta = -0.8) and mediated the effects of age on RT. These findings demonstrate that response slowing in visual discrimination is driven by the adoption of a more conservative response strategy. Age-related fornix decline may result in noisier communication of contextual information from the hippocampus to anterior decision-making regions and thus contribute to the conservative response strategy shift.

Structure, Function, and Molecular Landscapes of the Aging Retina

Because the central nervous system is largely nonrenewing, neurons and their synapses must be maintained over the lifetime of an individual to ensure circuit function. Age is a dominant risk factor for neural diseases, and declines in nervous system function are a common feature of aging even in the absence of disease. These alterations extend to the visual system and, in particular, to the retina. The retina is a site of clinically relevant age-related alterations but has also proven to be a uniquely approachable system for discovering principles that govern neural aging because it is well mapped, contains diverse neuron types, and is experimentally accessible. In this article, we review the structural and molecular impacts of aging on neurons within the inner and outer retina circuits. We further discuss the contribution of non-neuronal cell types and systems to retinal aging outcomes. Understanding how and why the retina ages is critical to efforts aimed at preventing age-related neural decline and restoring neural function.

Disturbances in primary visual processing as a function of healthy aging

For decades, visual entrainment paradigms have been widely used to investigate basic visual processing in healthy individuals and those with neurological disorders. While healthy aging is known to be associated with alterations in visual processing, whether this extends to visual entrainment responses and the precise cortical regions involved is not fully understood. Such knowledge is imperative given the recent surge in interest surrounding the use of flicker stimulation and entrainment in the context of identifying and treating Alzheimer's disease (AD). In the current study, we examined visual entrainment in eighty healthy aging adults using magnetoencephalography (MEG) and a 15 Hz entrainment paradigm, while controlling for age-related cortical thinning. MEG data were imaged using a time-frequency resolved beamformer and peak voxel time series were extracted to quantify the oscillatory dynamics underlying the processing of the visual flicker stimuli. We found that, as age increased, the mean amplitude of entrainment responses decreased and the latency of these responses increased. However, there was no effect of age on the trial-to-trial consistency in phase (i.e., inter-trial phase locking) nor amplitude (i.e., coefficient of variation) of these visual responses. Importantly, we discovered that the relationship between age and response amplitude was fully mediated by the latency of visual processing. These results indicate that aging is associated with robust changes in the latency and amplitude of visual entrainment responses within regions surrounding the calcarine fissure, which should be considered in studies examining neurological disorders such as AD and other conditions associated with increased age.

Age-related normal limits for spatial vision

PURPOSE

To establish age-related, normal limits of monocular and binocular spatial vision under photopic and mesopic conditions.

METHODS

Photopic and mesopic visual acuity (VA) and contrast thresholds (CTs) were measured with both positive and negative contrast optotypes under binocular and monocular viewing conditions using the Acuity-Plus (AP) test. The experiments were carried out on participants (age range from 10 to 86 years), who met pre-established, normal sight criteria. Mean and ± 2.5σ limits were calculated within each 5-year subgroup. A biologically meaningful model was then fitted to predict mean values and upper and lower threshold limits for VA and CT as a function of age. The best-fit model parameters describe normal aging of spatial vision for each of the 16 experimental conditions investigated.

RESULTS

Out of the 382 participants recruited for this study, 285 participants passed the selection criteria for normal aging. Log transforms were applied to ensure approximate normal distributions. Outliers were also removed for each of the 16 stimulus conditions investigated based on the ±2.5σ limit criterion. VA, CTs and the overall variability were found to be age-invariant up to ~50 years in the photopic condition. A lower, age-invariant limit of ~30 years was more appropriate for the mesopic range with a gradual, but accelerating increase in both mean thresholds and intersubject variability above this age. Binocular thresholds were smaller and much less variable when compared to the thresholds measured in either eye. Results with negative contrast optotypes were significantly better than the corresponding results measured with positive contrast (p < 0.004).

CONCLUSIONS

This project has established the expected age limits of spatial vision for monocular and binocular viewing under photopic and high mesopic lighting with both positive and negative contrast optotypes using a single test, which can be implemented either in the clinic or in an occupational setting.

Improvement of neural contrast sensitivity after long-term adaptation in pseudophakic eyes

An adaptive optics (AO) system was used to investigate the effect of long-term neural adaptation to the habitual optical profile on neural contrast sensitivity in pseudophakic eyes after the correction of all aberrations, defocus, and astigmatism. Pseudophakic eyes were assessed at 4 and 8 months postoperatively for changes in visual performance. Visual benefit was observed in all eyes at all spatial frequencies after AO correction. The average visual benefit across spatial frequencies was higher in the pseudophakic group (3.31) at 4 months postoperatively compared to the normal group (2.41). The average contrast sensitivity after AO correction in the pseudophakic group improved by a factor of 1.73 between 4 and 8 months postoperatively. Contrast sensitivity in pseudophakic eyes was poorer, which could be attributed to long-term adaptation to the habitual optical profiles before the cataract surgery, in conjunction with age-related vision loss. Improved visual performance in pseudophakic eyes suggests that the aged neural system can be re-adapted for altered ocular optics.

Healthy aging impairs face discrimination ability

Face images enable individual identities to be discriminated from one another. We aimed to quantify age-related changes in different aspects of face identity discrimination. Face discrimination sensitivity was measured with a memory-free "odd-one-out" task. Five age groups (N = 15) of healthy adults with normal vision were tested: 20, 50-59, 60-69, 70-79, and 80-89. Sensitivity was measured for full-face images (all features visible), external features (head-shape, hairline), internal features (nose, mouth, eyes, and eyebrows) and closed-contour shapes (control object). Sensitivity to full-faces continuously declined by approximately 13% per decade, after 50 years of age. When age-related differences in visual acuity were controlled, the effect of age on face discrimination sensitivity remained. Sensitivity to face features also deteriorated with age. Although the effect for external features was similar to full-faces, the rate of decline was considerably steeper (approximately 3.7 times) for internal, relative to external, features. In contrast, there was no effect of age on sensitivity to shapes. All age groups demonstrated the same overall pattern of sensitivity to different types of face information. Healthy aging was associated with a continuous decline in sensitivity to both full-faces and face features, although encoding of internal features was disproportionately impaired. This age-related deficit was independent of differences in low-level vision. That sensitivity to shapes was unaffected by age suggests these results cannot be explained by general cognitive decline or lower-level visual deficits. Instead, healthy aging is associated with a specific decline in the mechanisms that underlie face discrimination.

Reduced Vision-Related Quality of Life in Dementia: A Preliminary Report

BACKGROUND

Despite experimental evidence for concurrent dementia and visual impairment, there are no currently validated vision-related quality of life measures for use in this population.

OBJECTIVE

To establish the extent to which individuals with mild to moderate dementia self-report visual impairment and determine the efficacy of established vision-related quality of life measures for use in a dementia population.

METHODS

We compared vision-related quality of life in participants with mild-moderate dementia to healthy (dementia-free) older adults using two existing questionnaire measures already validated for use in older adults. These were the Visual Activities Questionnaire (VAQ) and the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25).

RESULTS

Responses on both the VAQ and VFQ-25 revealed a significant effect of dementia on self-reported vision-related quality of life. Visual impairment in dementia was identified in the domains of color discrimination, disability glare, light/dark adaption, acuity/spatial vision, depth perception, peripheral vision, visual search, and visual processing speed. Factor analysis of the data suggested that existing vision-related quality of life measures, designed for use in older adult populations, are likely to provide a robust means of assessing vision-related quality of life in older adults with dementia. This is particularly true of the VAQ, for which one latent factor emerged for both dementia and dementia-free samples.

CONCLUSION

Using existing measures designed for use in older adult populations, we have shown that people with dementia experience reduced vision-related quality of life.

Aging effects on contrast sensitivity in visual pathways: A pilot study on flicker adaptation

Contrast sensitivity is reduced in older adults and is often measured at an overall perceptual level. Recent human psychophysical studies have provided paradigms to measure contrast sensitivity independently in the magnocellular (MC) and parvocellular (PC) visual pathways and have reported desensitization in the MC pathway after flicker adaptation. The current study investigates the influence of aging on contrast sensitivity and on the desensitization effect in the two visual pathways. The steady- and pulsed-pedestal paradigms were used to measure contrast sensitivity under two adaptation conditions in 45 observers. In the non-flicker adaptation condition, observers adapted to a pedestal array of four 1°×1° squares presented with a steady luminance; in the flicker adaptation condition, observers adapted to a square-wave modulated luminance flicker of 7.5 Hz and 50% contrast. Results showed significant age-related contrast sensitivity reductions in the MC and PC pathways, with a significantly larger decrease of contrast sensitivity for individuals older than 50 years of age in the MC pathway but not in the PC pathway. These results are consistent with the hypothesis that sensitivity reduction observed at the overall perceptual level likely comes from both the MC and PC visual pathways, with a more dramatic reduction resulting from the MC pathway for adults >50 years of age. In addition, a similar desensitization effect from flicker adaptation was observed in the MC pathway for all ages, which suggests that aging may not affect the process of visual adaptation to rapid luminance flicker.

Changes of tuning but not dynamics of contrast adaptation with age

Normal aging results in pronounced optical and neural changes in the visual system. Processes of adaptation are thought to help compensate for many of these changes in order to maintain perceptual constancy, but it is uncertain how stable adaptation itself remains with aging. We compared the dynamics of adaptation in young (aged 19-24 years) and older (aged 66-74) adults. Contrast thresholds for Gabor patterns were tracked during and after 300 s adaptation to vertical and horizontal Gabor patches. The time course of contrast adaptation and asymptotic adaptation magnitude were similar between older and young adults when normalized for their respective baseline thresholds. Older adults showed stronger transfer of adaptation to the orthogonal orientation and there was an asymmetry between the transfer of adaptation between the horizontal and vertical orientations for both groups. These results suggest age-related changes in orientation tuning while the processes of cortical contrast adaptation remain largely intact with aging.

Age effects on saccadic suppression of luminance and color

Saccadic eye movements modulate visual perception: they initiate and terminate high acuity vision at a certain location in space, but before and during their execution visual contrast sensitivity is strongly attenuated for 100 to 200 ms. Transient perisaccadic perceptual distortions are assumed to be an important mechanism to maintain visual stability. Little is known about age effects on saccadic suppression, even though for healthy adults other major age-related changes are well documented, like a decrease of visual contrast sensitivity for intermediate and high spatial frequencies or an increase of saccade latencies. Here, we tested saccadic suppression of luminance and isoluminant chromatic flashes in 100 participants from eight to 78 years. To estimate the effect of saccadic suppression on contrast sensitivity, we used a two-alternative forced choice (2AFC) design and an adaptive staircase procedure to modulate the luminance or chromatic contrast of a flashed detection target during fixation and 15 ms after saccade onset. The target was a single horizontal luminance or chromatic line flashed 2° above or below the fixation or saccade target. Compared to fixation, average perisaccadic contrast sensitivity decreased significantly by 66% for luminance and by 36% for color. A significant correlation was found for the strength of saccadic suppression of luminance and color. However, a small age effect was found only for the strength of saccadic suppression of luminance, which increased from 64% to 70% from young to old age. We conclude that saccadic suppression for luminance and color is present in most participants independent of their age and that mechanisms of suppression stay relatively stable during healthy aging.

Supra‐threshold contrast matching and the effects of contrast threshold and age

BACKGROUND

The effects of age on contrast threshold are well known but little is known about its effect on supra-threshold contrast perception. This study examines supra-threshold contrast matching and the effects of age in naïve observers.

METHODS

Two age groups (from 20 to 50 years with 14 subjects and 51 years and older with 15 subjects) participated in the study. Contrast threshold and supra-threshold contrast matching up to 8.53 cycles per degree were measured.

RESULTS

Both age groups demonstrated some degree of contrast constancy at medium and higher contrasts but this was not perfect even at the highest contrast tested (55.9 per cent). There was no overall effect of age on supra-threshold contrast matching (p = 0.086) but there was an interaction between age and spatial frequency (p < 0.001). The plots of matched contrast against standard contrast showed that for some spatial frequencies, the slope was significantly different from unity, indicating a gain in the visual system for supra-threshold perception. This was still true when corrected for threshold differences.

CONCLUSION

Contrast constancy exists in a larger group of naïve subjects of different ages but does not perfectly compensate for the differences in thresholds. The results are discussed in terms of the currently proposed models of contrast perception.

Recent advances in measurement of monochromatic aberrations of human eyes

The field of aberrations of the human eye is moving rapidly, being driven by the desire to monitor and optimise vision following refractive surgery. It is important for ophthalmologists and optometrists to have an understanding of the magnitude of various aberrations and how these are likely to be affected by refractive surgery and other corrections. In this paper, I consider methods used to measure aberrations, the magnitude of aberrations in general populations and how these are affected by various factors (for example, age, refractive error, accommodation and refractive surgery) and how aberrations and their correction affect spatial visual performance.

Contrast Sensitivity on 1/f Noise Is More Greatly Impacted by Older Age for the Fovea Than Parafovea

SIGNIFICANCE

Contrast sensitivity changes across the visual field with age and is often measured clinically with various forms of perimetry on plain backgrounds. In daily life, the visual scene is more complicated, and therefore, the standard clinical measures of contrast sensitivity may not predict a patient's visual experience in more natural environments.

PURPOSE

This study aims to determine whether contrast thresholds in older adults are different from younger adults when measured on a 1/f noise background (a nonuniform background whose spatial frequency content is similar to those present in the natural vision environments).

METHODS

Twenty younger (age range, 20 to 35 years) and 20 older adults (age range, 61 to 79 years) with normal ocular health were recruited. Contrast thresholds were measured for a Gabor patch of 6 cycles per degree (sine wave grating masked by a Gaussian envelope of standard deviation 0.17°) presented on 1/f noise background (root-mean-square contrast, 0.05 and 0.20) that subtended 15° diameter of the central visual field. The stimulus was presented at four eccentricities (0°, 2°, 4°, and 6°) along the 45° meridian in the noise background, and nine contrast levels were tested at each eccentricity. The proportion of correct responses for detecting the target at each eccentricity was obtained, and psychometric functions were fit to estimate the contrast threshold.

RESULTS

Older adults demonstrate increased contrast thresholds compared with younger adults. There was an eccentricity-dependent interaction with age, with the difference between groups being highest in the fovea compared with other eccentricities. Performance was similar for the two noise backgrounds tested.

CONCLUSIONS

Our results revealed a strong eccentricity dependence in performance between older and younger adults, highlighting age-related differences in the contrast detection mechanisms between fovea and parafovea for stimuli presented on nonuniform backgrounds.

Effect of physiological aging on binocular vision

We see the world with two eyes. Binocular vision provides more ample information through interocular interaction. Previous studies have shown that aging impairs a variety of visual functions, but how aging affects binocular vision is still unclear. In this study, we measured three typical binocular functions-binocular combination, binocular rivalry, and stereo vision-to investigate aging-related effects on binocular vision in a relatively large sample (48 younger adults and 27 older adults) with normal or corrected-to-normal distance vision and no ophthalmological and mental diseases. We found that there were no consistent aging-related declines in binocular vision, with the worst effect on alternation frequency in binocular rivalry and no effect on binocular phase combination and stereo vision tested by Titmus. In addition, aging changed the correlation pattern among some of these binocular functions. These results reflected (at least partially) different aging-related mechanism(s) in binocular vision.

Ageing and multisensory integration: A review of the evidence, and a computational perspective

The processing of multisensory signals is crucial for effective interaction with the environment, but our ability to perform this vital function changes as we age. In the first part of this review, we summarise existing research into the effects of healthy ageing on multisensory integration. We note that age differences vary substantially with the paradigms and stimuli used: older adults often receive at least as much benefit (to both accuracy and response times) as younger controls from congruent multisensory stimuli, but are also consistently more negatively impacted by the presence of intersensory conflict. In the second part, we outline a normative Bayesian framework that provides a principled and computationally informed perspective on the key ingredients involved in multisensory perception, and how these are affected by ageing. Applying this framework to the existing literature, we conclude that changes to sensory reliability, prior expectations (together with attentional control), and decisional strategies all contribute to the age differences observed. However, we find no compelling evidence of any age-related changes to the basic inference mechanisms involved in multisensory perception.

Differential Circuit Mechanisms of Young and Aged Visual Cortex in the Mammalian Brain

The main goal of this review is to summarize and discuss (1) age-dependent structural reorganization of mammalian visual cortical circuits underlying complex visual behavior functions in primary visual cortex (V1) and multiple extrastriate visual areas, and (2) current evidence supporting the notion of compensatory mechanisms in aged visual circuits as well as the use of rehabilitative therapy for the recovery of neural plasticity in normal and diseased aging visual circuit mechanisms in different species. It is well known that aging significantly modulates both the structural and physiological properties of visual cortical neurons in V1 and other visual cortical areas in various species. Compensatory aged neural mechanisms correlate with the complexity of visual functions; however, they do not always result in major circuit alterations resulting in age-dependent decline in performance of a visual task or neurodegenerative disorders. Computational load and neural processing gradually increase with age, and the complexity of compensatory mechanisms correlates with the intricacy of higher form visual perceptions that are more evident in higher-order visual areas. It is particularly interesting to note that the visual perceptual processing of certain visual behavior functions does not change with age. This review aims to comprehensively discuss the effect of normal aging on neuroanatomical alterations that underlie critical visual functions and more importantly to highlight differences between compensatory mechanisms in aged neural circuits and neural processes related to visual disorders. This type of approach will further enhance our understanding of inter-areal and cortico-cortical connectivity of visual circuits in normal aging and identify major circuit alterations that occur in different visual deficits, thus facilitating the design and evaluation of potential rehabilitation therapies as well as the assessment of the extent of their rejuvenation.

Salience-based object prioritization during active viewing of naturalistic scenes in young and older adults

Whether fixation selection in real-world scenes is guided by image salience or by objects has been a matter of scientific debate. To contrast the two views, we compared effects of location-based and object-based visual salience in young and older (65 + years) adults. Generalized linear mixed models were used to assess the unique contribution of salience to fixation selection in scenes. When analysing fixation guidance without recurrence to objects, visual salience predicted whether image patches were fixated or not. This effect was reduced for the elderly, replicating an earlier finding. When using objects as the unit of analysis, we found that highly salient objects were more frequently selected for fixation than objects with low visual salience. Interestingly, this effect was larger for older adults. We also analysed where viewers fixate within objects, once they are selected. A preferred viewing location close to the centre of the object was found for both age groups. The results support the view that objects are important units of saccadic selection. Reconciling the salience view with the object view, we suggest that visual salience contributes to prioritization among objects. Moreover, the data point towards an increasing relevance of object-bound information with increasing age.

Age-related change in flicker thresholds with rod- and cone-enhanced stimuli

PURPOSE

Rod and cone photoreceptor-specific tests can be time-consuming. A new non-invasive test is described. The test is based on the measurement of flicker modulation thresholds with rod- and cone-enhanced visual stimuli, which requires only minimum adaptation time. Here, we investigated how the rod-and cone-mediated flicker thresholds vary with age.

METHODS

Monocular thresholds with rod and cone-enhanced stimuli were measured in 140 healthy adults, (age range: 18-75 years), foveally (0°) and at four parafoveal locations, at an eccentricity of 5° in each of the four quadrants using five, adaptive, interleaved staircases. Temporal frequencies, stimulus sizes, background luminance and spectral composition, were adjusted appropriately to achieve approximately 1 log unit separation in sensitivity between the rod- and cone-enhanced stimuli. Spectrally calibrated, 'neutral density' filters were used to enable adequate control of display luminance for rod enhanced stimuli.

RESULTS

The magnitude of central and parafoveal rod thresholds was significantly higher than the central and parafoveal cone thresholds, respectively (p < 0.001) in both the age groups. However, the rate of increase in central rod thresholds (y = 0.45x-12.79; linear regression equation) was not significantly steeper than the rate of increase in central (y = 0.29x-8.53) cone thresholds (p = 0.15). Centrally, cone thresholds showed a better correlation with rod central thresholds for the age > 45 years (Spearman correlation, ρ = 0.74, p < 0.001) compared to age ≤ 45 years (ρ = 0.41, p < 0.001).

CONCLUSIONS

Thresholds with rod- and cone-enhanced stimuli are largely invariant below 45 years of age and increase rapidly above this age. This age-wise normative database can be used as an effective functional-marker to assess photoreceptor sensitivities in retinal diseases.

Combining optical and neural components in physiological visual image quality metrics as functions of luminance and age

Visual image quality metrics combine comprehensive descriptions of ocular optics (from wavefront error) with a measure of the neural processing of the visual system (neural contrast sensitivity). To improve the ability of these metrics to track real-world changes in visual performance and to investigate the roles and interactions of those optical and neural components in foveal visual image quality as functions of age and target luminance, models of neural contrast sensitivity were constructed from the literature as functions of (1) retinal illuminance (Trolands, td), and (2) retinal illuminance and age. These models were then incorporated into calculation of the visual Strehl ratio (VSX). Best-corrected VSX values were determined at physiological pupil sizes over target luminances of 104 to 10-3 cd/m2 for 146 eyes spanning six decades of age. Optical and neural components of the metrics interact and contribute to visual image quality in three ways. At target luminances resulting in >900 td at physiological pupil size, neural processing is constant, and only aberrations (that change as pupil size changes with luminance) affect the metric. At low mesopic luminances below where pupil size asymptotes to maximum, optics are constant (maximum pupil), and only the neural component changes with luminance. Between these two levels, both optical and neural components of the metrics are affected by changes in target luminance. The model that accounted for both retinal illuminance and age allowed VSX, termed VSX(td,a), to best track visual acuity trends (measured at 160 and 200 cd/m2) as a function of age (20s through 70s) from the literature. Best-corrected VSX(td,a) decreased by 2.24 log units between maximum and minimum target luminances in the youngest eyes and by 2.58 log units in the oldest. The decrease due to age was more gradual at high target luminances (0.70 log units) and more pronounced as target luminance decreased (1.04 log units).

The Temporal Window of Visual Processing in Aging

Purpose

Aging affects a variety of visual functions. In this study, we aim to quantitatively investigate the temporal characteristics of visual processing in aging.

Methods

Twelve younger (24.1 ± 1.6 years) and 12 older observers (58.4 ± 3.6 years) participated in the study. All participants had normal or corrected-to-normal vision. The contrast thresholds of the participants were measured using an orientation discrimination task with white external noise masks. The target-mask stimulus onset asynchronies were 16.7 ms, 33.4 ms, 50.0 ms, 83.4 ms, and ∞ (no external noise masks) in separate conditions. The signal stimulus was carefully chosen such that it was equally visible for the younger and older participants. An elaborated perceptual template model (ePTM) was fit to the data of each participant.

Results

Without masks, there was no difference in contrast thresholds between the younger and older groups (P = 0.707). With masks, contrast thresholds in the older group elevated more than those in the younger group, and the pattern of threshold elevation differed in the two groups. The ePTM fitted the data well, with the older observers having lower template gains than the younger observers (P = 3.58 × 10-6). A further analysis of the weight parameters of the temporal window revealed that the older observers had a flatter temporal window than the younger observers (P = 0.025).

Conclusions

Age-related temporal processing deficits were found in older observers with normal contrast sensitivity to the signal stimuli. The deficits were accounted for by the inferior temporal processing window of the visual system in aging.

Aging affects gain and internal noise in the visual system

Visual functions decline with age, but how aging degrades visual functions remains controversial. In the current study, the mechanisms underlying age-related visual declines were examined psychophysically. We developed an efficient method to quickly explore contrast sensitivity as a function of nine spatial frequencies at three levels of external noise in both young and old subjects. Fifty-two young and twenty-six old subjects have been screened for ophthalmological and mental diseases and participated in the experiment. Contrast sensitivity varied significantly with spatial frequency, age, and level of external noise. By adopting a nonlinear observer model, we decomposed contrast sensitivity into inefficiencies in internal additive noise, internal multiplicative noise, perceptual template gain, and/or system non-linearity. Model analysis revealed that aging impacts both internal additive noise and perceptual template gain, and such age-related degradation is tuned to spatial frequency, which is also a good predictor to discriminate old from young. The quick characterization of contrast sensitivity functions at different noise levels and the accompanying analysis developed in the current study may have profound application in other clinical populations.

Contrast sensitivity impairment in drug-naïve Parkinson's disease patients associates with early cognitive decline

OBJECTIVES

To investigate the contrast sensitivity function in drug-naïve Parkinson's disease (PD) patients and its predictive value with longitudinal follow-up data.

METHODS

We included newly diagnosed non-demented PD patients who performed contrast sensitivity test between 2013 and 2014. Contrast sensitivity function at drug-naïve state in PD patients was compared with age-matched normal control data of our center. Correlation between contrast sensitivity function and parkinsonian motor and non-motor features including the Mini-Mental State Exam (MMSE) score at the time of diagnosis were analyzed by linear regression. With longitudinal follow-up data after initiating anti-parkinsonian therapy, the risk conferred on subsequent visual hallucinations and cognitive impairment requiring anti-dementia drugs was analyzed by dichotomizing PD group based on the initial contrast sensitivity function.

RESULTS

Forty-eight patients were finally included, and mean follow-up periods were 43 months. Contrast sensitivity function in drug-naïve PD patients was significantly worse than controls. Contrast sensitivity function correlated with sleep disturbance (p = 0.001) and global cognitive status reflected by the MMSE score (p = 0.020). It also associated with further decline in the MMSE during the follow-ups (p = 0.029). Patients with below average contrast sensitivity function at the time of diagnosis showed higher risk of cognitive decline requiring anti-dementia drugs (adjusted odds ratio = 4.68, p = 0.04) and of visual hallucinations (adjusted odds ratio = 12.54, p = 0.04) than those above average function during the follow-up.

CONCLUSION

Contrast sensitivity impairment in drug-naïve PD patients associates with clinical demand for therapeutic intervention of cognitive decline as well as development of visual hallucinations in the early course of the disease.

Prevalence of Computer Vision Syndrome and Its Relationship with Ergonomic and Individual Factors in Presbyopic VDT Workers Using Progressive Addition Lenses

This cross-sectional study estimated computer vision syndrome (CVS) prevalence and analysed its relationship with video display terminal (VDT) exposure, as well as sociodemographic, refractive, environmental, and ergonomic characteristics in 109 presbyopic VDT workers wearing progressive addition lenses (PALs). Usual spectacles were measured with a lens analyser, and subjective refraction was performed by an optometrist. CVS was measured with the CVS-Q©. VDT exposure was collected. Ergonomic evaluations were conducted in a normal working posture looking at the screen. Air temperature and relative humidity were measured (thermohygrometer), and illumination was measured (luxmeter). Descriptive analysis and differences in CVS prevalence, as a function of the explanatory variables, were performed (chi-square test). Multivariate logistic regression was used to identify factors associated with CVS (OR and 95% CI). The mean age was 54.0 ± 4.8 years, and 43.1% were women. The mean hours of VDT use at work was 6.5 ± 1.3 hours/day. The prevalence of CVS was 74.3%. CVS was significantly associated with women (OR 3.40; 95% CI, 1.12–10.33), non-neutral neck posture (OR 3.27; 95% CI, 1.03–10.41) and altered workplace lighting (OR 3.64; 95% CI, 1.22–10.81). Providing training and information to workers regarding the importance of adequate lighting and ergonomic postures during VDT use is advised to decrease CVS and increase workplace quality of life.

Multifocal intraocular lenses and retinal diseases

Purpose

Multifocal intraocular lenses (MIOLs) are often discouraged in patients with or at risk of retinal disorders (including diabetic retinopathy, age-related macular degeneration, and epiretinal membranes), as MIOLs are believed to reduce contrast sensitivity (CS). Concerns with MIOLs have also been raised in individuals with visual field defects, fixation instability or eccentric preferred retinal locations. The aim of this study is to review the influence of MIOL on quality of vision in patients with retinal diseases.

Methods

We reviewed the PubMed and Web of Science databases to identify relevant studies using the following keywords: multifocal intraocular lens, cataract surgery, cataract extraction, lens exchange, diabetic retinopathy, age-related macular degeneration, and contrast sensitivity.

Results

Studies evaluating CS in MIOLs present conflicting results: MIOLs either did not influence CS or resulted in worse performance under low-illuminance conditions and higher spatial frequencies when compared to monofocal IOLs. Nevertheless, MIOLs preserved CS levels within the age-matched normal range. Two studies reported that patients with concurrent retinal diseases receiving a MIOL, both unilaterally and bilaterally, reported a significant improvement in visual-related outcomes. Individuals with a monofocal IOL in one eye and a MIOL in the fellow eye reported greater subjective satisfaction with the MIOL.

Conclusion

We were unable to find evidence suggesting that patients with retinal diseases should be advised against MIOLs. Nevertheless, more research is needed to address the aforementioned concerns and to optimize the use of MIOLs in eyes with retinal disease.

Electronic supplementary material

The online version of this article (10.1007/s00417-020-04603-0) contains supplementary material, which is available to authorized users.

Aging affects correlation within the V1 neuronal population in rhesus monkeys

Visual function declines with age. This deterioration results not only from changes in the optical system but also from the functional degradation of the central visual cortex. Although numerous studies have explored the mechanisms of age-related influences on vision, they have failed to acknowledge the significance of neuronal correlation in dysfunction of the visual cortex. Previous research has focused on the functional degradation of individual neurons, with age-induced changes in correlation between neurons still unknown. In the present study, using electrophysiological techniques, we investigated the age-related changes in neuronal correlation in the macaque V1 area and the underlying mechanisms of those changes. Our results showed that aging led to an increase in the correlation of neurons and changed the noise-signal correlation structure, which may impact population coding efficiency. Furthermore, we found that the age-induced decline in the inhibitory circuitry accounted for the alteration in neuronal correlation.

Reconciling age-related changes in behavioural and neural indices of human perceptual decision-making

Ageing impacts on decision-making behaviour across a range of cognitive tasks and scenarios. Computational modelling has proved valuable in providing mechanistic interpretations of these age-related differences; however, the extent to which model parameter differences accurately reflect changes to the underlying neural computations remains unclear. Here, we report that age-related effects on neural signatures of decision formation are inconsistent with behavioural fits derived from a prominent accumulation-to-bound model. Most notably, model-predicted bound differences were absent neurophysiologically. However, constraining the model to match the decision-predictive elements of the brain signals provided more parsimonious fits to behaviour and generated predictions regarding the neural data that were empirically validated. These included a task-dependent slowing of evidence accumulation among older adults and reduced between-trial accumulation rate variability, which was linked to enhanced attentional engagement. Our findings highlight how combining neurophysiological measurements with computational modelling can yield unique insights into group differences in neural decision mechanisms.

Measuring the Contrast Sensitivity Function Using the qCSF Method With 10 Digits

PURPOSE

The Bayesian adaptive quick contrast sensitivity function (qCSF) method with a 10-letter identification task provides an efficient CSF assessment. However, large populations are unfamiliar with letters and cannot benefit from this test. To overcome the barrier, we conducted this study.

METHOD

A new font for digits (0∼9) was created. The digits were then filtered with a raised cosine filter, rescaled to different sizes to cover spatial frequencies from 0.5 to 16 cycles per degree (cpd), and used as stimuli in a 10-alternative forced choice (10AFC) digit identification task. With the 10AFC digit identification task, the CSFs of five young and five old observers were measured using the qCSF and Psi methods. The estimates from the latter served as reference.

RESULTS

The new digit font showed significantly improved similarity structure, Levene's test, F(1, 88) = 6.36, P = 0.014. With the 10-digit identification task, the CSFs obtained with the qCSF method matched well with those obtained with the Psi method (root mean square error [RMSE] = 0.053 log10 units). With approximately 30 trials, the precision of the qCSF method reached 0.1 log10 units. With approximately 75 trials, the precision of the CSFs obtained with the qCSF was comparable to that of the CSFs measured by the Psi method in 150 trials.

CONCLUSIONS

The qCSF with the 10 digit identification task is validated for both young and old observers.

TRANSLATIONAL RELEVANCE

The qCSF method with the 10-digit identification task provides an efficient and precise CSF test especially for people who are unfamiliar with letters.

Macular Inner Retinal Layer Thickness in Relation to Photopic and Mesopic Contrast Sensitivity in Healthy Young and Older Subjects

Purpose

To examine relationships between the thicknesses of ganglion cell (GC)-related macular layers and central photopic or mesopic contrast sensitivity (CS) in healthy eyes.

Methods

Measurements were made in 38 young and 38 older healthy individuals. Total, inner, and outer retinal layer (IRL) thicknesses were measured in the macula region through spectral-domain optical coherence tomography (SD-OCT) across three subfields, or rings, centered at the fovea: central foveal, pericentral, and peripheral. Ganglion cell complex and circumpapillary retinal nerve fiber layer thicknesses were also measured. Low-spatial-frequency CS for gratings presented at the central 10° visual field were measured through computerized psychophysical tests under photopic and mesopic conditions. Relationships were examined by uni- and multivariate regression analysis.

Results

Peripheral IRL thickness emerged as the only independent predictor of photopic CS (P = 0.001) in the young group and of photopic (P = 0.026) and mesopic CS (P = 0.001) in the older group. The slopes of regression lines used to predict CS from peripheral IRL thickness were significantly different for pair-wise comparisons of both photopic CS and age group (P = 0.0001) and mesopic CS (P = 0.0001) and age group. These models explained 37% of the variability in photopic CS and 36% of the variability in mesopic CS.

Conclusions

Macular IRL thinning likely due to GC loss was related to reduced photopic and mesopic CS in older healthy eyes. In contrast, in the young eyes, a thicker macular IRL, possibly indicating transient gliosis, was associated with reduced CS.

Changes in the spatial spread of attention with ageing

Spatial attention is a necessary cognitive process, allowing for the direction of limited capacity resources to varying locations in the visual field for improved visual processing. Thus, understanding how ageing influences these processes is vital. The current study explored the relationship between the spatial spread of attention and healthy ageing using an inhibition of return task to tap visual attention processing. This task allowed us to measure the spatial distribution of inhibition, and thus acted as a marker for attentional spread. Past research has indicated minimal age differences in inhibitory spread. However, these studies used placeholder stimuli, which may have restricted the range over which age differences could be reliably measured. To address this, in Experiment One, we measured the relationship between the spatial spread of inhibition and healthy ageing using a method which did not employ placeholders. In contrast to past research, an age difference in inhibitory spread was observed, where in comparison to younger adults, older adults exhibited a relatively restricted spread of attention. Experiment Two then confirmed these findings, by directly comparing inhibitory spread for placeholder present and placeholder absent conditions, across younger and older adults. Again, it was found that age differences in inhibitory spread emerged, but only in the placeholder absent condition. Possible reasons for the observed age differences in attention are discussed.

Spatial vision in older adults: perceptual changes and neural bases

PURPOSE

The number of older adults is rapidly increasing internationally, leading to a significant increase in research on how healthy ageing impacts vision. Most clinical assessments of spatial vision involve simple detection (letter acuity, grating contrast sensitivity, perimetry). However, most natural visual environments are more spatially complicated, requiring contrast discrimination, and the delineation of object boundaries and contours, which are typically present on non-uniform backgrounds. In this review we discuss recent research that reports on the effects of normal ageing on these more complex visual functions, specifically in the context of recent neurophysiological studies.

RECENT FINDINGS

Recent research has concentrated on understanding the effects of healthy ageing on neural responses within the visual pathway in animal models. Such neurophysiological research has led to numerous, subsequently tested, hypotheses regarding the likely impact of healthy human ageing on specific aspects of spatial vision.

SUMMARY

Healthy normal ageing impacts significantly on spatial visual information processing from the retina through to visual cortex. Some human data validates that obtained from studies of animal physiology, however some findings indicate that rethinking of presumed neural substrates is required. Notably, not all spatial visual processes are altered by age. Healthy normal ageing impacts significantly on some spatial visual processes (in particular centre-surround tasks), but leaves contrast discrimination, contrast adaptation, and orientation discrimination relatively intact. The study of older adult vision contributes to knowledge of the brain mechanisms altered by the ageing process, can provide practical information regarding visual environments that older adults may find challenging, and may lead to new methods of assessing visual performance in clinical environments.

Useful field of view test performance throughout adulthood in subjects without ocular disorders

Previous research has shown an age-related decline in Useful Field of View (UFOV) test performance, which measures the duration required to extract relevant information from a scene in three subtasks. However, these results are mostly based on data that may have been confounded by (age-related) ocular diseases. We examined UFOV performance in subjects aged 19.5 to 70.3 years to investigate how UFOV performance changes throughout adulthood. All subjects underwent a thorough ophthalmological examination to exclude ocular disorders. We also examined some elementary visual functions, i.e., near and far visual acuity, crowding and contrast sensitivity. We investigated whether these functions were related to age and whether they could explain a possible age-related decline in UFOV performance. The subjects (n = 41) performed very well on almost every measure and reached far better UFOV and visual acuity scores than those reported by other studies that relied on self-reported absence of ocular pathology. We did not find significant relationships between age and any of the elementary visual functions or the first two UFOV subtasks (R2UFOV1 = 0.03, p = 0.25; R2UFOV2 = 0.07, p = 0.10). However, we found an age-related decline in performance on the third UFOV subtask (R2UFOV3 = 0.36, p < 0.001), which was unrelated to performance on the elementary visual function tasks. Our results show that performance on the first two UFOV subtasks as well as central elementary visual functions may remain high in the absence of obvious ophthalmological pathology.

Effects of aging, word frequency, and text stimulus quality on reading across the adult lifespan: Evidence from eye movements

Reductions in stimulus quality may disrupt the reading performance of older adults more when compared with young adults because of sensory declines that begin early in middle age. However, few studies have investigated adult age differences in the effects of stimulus quality on reading, and none have examined how this affects lexical processing and eye movement control. Accordingly, we report two experiments that examine the effects of reduced stimulus quality on the eye movements of young (18–24 years), middle-aged (41–51 years), and older (65+ years) adult readers. In Experiment 1, participants read sentences that contained a high- or low-frequency critical word and that were presented normally or with contrast reduced so that words appeared faint. Experiment 2 further investigated effects of reduced stimulus quality using a gaze-contingent technique to present upcoming text normally or with contrast reduced. Typical patterns of age-related reading difficulty (e.g., slower reading, more regressions) were observed in both experiments. In addition, eye movements were disrupted more for older than younger adults when all text (Experiment 1) or just upcoming text (Experiment 2) appeared faint. Moreover, there was an interaction between stimulus quality and word frequency (Experiment 1), such that readers fixated faint low-frequency words for disproportionately longer. Crucially, this effect was similar across all age groups. Thus, although older readers suffer more from reduced stimulus quality, this additional difficulty primarily affects their visual processing of text. These findings have important implications for understanding the role of stimulus quality on reading behavior across the lifespan.

Binocular Vision Disorders and Visual Attention: Associations With Balance and Mobility in Older Adults

Understanding which aspects of vision are related to falls is important. We examine the associations between tests of balance, mobility, fear of falling (FES-1) and aspects of vision in 72 adults aged 70+. Balance and mobility were examined using the One Legged Stance test (OLST), the Sit to Stand test (STST) and the 5 Meter Walking test (5MWT). Visual measures included visual acuity (VA), contrast sensitivity, stereoacuity, binocular vision (BV) measurements, Useful field of View (UFV) and Attended Field of View (AFOV). Reduced performance on the OLST and the STST was significantly correlated with abnormal BV and poorer intermediate VA. Poorer function on the 5MWT and the FES-I was also predicted by poor intermediate VA and poorer performance on the OLST, STST and the 5MWT was associated with UFV errors. The results are of high importance as many BV disorders are treatable and visual attention is trainable.

Age-related macular degeneration changes the processing of visual scenes in the brain

In age-related macular degeneration (AMD), the processing of fine details in a visual scene, based on a high spatial frequency processing, is impaired, while the processing of global shapes, based on a low spatial frequency processing, is relatively well preserved. The present fMRI study aimed to investigate the residual abilities and functional brain changes of spatial frequency processing in visual scenes in AMD patients. AMD patients and normally sighted elderly participants performed a categorization task using large black and white photographs of scenes (indoors vs. outdoors) filtered in low and high spatial frequencies, and nonfiltered. The study also explored the effect of luminance contrast on the processing of high spatial frequencies. The contrast across scenes was either unmodified or equalized using a root-mean-square contrast normalization in order to increase contrast in high-pass filtered scenes. Performance was lower for high-pass filtered scenes than for low-pass and nonfiltered scenes, for both AMD patients and controls. The deficit for processing high spatial frequencies was more pronounced in AMD patients than in controls and was associated with lower activity for patients than controls not only in the occipital areas dedicated to central and peripheral visual fields but also in a distant cerebral region specialized for scene perception, the parahippocampal place area. Increasing the contrast improved the processing of high spatial frequency content and spurred activation of the occipital cortex for AMD patients. These findings may lead to new perspectives for rehabilitation procedures for AMD patients.

The effects of aging vitreous on contrast sensitivity function

PURPOSE

Contrast sensitivity function (CSF) declines with age. When unassociated with cataracts, this is hypothesized to be due to macular ganglion cell complex (GCC) thinning. However, other studies found associations with increased vitreous echodensity and posterior vitreous detachment (PVD). We investigate the relationship between CSF, vitreous echodensity, PVD, and GCC thickness as related to age in the same subjects.

METHODS

Age, CSF (Weber index: %W), vitreous echodensity (quantitative ultrasonography [QUS]), lens status (phakia or pseudophakia), best-corrected visual acuity (BCVA), and GCC thickness (SD-OCT) were evaluated in 57 eyes of 57 subjects with (n = 32, mean age = 62 years) and without (n = 25, mean age = 44 years) PVD (P < 0.001). A multivariate linear regression analysis was performed to assess the effects of independent variables on CSF.

RESULTS

CSF was 51.2% worse in eyes with PVD (2.98 ± 0.31 %W) compared to no PVD (1.97 ± 0.24 %W; P < 0.001). QUS was 55.8% greater in eyes with PVD than those without (P < 0.001). Among all subjects, PVD status, vitreous echodensity, and age were the only independent variables demonstrating significant effects on CSF. Lens status, BCVA, and GCC thickness did not demonstrate association with CSF.

CONCLUSIONS

PVD, vitreous echodensity, and age are determinants of CSF. PVD and increased vitreous echodensity are each associated with diminished CSF, independent of age. Thus, in the absence of GCC thinning and cataracts, vitreous changes may be a cause of decreased CSF with age.

The impact of natural aging on computational and neural indices of perceptual decision making: A review

It is well established that natural aging negatively impacts on a wide variety of cognitive functions and research has sought to identify core neural mechanisms that may account for these disparate changes. A central feature of any cognitive task is the requirement to translate sensory information into an appropriate action - a process commonly known as perceptual decision making. While computational, psychophysical, and neurophysiological research has made substantial progress in establishing the key computations and neural mechanisms underpinning decision making, it is only relatively recently that this knowledge has begun to be applied to research on aging. The purpose of this review is to provide an overview of this work which is beginning to offer new insights into the core psychological processes that mediate age-related cognitive decline in adults aged 65 years and over. Mathematical modelling studies have consistently reported that older adults display longer non-decisional processing times and implement more conservative decision policies than their younger counterparts. However, there are limits on what we can learn from behavioural modeling alone and neurophysiological analyses can play an essential role in empirically validating model predictions and in pinpointing the precise neural mechanisms that are impacted by aging. Although few studies to date have explicitly examined correspondences between computational models and neural data with respect to cognitive aging, neurophysiological studies have already highlighted age-related changes at multiple levels of the sensorimotor hierarchy that are likely to be consequential for decision making behaviour. Here, we provide an overview of this literature and suggest some future directions for the field.

Higher Contrast Requirement for Letter Recognition and Macular RGC+ Layer Thinning in Glaucoma Patients and Older Adults

Purpose

Growing evidence suggests the involvement of the macula even in early stages of glaucoma. However, little is known about the impact of glaucomatous macular damage on central pattern vision. Here we examine the contrast requirement for letter recognition and its relationship with retinal thickness in the macular region.

Methods

A total of 40 participants were recruited: 13 patients with glaucoma (mean age = 65.6 ± 6.6 years), 14 age-similar normally sighted adults (59.1 ± 9.1 years), and 13 young normally sighted adults (21.0 ± 2.0 years). For each participant, letter-recognition contrast thresholds were obtained using a letter recognition task in which participants identified English letters presented at varying retinal locations across the central 12° visual field, including the fovea. The macular retinal ganglion cell plus inner plexiform (RGC+) layer thickness was also evaluated using spectral-domain optical coherence tomography (SD-OCT).

Results

Compared to age-similar normal controls, glaucoma patients exhibited a significant increase in letter-recognition contrast thresholds (by 236%, P < 0.001) and a significant decrease in RGC+ layer thickness (by 17%, P < 0.001) even after controlling for age, pupil diameter, and visual acuity. Compared to normal young adults, older adults showed a significant increase in letter-recognition contrast thresholds and a significant decrease in RGC+ layer thickness. Across all subjects, the thickness of macular RGC+ layer was significantly correlated with letter-recognition contrast thresholds, even after correcting for pupil diameter and visual acuity (r = −0.65, P < 0.001).

Conclusions

Our results show that both glaucoma and normal aging likely bring about a thinning of the macular RGC+ layer; the macular RGC+ layer thickness appears to be associated with the contrast requirements for letter recognition in central vision.

Vision improvement in pilots with presbyopia following perceptual learning

Israeli Air Force (IAF) pilots continue flying combat missions after the symptoms of natural near-vision deterioration, termed presbyopia, begin to be noticeable. Because modern pilots rely on the displays of the aircraft control and performance instruments, near visual acuity (VA) is essential in the cockpit. We aimed to apply a method previously shown to improve visual performance of presbyopes, and test whether presbyopic IAF pilots can overcome the limitation imposed by presbyopia. Participants were selected by the IAF aeromedical unit as having at least initial presbyopia and trained using a structured personalized perceptual learning method (GlassesOff application), based on detecting briefly presented low-contrast Gabor stimuli, under the conditions of spatial and temporal constraints, from a distance of 40 cm. Our results show that despite their initial visual advantage over age-matched peers, training resulted in robust improvements in various basic visual functions, including static and temporal VA, stereoacuity, spatial crowding, contrast sensitivity and contrast discrimination. Moreover, improvements generalized to higher-level tasks, such as sentence reading and aerial photography interpretation (specifically designed to reflect IAF pilots' expertise in analyzing noisy low-contrast input). In concert with earlier suggestions, gains in visual processing speed are plausible to account, at least partially, for the observed training-induced improvements.

Contrast Sensitivity in Patients With Emmetropic Presbyopia Before and After Small-Aperture Inlay Implantation

PURPOSE

To develop a normative contrast sensitivity function and examine the postoperative contrast sensitivity outcomes for emmetropic patients with presbyopia implanted with a KAMRA intracorneal inlay (AcuFocus Inc., Irvine, CA) in their non-dominant eyes.

METHODS

A prospective, non-randomized, multicenter clinical trial was conducted on 507 patients between 45 and 60 years of age who were monocularly implanted with the KAMRA inlay. A predetermined subgroup of 335 patients in the contrast sensitivity substudy were measured preoperatively and postoperatively with the Functional Acuity Contrast Test (FACT) chart in the Optec 6500 Vision Tester (Stereo Optical Co., Chicago, IL) under monocular and binocular, photopic and mesopic without glare, and binocular mesopic with glare conditions each over four spatial frequencies (3, 6, 12, and 18 cycles per degree for photopic conditions and 1.5, 3, 6, and 12 cycles per degree for mesopic conditions). Normative ranges were developed using 1.96 standard deviations from the preoperative mean logCS (log10 unit of contrast sensitivity).

RESULTS

The preoperative contrast sensitivity measurements were used to develop the normative contrast sensitivity curves. Postoperatively, contrast sensitivity was stable both monocularly and binocularly and average contrast sensitivity remained within the normative ranges. Postoperative contrast sensitivity was mildly reduced monocularly but not binocularly, and the ratio of area under logCS function comparing postoperative to preoperative values was above 90% for all but one condition.

CONCLUSIONS

Normative contrast sensitivity curves for a presbyopic population are established to provide a referent in the investigation of the impact of other presbyopia-correcting ophthalmic procedures on contrast sensitivity. [J Refract Surg. 2016;32(6):386-393.].

Temporal aspects of natural scene categorisation in healthy ageing

The visual system has an extraordinary capability to extract categorical information from complex scenes. Age-related deficits in visual temporal processing have been found with both low-level and high-level stimuli. However, it is unknown to which extent those deficits extend to the processing of complex scenes. Here, we investigated the temporal characteristics of natural scene categorisation in healthy ageing. Using a backward masking paradigm, we asked young-old (aged 59-70), old-old (aged 70+) and younger adults (18-31years) to perform a go/no-go task, in which they had to respond to images of animals whilst ignoring images of landscapes. Both age groups were overall faster and more accurate in responding to the target images as the stimulus onset asynchrony (SOA) between target image and mask increased. Older adults, especially those in the old-old group, were significantly less accurate than younger adults for short SOAs but performed equally well at long SOAs. However, we found no age-difference in reaction times. Our findings suggest that the temporal processing of complex scenes is impaired in healthy older adults independently of reduced motor abilities. They also indicate that such deficits in natural scene categorisation become more evident with increasing age. Our findings might have important implications for the wellbeing of older adults and road safety in general.

Pattern Recognition Analysis of Age-Related Retinal Ganglion Cell Signatures in the Human Eye

Purpose

To characterize macular ganglion cell layer (GCL) changes with age and provide a framework to assess changes in ocular disease. This study used data clustering to analyze macular GCL patterns from optical coherence tomography (OCT) in a large cohort of subjects without ocular disease.

Methods

Single eyes of 201 patients evaluated at the Centre for Eye Health (Sydney, Australia) were retrospectively enrolled (age range, 20–85); 8 × 8 grid locations obtained from Spectralis OCT macular scans were analyzed with unsupervised classification into statistically separable classes sharing common GCL thickness and change with age. The resulting classes and gridwise data were fitted with linear and segmented linear regression curves. Additionally, normalized data were analyzed to determine regression as a percentage. Accuracy of each model was examined through comparison of predicted 50-year-old equivalent macular GCL thickness for the entire cohort to a true 50-year-old reference cohort.

Results

Pattern recognition clustered GCL thickness across the macula into five to eight spatially concentric classes. F-test demonstrated segmented linear regression to be the most appropriate model for macular GCL change. The pattern recognition–derived and normalized model revealed less difference between the predicted macular GCL thickness and the reference cohort (average ± SD 0.19 ± 0.92 and −0.30 ± 0.61 μm) than a gridwise model (average ± SD 0.62 ± 1.43 μm).

Conclusions

Pattern recognition successfully identified statistically separable macular areas that undergo a segmented linear reduction with age. This regression model better predicted macular GCL thickness. The various unique spatial patterns revealed by pattern recognition combined with core GCL thickness data provide a framework to analyze GCL loss in ocular disease.