Contrast sensitivity for letter optotypes vs. gratings under conditions biased toward parvocellular and magnocellular pathways

Evaluation of the SpotChecks contrast sensitivity test in healthy adults

PURPOSE

SpotChecks is a new contrast sensitivity (CS) test designed for self-monitoring of vision. This study assessed the test-retest repeatability of take-home SpotChecks, in-office SpotChecks and near Pelli-Robson charts in healthy adults.

METHODS

One eye of 61 healthy adults with near visual acuity (VA) of 6/9 or better (age range 22-84, mean 49 [18] years) was tested during two office visits (mean 10 [8] days apart). Each visit included high-contrast VA, then 12 randomly ordered CS tests (6 different SpotChecks and 6 different Pelli-Robson) under the same lighting (luminance 110 cd/m2), all at near in the same eye with habitual correction. The same eye was self-tested with take-home SpotChecks once a day on 6 days between the office visits. SpotChecks was scored by the logCS at the highest line with ≥2 errors. Pelli-Robson was scored by [0.05 × number of letters read correctly - 0.15]. Repeatability of logCS was defined as 1.962 $$ \sqrt{2} $$ Sw, Sw representing within-subject standard deviation. Comparison for repeatability was performed with Bootstrap hypothesis test.

RESULTS

SpotChecks and Pelli-Robson showed similar intra-session or inter-visit repeatability (p = 0.14-0.81). Inter-day repeatability for take-home SpotChecks was 0.18 logCS, the same as that from the first measurements of two office visits with SpotChecks or Pelli-Robson. Inter-visit repeatability improved to 0.15 by using the average of two repeated measurements for SpotChecks (p = 0.02) or three repeated measurements for Pelli-Robson (p = 0.04). Age showed a small effect on logCS (-0.015/decade, p = 0.02) for both SpotChecks and Pelli-Robson. Mean logCS was 0.05 lower in those ≥50 years (SpotChecks 1.84 [0.10] and Pelli-Robson 1.77 [0.10]) compared with those <50 years of age (SpotChecks 1.89 [0.07] and Pelli-Robson 1.83 [0.07]).

CONCLUSIONS

SpotChecks showed good repeatability with take-home and in-office testing in healthy adults, making it a promising tool for monitoring disease progression at home.

Further Examination of the Pulsed- and Steady-Pedestal Paradigms under Hypothetical Parvocellular- and Magnocellular-Biased Conditions

The pulsed- and steady-pedestal paradigms were designed to track increment thresholds (ΔC) as a function of pedestal contrast (C) for the parvocellular (P) and magnocellular (M) systems, respectively. These paradigms produce contrasting results: linear relationships between ΔC and C are observed in the pulsed-pedestal paradigm, indicative of the P system's processing, while the steady-pedestal paradigm reveals nonlinear functions, characteristic of the M system's response. However, we recently found the P model fits better than the M model for both paradigms, using Gabor stimuli biased towards the M or P systems based on their sensitivity to color and spatial frequency. Here, we used two-square pedestals under green vs. red light in the lower-left vs. upper-right visual fields to bias processing towards the M vs. P system, respectively. Based on our previous findings, we predicted the following: (1) steeper ΔC vs. C functions with the pulsed than the steady pedestal due to different task demands; (2) lower ΔCs in the upper-right vs. lower-left quadrant due to its bias towards P-system processing there; (3) no effect of color, since both paradigms track the P-system; and, most importantly (4) contrast gain should not be higher for the steady than for the pulsed pedestal. In general, our predictions were confirmed, replicating our previous findings and providing further evidence questioning the general validity of using the pulsed- and steady-pedestal paradigms to differentiate the P and M systems.

Papadopoulou E, Almpanidou S, Karamitopoulos L, Almaliotis D. Evaluation of contrast sensitivity in visually impaired individuals using K-CS test. A novel smartphone-based contrast sensitivity test-Design and validation

BACKGROUND

To describe the development and investigate the accuracy of a novel smartphone-based Contrast Sensitivity (CS) application, the K-CS test.

METHODS

A total of 67 visually impaired and 50 normal participants were examined monocularly using the novel digital K-CS test and the Pelli-Robson (PR) chart. The K-CS test examines letter contrast sensitivity in logarithmic units, using eight levels of contrast from logCS = ~0,1 to logCS = ~2,1 at two spatial frequencies of 1.5 and 3 cycles per degree (cpd). The K-CS test was compared to the gold standard, PR test and intra-session test repeatability was also examined.

RESULTS

The K-CS test in normally sighted was found to agree well with the PR, providing comparable mean scores in logCS (±SD) (K-CS = 1.908 ± 0.06 versus PR = 1.93 ± 0.05) at 1.5 cpd and mean (± SD) logCS at 3 cpd (K-CS = 1.83 ± 0.13 versus PR = 1.86 ± 0.07). The mean best corrected visual acuity of visually impaired participants was 0.67 LogMAR (SD = 0.21) and the K-CS was also found to agree well with the Pelli-Robson in this group, with an equivalent mean (±SD) logCS at 1.5 cpd: (K-CS = 1.19 ± 0.27, PR = 1.15 ± 0.31), 3 cpd: K-CS = 1.01 ± 0.33, PR = 0.94 ± 0.34. Regarding the intra-session test repeatability, both the K-CS test and the PR test showed good repeatability in terms of the 95% limits of agreement (LoA): K-CS = ±0.112 at 1.5 cpd and ±0.133 at 3 cpd, PR = ±0.143 at 1.5 cpd and ±0.183 in 3 cpd in visually impaired individuals.

CONCLUSION

The K-CS test provides a quick assessment of the CS both in normally sighted and visually impaired individuals. The K-CS could serve as an alternative tool to assess contrast sensitivity function using a smartphone and provides results that agree well with the commonly used PR test.

Examining Increment thresholds as a function of pedestal contrast under hypothetical parvo- and magnocellular-biased conditions

Theoretically, the pulsed- and steady-pedestal paradigms are thought to track contrast-increment thresholds (ΔC) as a function of pedestal contrast (C) for the parvocellular (P) and magnocellular (M) systems, respectively, yielding linear ΔC versus C functions for the pulsed- and nonlinear functions for the steady-pedestal paradigm. A recent study utilizing these paradigms to isolate the P and M systems reported no evidence of the M system being suppressed by red light, contrary to previous physiological and psychophysical findings. Curious as to why this may have occurred, we examined how ΔC varies with C for the P and M systems using the pulsed- and steady-pedestal paradigms and stimuli biased towards the P or M systems based on their sensitivity to spatial frequency (SF) and color. We found no effect of color and little influence of SF. To explain this lack of color effects, we used a quantitative model of ΔC (as it changes with C) to obtain Csat and contrast-gain values. The contrast-gain values (i) contradicted the hypothesis that the steady-pedestal paradigm tracks the M-system response, and (ii) our obtained Csat values indicated strongly that both pulsed- and steady-pedestal paradigms track primarily the P-system response.

Randomised placebo-controlled clinical trial evaluating the impact of a new visual rehabilitation program on neuroadaptation in patients implanted with trifocal intraocular lenses

PURPOSE

To evaluate the efficacy of a new visual training program for improving the visual function in patients implanted with trifocal intraocular lenses (IOLs).

METHODS

Randomised placebo-controlled clinical trial enrolling 60 subjects (age, 47-75 years) undergoing cataract surgery with implantation of trifocal diffractive IOL. Home-based active visual training was prescribed immediately after surgery to all of them (20 sessions, 30 min): 31 subjects using a serious game based on Gabor patches (study group) and 29 using a placebo software (placebo group). Visual acuity, contrast sensitivity (CS), and perception of visual disturbances (QoV questionnaire) were evaluated before and after training. Likewise, in a small subgroup, resting-state functional magnetic resonance imaging (rs-fMRI) analysis was performed.

RESULTS

No significant differences were found between groups in compliance time (p = 0.70). After training, only significant improvements in monocular uncorrected intermediate visual acuity were found in the study group (p ≤ 0.01), although differences between groups did not reach statistical significance (p ≥ 0.11). Likewise, significantly better binocular far CS values were found in the study group for the spatial frequencies of 6 (p = 0.01) and 12 cpd (p = 0.03). More visual symptoms of the QoV questionnaire experienced a significant change in the level of bothersomeness in the study group. Rs-fMRI revealed the presence significant changes reflecting higher functional connectivity after the training with the serious game.

CONCLUSIONS

A 3-week visual training program based on the use of Gabor patches after bilateral implantation of trifocal diffractive IOLs may be beneficial for optimising the visual function, with neural changes associated suggesting an acceleration of neuroadaptation. Trial registration ClinicalTrials.gov, NCT04985097. Registered 02 August 2021, https://clinicaltrials.gov/(NCT04985097 ).

Combined therapy of bilateral transcranial direct current stimulation and ocular occlusion improves visual function in adults with amblyopia, a randomized pilot study

Background

Amblyopia is the interocular visual acuity difference of two lines or more with the best correction in both eyes. It is treated with ocular occlusion therapy, but its success depends on neuroplasticity, and thus is effective in children but not adults. Transcranial Direct Current Stimulation (tDCS) is suggested to increase neuroplasticity.

Objective

To determine if combined intervention of bilateral tDCS and ocular occlusion improves visual function in adults with amblyopia.

Methods

A double-blind randomized, controlled pilot trial was conducted in 10 volunteers with amblyopia. While applying ocular occlusion and performing a reading task, participants received bilateral tDCS (n = 5) or sham stimulation (n = 5), with the anodal tDCS electrode in the contralateral visual cortex and the cathodal in the ipsilateral visual cortex in relation to the amblyopic eye. Visual function (through visual acuity, stereopsis, and contrast sensitivity tests) and visual evoked potential (with checkerboard pattern stimuli presentation) were evaluated immediately after.

Results

A total of 30 min after treatment with bilateral tDCS, visual acuity improved by 0.16 (± 0.025) LogMAR in the treatment group compared with no improvement (-0.02 ± 0.02) in five controls (p = 0.0079), along with a significant increase in the amplitude of visual evoked potentials of the amblyopic eye response (p = 0.0286). No significant changes were observed in stereopsis and contrast sensitivity. No volunteer reported any harm derived from the intervention.

Conclusion

Our study is the first to combine anodal and cathodal tDCS for the treatment of amblyopia, showing transient improved visual acuity in amblyopic adults.

Contrast Sensitivity and Equivalent Intrinsic Noise in X-Linked Retinoschisis

Purpose

To define relationships among contrast sensitivity (CS), equivalent intrinsic noise (Neq; a measure of noise within the visual pathway), and retinal thickness in X-linked retinoschisis (XLRS).

Methods

Nine XLRS and 10 visually-normal subjects participated. CS was measured in the presence and absence of luminance noise. These data were fit with a standard model to estimate Neq and sampling efficiency (an estimate of the ability to use stimulus information). Optical coherence tomography images were obtained to quantify outer nuclear layer (ONL+) and outer segment (OS+) thickness. A linear structure-function model was used to describe the relationship between CS and the product of ONL+ and OS+ thickness.

Results

CS in the absence of noise (CS0) for the XLRS subjects ranged from normal to as much as 1.5× below the lower limit of normal. Four of the nine subjects with XLRS had abnormally high Neq, whereas two others had sampling efficiency that was borderline abnormal. Log CS0 for the subjects with XLRS was correlated significantly with log Neq (r = -0.78, P = 0.01), but not with log efficiency (r = 0.19, P = 0.63). CS0 and Neq, but not efficiency, conformed to the linear ONL+ × OS+ structure-function model.

Conclusions

The XLRS subjects in this study who had elevated internal noise had abnormally low CS; both internal noise and CS fell within the predicted limits of a structure-function model.

Translational Relevance

Internal noise measurements can provide insight into a source of CS loss in some individuals with XLRS.

Preliminary Evaluation of the Clinical Benefit of a Novel Visual Rehabilitation Program in Patients Implanted with Trifocal Diffractive Intraocular Lenses: A Blinded Randomized Placebo-Controlled Clinical Trial

The authors of this study evaluated the potential benefit on visual performance of a novel 3 week visual rehabilitation program based on the use of Gabor patches in patients undergoing bilateral cataract surgery with the implantation of two models of trifocal diffractive intraocular lens (IOL). A total of 30 patients were randomly assigned to two groups: a study group (15 patients) that used a videogame based on Gabor patches and a placebo group (15 patients) that used a videogame without specific stimuli for improving visual performance. No statistically significant differences between groups were found in distance, intermediate, and near post-training visual acuity (p ≥ 0.15). Significantly better distance contrast sensitivity (CS) was found for the spatial frequencies of 6 (p = 0.02) and 12 cpd (p = 0.01) in the study group. Likewise, significantly better values of near CS were found in the study group compared to the placebo group for the spatial frequency of 1.5 cpd (p = 0.02). In conclusion, a 3 week visual rehabilitation program based on the use of Gabor patches in the immediate postoperative period after the bilateral implantation of trifocal diffractive IOLs seems to be beneficial for improving both distance and near visual performance achieved with the implant.

Temporal Frequency Abnormalities in Early-Stage Diabetic Retinopathy Assessed by Electroretinography

Purpose

To define the nature and extent of temporal frequency abnormalities in diabetics who have mild or no nonproliferative diabetic retinopathy (NPDR) by using the flicker electroretinogram (ERG).

Methods

Light-adapted flicker ERGs were recorded from 20 diabetics who have no clinically apparent retinopathy, 20 diabetics who have mild NPDR, and 20 nondiabetic, age-equivalent controls. ERGs were elicited by full-field sinusoidal flicker across the temporal frequency range of 6 to 100 Hz and were recorded using conventional techniques. The amplitude and phase of the fundamental and harmonic response components were derived by Fourier analysis and compared among the groups.

Results

Analysis of variance indicated that compared with the controls, both patient groups had significant amplitude reductions of the fundamental ERG component for temporal frequencies greater than 56 Hz (all P ≤ 0.03). Modeling the amplitude measurements indicated that both patient groups had significant reductions in the high-frequency response cutoff. Response phase, however, did not differ significantly among the groups at any frequency. The amplitude and phase of the high-frequency harmonics (32–96 Hz) of the patients' responses to a low-frequency stimulus (16 Hz) were normal over the temporal frequency range that the fundamental response was abnormal.

Conclusions

Taken together, the diabetics' fundamental amplitude attenuation for rapid flicker combined with their normal high-frequency harmonic responses generated by slow flicker suggest that the likely site of the abnormal temporal filtering occurs prior to the nonlinearity that generates the harmonic components of the ERG, implicating a photoreceptor origin.

Reduced Contrast Sensitivity is Associated With Elevated Equivalent Intrinsic Noise in Type 2 Diabetics Who Have Mild or No Retinopathy

Purpose

To evaluate explanations for contrast sensitivity (CS) losses in subjects who have mild nonproliferative diabetic retinopathy (NPDR) or no diabetic retinopathy (NDR) by measuring and modeling CS in luminance noise.

Methods

Ten diabetic subjects with NDR, 10 with mild NPDR, and 10 age-equivalent nondiabetic controls participated. Contrast threshold energy (E_t) was measured for letters presented in the absence of noise (E_t0) and in four levels of luminance noise. Data were fit with the linear amplifier model to estimate inferred noise level within the visual pathway (N_eq) and sampling efficiency (ability to use stimulus information optimally). E_t0, N_eq, and efficiency were compared to clinical characteristics.

Results

N_eq was correlated with E_t0 for the diabetic subjects (r = 0.93, P < 0.001) and ranged from normal to 12-times the upper limit of normal. ANOVA indicated significant differences among the subject groups for E_t0 and N_eq (both F > 11.92, P < 0.001). E_t0 and N_eq were elevated for the mild NPDR group compared to the control and NDR groups (all t > 3.89, P ≤ 0.001); the NDR and control groups did not differ significantly (all t < 0.61, P > 0.55). There were no significant efficiency differences among the groups (F = 1.29, P = 0.29). N_eq was correlated significantly with disease duration, microperimetric sensitivity, and Pelli-Robson CS.

Conclusions

Elevated contrast threshold may be associated with increased intrinsic noise in early-stage diabetic subjects. Results suggest that noise-based CS measurements can provide important information about early neural dysfunction in these individuals.

New Precision Metrics for Contrast Sensitivity Testing

Visual sensitivity is comprehensively described by the contrast sensitivity function (CSF), but current routine clinical care does not include its assessment because of the time-consuming need to estimate thresholds for a large number of spatial frequencies. The quick CSF method, however, dramatically reduces testing times by using a Bayesian information maximization rule. We evaluate the test-retest variability of a tablet-based quick CSF implementation in a study with 100 subjects who repeatedly assessed their vision with and without optical correction. We first discuss two commonly used measures of repeatability, intraclass correlation and the Bland-Altman Coefficient of Repeatability, and show that they are vulnerable to artifacts. Instead, we propose to formulate precision as an information retrieval task: from all repeat test scores, can we retrieve a certain individual based on their first test score? We then use rank-based analyses such as mean average precision as a better measure to compare different test metrics, and show that the highest test-retest precision is achieved using a summary statistic, the area under the log CSF (AULCSF). This demonstrates the benefit of assessment of the whole CSF compared to sensitivity at individual spatial frequencies only. AULCSF also yields best discrimination performance (99.2%) between measurements that were taken with and without glasses, respectively, even better than CSF Acuity. The tablet-based quick CSF thus enables the rapid and reliable home monitoring of visual function, which has the potential to improve early diagnosis and treatment of ophthalmic pathologies such as diabetic retinopathy or age-related macular degeneration.

Multidimensional Functional and Structural Evaluation Reveals Neuroretinal Impairment in Early Diabetic Retinopathy

Purpose

To test whether quantitative functional tests and optical coherence tomography (OCT)-defined structure can serve as effective tools to diagnose and monitor early diabetic neuroretinal disease.

Methods

Fifty-seven subjects with diabetes (23 without diabetic retinopathy [no DR], 19 with mild nonproliferative diabetic retinopathy [mild NPDR], 15 with moderate to severe [moderate NPDR]), and 18 controls underwent full ophthalmic examination, fundus photography, spectral-domain optical coherence tomography (SD-OCT), e-ETDRS (Early Treatment Diabetic Retinopathy Study) acuity, and the quick contrast sensitivity function (qCSF) method. Perimetry testing included short-wavelength automated perimetry (SWAP), standard automated perimetry (SAP), frequency doubling perimetry (FDP), and rarebit perimetry (RBP).

Results

ETDRS acuity and RBP were not sensitive for functional differences among subjects with diabetes. AULCSF, a metric of qCSF, was reduced in diabetics with moderate compared to mild NPDR (P = 0.03), and in subjects with no DR compared to controls (P = 0.04). SWAP and SAP mean deviation (MD) and foveal threshold (FT) were reduced in moderate compared to mild NPDR (SWAP, MD P = 0.002, FT P = 0.0006; SAP, MD P = 0.02, FT P = 0.007). FDP 10-2 showed reduced MD in moderate compared to mild NPDR (P = 0.02), and FDP 24-2 revealed reduced pattern standard deviation (PSD) in mild NPDR compared to no DR (P = 0.02). Structural analysis revealed thinning of the ganglion cell layer and inner plexiform layer (GCL+IPL) of moderate NPDR subjects compared to controls. The thinner GCL+IPL correlated with impaired retinal function.

Conclusions

This multimodal testing analysis reveals insights into disruption of the neuroretina in diabetes and may accelerate the testing of novel therapies.

Luminance noise as a novel approach for measuring contrast sensitivity within the magnocellular and parvocellular pathways

This study evaluated the extent to which different types of luminance noise can be used to target selectively the inferred magnocellular (MC) and parvocellular (PC) visual pathways. Letter contrast sensitivity (CS) was measured for three visually normal subjects for letters of different size (0.8°-5.3°) under established paradigms intended to target the MC pathway (steady-pedestal paradigm) and PC pathway (pulsed-pedestal paradigm). Results obtained under these paradigms were compared to those obtained in asynchronous static noise (a field of unchanging luminance noise) and asynchronous dynamic noise (a field of randomly changing luminance noise). CS was measured for letters that were high- and low-pass filtered using a range of filter cutoffs to quantify the object frequency information (cycles per letter) mediating letter identification, which was used as an index of the pathway mediating CS. A follow-up experiment was performed to determine the range of letter duration over which MC and PC pathway CS can be targeted. Analysis of variance indicated that the object frequencies measured under the static noise and steady-pedestal paradigms did not differ significantly (p ≥ 0.065), but differed considerably from those measured under the dynamic noise (both p < 0.001) and pulsed-pedestal (both p < 0.001) paradigms. The object frequencies mediating letter identification increased as duration increased under the steady-pedestal paradigm, but were independent of target duration (50-800 ms) under the pulsed-pedestal paradigm, in static noise, and in dynamic noise. These data suggest that the spatiotemporal characteristics of noise can be manipulated to target the inferred MC (static noise) and PC (dynamic noise) pathways. The results also suggest that CS within these pathways can be measured at long stimulus durations, which has potential importance in the design of future clinical CS tests.

Assessing Suppression in Amblyopic Children With a Dichoptic Eye Chart

Purpose

Suppression has a key role in the etiology of amblyopia, and contrast-balanced binocular treatment can overcome suppression and improve visual acuity. Quantitative assessment of suppression could have a role in managing amblyopia. We describe a novel eye chart to assess suppression in children.

Methods

We enrolled 100 children (7–12 years; 63 amblyopic, 25 nonamblyopic with strabismus or anisometropia, 12 controls) in the primary cohort and 22 children (3–6 years; 13 amblyopic, 9 nonamblyopic) in a secondary cohort. Letters were presented on a dichoptic display (5 letters per line). Children wore polarized glasses so that each eye saw a different letter chart. At each position, the identity of the letter and its contrast on each eye's chart differed. Children read 8 lines of letters for each of 3 letter sizes. The contrast balance ratio was the ratio at which 50% of letters seen by the amblyopic eye were reported.

Results

Amblyopic children had significantly higher contrast balance ratios for all letter sizes compared to nonamblyopic children and controls, requiring 4.6 to 5.6 times more contrast in the amblyopic eye compared to the fellow eye (P < 0.0001). Amblyopic eye visual acuity was correlated with contrast balance ratio (r ranged from 0.49–0.57 for the 3 letter sizes). Change in visual acuity with amblyopia treatment was correlated with change in contrast balance ratio (r ranged from 0.43–0.62 for the 3 letter sizes).

Conclusions

Severity of suppression can be monitored as part of a routine clinical exam in the management of amblyopia in children.

M&S Smart System Contrast Sensitivity Measurements Compared With Standard Visual Function Measurements in Primary Open-Angle Glaucoma Patients

PURPOSE

To evaluate the nature and extent of letter contrast sensitivity (CS) deficits in glaucoma patients using a commercially available computer-based system (M&S Smart System II) and to compare the letter CS measurements to standard clinical measures of visual function.

METHODS

Ninety-four subjects with primary open-angle glaucoma participated. Each subject underwent visual acuity, letter CS, and standard automated perimetry testing (Humphrey SITA 24-2). All subjects had a best-corrected visual acuity (BCVA) of 0.3 log MAR (20/40 Snellen equivalent) or better and reliable standard automated perimetry (fixation losses, false positives, and false negatives <33%). CS functions were estimated from the letter CS and BCVA measurements. The area under the CS function (AUCSF), which is a combined index of CS and BCVA, was derived and analyzed.

RESULTS

The mean (± SD) BCVA was 0.08±0.10 log MAR (∼20/25 Snellen equivalent), the mean CS was 1.38±0.17, and the mean Humphrey Visual Field mean deviation (HVF MD) was -7.22±8.10 dB. Letter CS and HVF MD correlated significantly (r=0.51, P<0.001). BCVA correlated significantly with letter CS (r=-0.22, P=0.03), but not with HVF MD (r=-0.12, P=0.26). A subset of the subject sample (∼20%) had moderate to no field loss (≤-6 dB MD) and minimal to no BCVA loss (≤0.3 log MAR), but had poor letter CS. AUCSF was correlated significantly with HVF MD (r=0.46, P<0.001).

CONCLUSIONS

The present study is the first to evaluate letter CS in glaucoma using the digital M&S Smart System II display. Letter CS correlated significantly with standard HVF MD measurements, suggesting that letter CS may provide a useful adjunct test of visual function for glaucoma patients. In addition, the significant correlation between HVF MD and the combined index of CS and BCVA (AUCSF) suggests that this measure may also be useful for quantifying visual dysfunction in glaucoma patients.

A hierarchical Bayesian approach to adaptive vision testing: A case study with the contrast sensitivity function

Measurement efficiency is of concern when a large number of observations are required to obtain reliable estimates for parametric models of vision. The standard entropy-based Bayesian adaptive testing procedures addressed the issue by selecting the most informative stimulus in sequential experimental trials. Noninformative, diffuse priors were commonly used in those tests. Hierarchical adaptive design optimization (HADO; Kim, Pitt, Lu, Steyvers, & Myung, 2014) further improves the efficiency of the standard Bayesian adaptive testing procedures by constructing an informative prior using data from observers who have already participated in the experiment. The present study represents an empirical validation of HADO in estimating the human contrast sensitivity function. The results show that HADO significantly improves the accuracy and precision of parameter estimates, and therefore requires many fewer observations to obtain reliable inference about contrast sensitivity, compared to the method of quick contrast sensitivity function (Lesmes, Lu, Baek, & Albright, 2010), which uses the standard Bayesian procedure. The improvement with HADO was maintained even when the prior was constructed from heterogeneous populations or a relatively small number of observers. These results of this case study support the conclusion that HADO can be used in Bayesian adaptive testing by replacing noninformative, diffuse priors with statistically justified informative priors without introducing unwanted bias.

Evaluating the performance of the quick CSF method in detecting contrast sensitivity function changes

The contrast sensitivity function (CSF) has shown promise as a functional vision endpoint for monitoring the changes in functional vision that accompany eye disease or its treatment. However, detecting CSF changes with precision and efficiency at both the individual and group levels is very challenging. By exploiting the Bayesian foundation of the quick CSF method (Lesmes, Lu, Baek, & Albright, 2010), we developed and evaluated metrics for detecting CSF changes at both the individual and group levels. A 10-letter identification task was used to assess the systematic changes in the CSF measured in three luminance conditions in 112 naïve normal observers. The data from the large sample allowed us to estimate the test-retest reliability of the quick CSF procedure and evaluate its performance in detecting CSF changes at both the individual and group levels. The test-retest reliability reached 0.974 with 50 trials. In 50 trials, the quick CSF method can detect a medium 0.30 log unit area under log CSF change with 94.0% accuracy at the individual observer level. At the group level, a power analysis based on the empirical distribution of CSF changes from the large sample showed that a very small area under log CSF change (0.025 log unit) could be detected by the quick CSF method with 112 observers and 50 trials. These results make it plausible to apply the method to monitor the progression of visual diseases or treatment effects on individual patients and greatly reduce the time, sample size, and costs in clinical trials at the group level.

Spatial-frequency dependent binocular imbalance in amblyopia

While amblyopia involves both binocular imbalance and deficits in processing high spatial frequency information, little is known about the spatial-frequency dependence of binocular imbalance. Here we examined binocular imbalance as a function of spatial frequency in amblyopia using a novel computer-based method. Binocular imbalance at four spatial frequencies was measured with a novel dichoptic letter chart in individuals with amblyopia, or normal vision. Our dichoptic letter chart was composed of band-pass filtered letters arranged in a layout similar to the ETDRS acuity chart. A different chart was presented to each eye of the observer via stereo-shutter glasses. The relative contrast of the corresponding letter in each eye was adjusted by a computer staircase to determine a binocular Balance Point at which the observer reports the letter presented to either eye with equal probability. Amblyopes showed pronounced binocular imbalance across all spatial frequencies, with greater imbalance at high compared to low spatial frequencies (an average increase of 19%, p < 0.01). Good test-retest reliability of the method was demonstrated by the Bland-Altman plot. Our findings suggest that spatial-frequency dependent binocular imbalance may be useful for diagnosing amblyopia and as an outcome measure for recovery of binocular vision following therapy.

Using 10AFC to further improve the efficiency of the quick CSF method

The contrast sensitivity function (CSF) provides a fundamental characterization of spatial vision, important for basic and clinical applications, but its long testing times have prevented easy, widespread assessment. The original quick CSF method was developed using a two-alternative forced choice (2AFC) grating orientation identification task (Lesmes, Lu, Baek, & Albright, 2010), and obtained precise CSF assessments while reducing the testing burden to only 50 trials. In this study, we attempt to further improve the efficiency of the quick CSF method by exploiting the properties of psychometric functions in multiple-alternative forced choice (m-AFC) tasks. A simulation study evaluated the effect of the number of alternatives m on the efficiency of the sensitivity measurement by the quick CSF method, and a psychophysical study validated the quick CS method in a 10AFC task. We found that increasing the number of alternatives of the forced-choice task greatly improved the efficiency of CSF assessment in both simulation and psychophysical studies. The quick CSF method based on a 10-letter identification task can assess the CSF with an averaged standard deviation of 0.10 decimal log unit in less than 2 minutes.

Effect of luminance noise on the object frequencies mediating letter identification

Purpose: To determine if the same object frequency information mediates letter contrast threshold in the presence and absence of additive luminance noise (i.e., “noise-invariant processing”) for letters of different size.

Methods: Contrast thresholds for Sloan letters ranging in size from 0.9 to 1.8 log MAR were obtained from three visually normal observers under three paradigms: (1) high- and low-pass Gaussian filtered letters were presented against a uniform adapting field; (2) high- and low-pass Gaussian filtered letters were presented in additive white luminance noise; and (3) unfiltered letters were presented in high- and low-pass Gaussian filtered luminance noise. A range of high- and low-pass filter cutoffs were used to limit selectively the object frequency content of the letters (paradigms 1 and 2) or noise (paradigm 3). The object frequencies mediating letter identification under each paradigm were derived from plots of log contrast threshold vs. log filter cutoff frequency.

Results: The object frequency band mediating letter identification systematically shifted to higher frequencies with increasing log MAR letter size under all three paradigms. However, the relationship between object frequency and letter size depended on the paradigm under which the measurements were obtained. The largest difference in object frequency among the paradigms was observed at 1.8 log MAR, where the addition of white noise nearly doubled the center frequency of the band of object frequencies mediating letter identification, compared to measurements made in the absence of noise.

Conclusion: Noise can affect the object frequency band mediating letter contrast threshold, particularly for large letters, an effect that is likely due to strong masking of the low frequency letter components by low frequency noise checks. This finding indicates that noise-invariant processing cannot necessarily be assumed for large letters presented in white noise.

Magno and parvo stimuli affect illusory directional hearing in normal and dyslexic readers

In an experimental paradigm adapted from Hari (1995), forty observers listened via headphones to 8 binaural clicks: 4 left-ear leading followed by 4 right-ear leading with either 38 or 140 ms interstimulus intervals (ISIs). Concurrently, they viewed either foveal or peripheral visual stimuli designed to activate either the parvocellular or magnocellular pathway. They then reported the perceived location of each click-pair. Our results replicated Hari's finding that observers mistake the perceived location of short ISI click-pairs more often than long. That is, when ISIs were short, the sounds seemed to play across the inside of the head in a phenomenon called illusory directional hearing. However, when click-pairs were accompanied by peripheral visual stimuli that activated the magnocellular pathway, observers were more accurate than when there were no visual stimuli. Conversely, parvocellular-activating foveal visual stimuli produced more illusory hearing than when there were no visual stimuli. These findings suggest that activating the slow sustained parvocellular system may result in a longer processing window. Thirty dyslexic observers who repeated the experimental paradigm had an even longer processing window than control observers indicating that dyslexics may have a magnocellular system deficit.

Magnocellular and Parvocellular Pathway Influences on Location-Based Inhibition-Of-Return

The roles of the parvocellular (P) and magnocellular (M) retino-geniculo-cortical pathways during shifts of visual attention were investigated by creating M/dorsal-biased (eg low spatial frequency target, no objects present) and P/ventral-biased (ie high spatial frequency target, the perception of 3-D objects) stimulus conditions and measuring location-based inhibition-of-return (IOR). P/ventral-biased conditions produced the greatest IOR. M/dorsal-biased conditions produced the least IOR, in one instance eliminating it altogether. The results indicate a close relationship between IOR magnitude and relative P/ventral and M/dorsal activity with location-based IOR related more to P/ventral than to M/dorsal activity.

Oxygenation state and mesopic sensitivity to dynamic contrast stimuli

PURPOSE

Comparative studies suggest that increasing photoreceptor oxygen consumption in dim light, relative to bright light, may make the outer retina susceptible to hypoxia at light levels relevant to aviation at night. Accordingly, this study investigates effects of relevant oxygenation states on sensitivity to a dynamic contrast stimulus at low photopic and mesopic light levels experienced during night flying.

METHODS

Threshold sensitivity to frequency-doubled contrast stimuli was assessed under mild hypoxia (breathing 14.1% oxygen), hyperoxia (100% oxygen), and normoxia (air) using frequency doubling perimetry, viewing at background fields of approximately 10 cd/m2 and approximately 1 cd/m2. Data were analyzed by retinal eccentricity and visual field quadrant.

RESULTS

At low photopic luminance (approximately 10 cd/m2), sensitivity was marginally enhanced when breathing 100% oxygen. At mesopic luminance (approximately 1 cd/m2), sensitivity was consistently poorest with hypoxia and greatest with supplementary oxygen at all eccentricities and in all field quadrants, suggesting oxygen-dependent performance.

CONCLUSIONS

The known effects of oxygenation state on pupil size are likely to influence frequency doubling perimetry thresholds, but oxygen-dependent changes in mesopic sensitivity are greater than expected from altered retinal illumination alone and support outer retinal (photoreceptor) susceptibility to hypoxia under twilight viewing.

Spatial frequencies used in Landolt C orientation judgments: relation to inferred magnocellular and parvocellular pathways

The purpose of this study was to define the spatial frequencies that underlie judgments of Landolt C orientation under test conditions designed to favor either the magnocellular (MC) or parvocellular (PC) pathway. Contrast thresholds of two observers were measured for briefly presented Landolt Cs of four sizes, using steady- and pulsed-pedestal paradigms to bias performance toward the MC and PC pathways, respectively. Contrast thresholds were derived from a two-alternative forced-choice orientation judgment task using the QUEST procedure. The Landolt Cs were either low-pass or high-pass Gaussian filtered with a range of cutoff object spatial frequencies (cycles per letter) to limit their frequency content. Center object frequencies were derived from plots of log contrast threshold for orientation judgments vs. log filter cutoff object frequency. The function relating center object frequency to Landolt C angular subtense was nonlinear on log-log coordinates for both the steady- and pulsed-pedestal paradigms, indicating that different object frequencies were used to judge Landolt C orientation at different optotype sizes. However, the function was substantially steeper under the pulsed-pedestal than under the steady-pedestal paradigm, such that a large change in optotype size produced a relatively small change in retinal spatial frequency (cycles per degree). The pattern of results is consistent with previously reported differences between the spatial contrast sensitivity functions of the inferred MC and PC pathways.

Magnocellular and parvocellular visual pathway contributions to visual field anisotropies

It is well established that sensitivity is not necessarily equivalent at isoeccentric locations across the visual field. The focus of this study was a psychophysical examination of the spatial sensitivity differences between the upper and lower visual hemifields under conditions biased toward the presumed magnocellular or parvocellular visual pathway. Experiment 1 showed higher contrast sensitivity in the lower visual field when visual sensitivity was biased toward the parvocellular pathway; no visual field anisotropy was found when sensitivity was biased toward the magnocellular pathway. Experiment 2 showed that the magnitude of the contrast sensitivity anisotropy within the presumed parvocellular pathway increased when test targets of higher spatial frequency were used. The results of this study have relevance for the design both of psychophysical paradigms and clinical training programs for patients with heterogeneous visual field loss.