A population study of binocular function

Stereo-anomaly is found more frequently in tasks that require discrimination between depths

Within the population of humans with otherwise normal vision, there exists some proportion whose ability to perceive depth from binocular disparity is poor or absent. The prevalence of this "stereo-anomaly" has been reported to be as small as 2%, or as great as 30%. We set out to investigate this discrepancy. We used a digital tool to measure stereoacuity in tasks requiring either the detection of disparity or the discrimination of the direction of disparity. In a cohort of 228 participants, we found that 98% were able to consistently perform the detection task. Of these, only 69% consistently performed the discrimination task. The 31% of participants who had difficulty with the discrimination task could further be divided into 17% who were consistently unable to perform the task and 14% who showed limited ability. This suggests that identification of the direction of disparity requires further processing beyond merely detecting its presence.

Comparison of Foraging Interactive D-prime and Angular Indication Measurement Stereo with different methods to assess stereopsis

PURPOSE

Stereopsis is a critical visual function, however clinical stereotests are time-consuming, coarse in resolution, suffer memorization artifacts, poor repeatability, and low agreement with other tests. Foraging Interactive D-prime (FInD) Stereo and Angular Indication Measurement (AIM) Stereo were designed to address these problems. Here, their performance was compared with 2-Alternative-Forced-Choice (2-AFC) paradigms (FInD Stereo only) and clinical tests (Titmus and Randot) in 40 normally-sighted and 5 binocularly impaired participants (FInD Stereo only).

METHODS

During FInD tasks, participants indicated which cells in three 4*4 charts of bandpass-filtered targets (1,2,4,8c/° conditions) contained depth, compared with 2-AFC and clinical tests. During the AIM task, participants reported the orientation of depth-defined bars in three 4*4 charts. Stereoscopic disparity was adaptively changed after each chart. Inter-test agreement, repeatability and duration were compared.

RESULTS

Test duration was significantly longer for 2-AFC (mean = 317s;79s per condition) than FInD (216s,18s per chart), AIM (179s, 60s per chart), Titmus (66s) or RanDot (97s). Estimates of stereoacuity differed across tests and were higher by a factor of 1.1 for AIM and 1.3 for FInD. No effect of stimulus spatial frequency was found. Agreement among tests was generally low (R2 = 0.001 to 0.24) and was highest between FInD and 2-AFC (R2 = 0.24;p<0.01). Stereoacuity deficits were detected by all tests in binocularly impaired participants.

CONCLUSIONS

Agreement among all tests was low. FInD and AIM inter-test agreement was comparable with other methods. FInD Stereo detected stereo deficits and may only require one condition to identify these deficits. AIM and FInD are response-adaptive, self-administrable methods that can estimate stereoacuity reliably within one minute.

Classification images for aerial images capture visual expertise for binocular disparity and a prior for lighting from above

Using a novel approach to classification images (CIs), we investigated the visual expertise of surveyors for luminance and binocular disparity cues simultaneously after screening for stereoacuity. Stereoscopic aerial images of hedges and ditches were classified in 10,000 trials by six trained remote sensing surveyors and six novices. Images were heavily masked with luminance and disparity noise simultaneously. Hedge and ditch images had reversed disparity on around half the trials meaning hedges became ditch-like and vice versa. The hedge and ditch images were also flipped vertically on around half the trials, changing the direction of the light source and completing a 2 × 2 × 2 stimulus design. CIs were generated by accumulating the noise textures associated with "hedge" and "ditch" classifications, respectively, and subtracting one from the other. Typical CIs had a central peak with one or two negative side-lobes. We found clear differences in the amplitudes and shapes of perceptual templates across groups and noise-type, with experts prioritizing binocular disparity and using this more effectively. Contrariwise, novices used luminance cues more than experts meaning that task motivation alone could not explain group differences. Asymmetries in the luminance CIs revealed individual differences for lighting interpretation, with experts less prone to assume lighting from above, consistent with their training on aerial images of UK scenes lit by a southerly sun. Our results show that (i) dual noise in images can be used to produce simultaneous CI pairs, (ii) expertise for disparity cues does not depend on stereoacuity, (iii) CIs reveal the visual strategies developed by experts, (iv) top-down perceptual biases can be overcome with long-term learning effects, and (v) CIs have practical potential for directing visual training.

Toward a theory of perspective perception in pictures

This paper reviews projection models and their perception in realistic pictures, and proposes hypotheses for three-dimensional (3D) shape and space perception in pictures. In these hypotheses, eye fixations, and foveal vision play a central role. Many past theories and experimental studies focus solely on linear perspective. Yet, these theories fail to explain many important perceptual phenomena, including the effectiveness of nonlinear projections. Indeed, few classical paintings strictly obey linear perspective, nor do the best distortion-avoidance techniques for wide-angle computational photography. The hypotheses here employ a two-stage model for 3D human vision. When viewing a picture, the first stage perceives 3D shape for the current gaze. Each fixation has its own perspective projection, but, owing to the nature of foveal and peripheral vision, shape information is obtained primarily for a small region of the picture around the fixation. As a viewer moves their eyes, the second stage continually integrates some of the per-gaze information into an overall interpretation of a picture. The interpretation need not be geometrically stable or consistent over time. It is argued that this framework could explain many disparate pictorial phenomena, including different projection styles throughout art history and computational photography, while being consistent with the constraints of human 3D vision. The paper reviews open questions and suggests new studies to explore these hypotheses.

Two Disparity Channels in Human Visual Cortex With Different Contrast and Blur Sensitivity

Purpose

Our goal is to describe the contrast and blur sensitivity of multiple horizontal disparity subsystems and to relate them to the contrast and spatial sensitivities of their monocular inputs.

Methods

Steady-state visual evoked potential (SSVEP) amplitudes were recorded in response to dynamic random dot stereograms (DRDSs) alternating at 2 Hz between zero disparity and varying magnitudes of crossed disparity for disparity plane and disparity grating stimuli. Half-image contrasts ranged between 2.5% and 80% and over a range of Gaussian blurs from 1.4 to 12 arcmin. Separate experiments measured contrast and blur sensitivity for the monocular half-images.

Results

The first and second harmonics disparity responses were maximal for disparity gratings and for the disparity plane condition, respectively. The first harmonic of the disparity grating response was more affected by both contrast and blur than was the second harmonic of the disparity plane response, which had higher contrast sensitivity than the first harmonic.

Conclusions

The corrugation frequency, contrast, and blur tuning of the first harmonic suggest that it reflects activity of neurons tuned to higher luminance spatial frequencies that are selective for relative disparity, whereas the second harmonic reflects the activity of neurons sensitive to absolute disparity that are driven by low monocular spatial frequencies.

Translational Relevance

SSVEPs to DRDSs provide two objective neural measures of disparity processing, the first harmonic-whose stimulus preferences are similar to those of behavioral stereoacuity-and the second harmonic that represents an independent disparity-specific but not necessarily stereoscopic mechanism.

13q32.1 as a candidate region for physiological anisocoria

BACKGROUND

Physiological anisocoria is an asymmetry of pupil size in the absence of pathology.

METHODS

Images of the pupils under standard illumination were collected in the course of a whole-genome association study of a range of visual functions in 1060 healthy adults. DNA for each participant was extracted from saliva samples.

RESULTS

We found no relationship between anisocoria and the difference in refraction between the eyes, nor between anisocoria and difference in acuity. There was a small but significant relationship with lightness of the iris, in that the eye with the smaller pupil was associated with the lighter iris. There was a strong association between anisocoria and a local region of chromosome 13 (13q32.1), a region lying between the genes GPR180 and SOX21. The strongest association was with the single-nucleotide polymorphism rs9524583.

CONCLUSION

The very specific region associated with anisocoria is one where microdeletions (or microduplications) are known to lead to abnormal development of pupil dilator muscle and hence to the autosomal dominant condition of microcoria. It is possible that alterations at 13q32.1 act by altering the expression of SOX21, which encodes a nuclear transcription factor.

Comparing the Effectiveness of Smartphone Applications in the Measurement of Interpupillary Distance

Purpose To determine the accuracy of three smartphone applications in the measurement of interpupillary distance (IPD). Methods This study compared measurements from three smartphone applications to measurements obtained by a single trained examiner using a digital pupilometer in 44 subjects. The mean absolute error (MAE) of IPD prediction by each application was compared. Additionally, the frequency at which each application measured IPD within ± 0.05 mm, ± 0.10 mm, ± 0.25 mm, ± 0.50 mm, ± 0.75 mm, and ± 1.00 mm of the digital pupilometer measurement was determined. Results The Eye Measure (Dotty Digital, Sydney, New South Wales, Australia) and Warby Parker (Warby Parker, New York, New York) applications had significantly lower MAE of IPD measurements (0.511364 mm) compared to the PDCheck AR (EyeQue Corp., Newark, California) application (1.375 mm). The Warby Parker application most frequently obtained accurate IPD measurements within the following ranges: ± 0.05 mm, ± 0.10 mm, ± 0.25 mm, ± 0.50 mm, ± 0.75 mm, and ± 1.00 mm. Conclusion Of the three smartphone applications compared in this study, the Warby Parker application performed to the highest degree of accuracy and may serve as an adequate alternative when conventional IPD measurement methods are either unavailable or unable to be performed accurately.

Design guidelines for limiting and eliminating virtual reality-induced symptoms and effects at work: a comprehensive, factor-oriented review

Virtual reality (VR) can induce side effects known as virtual reality-induced symptoms and effects (VRISE). To address this concern, we identify a literature-based listing of these factors thought to influence VRISE with a focus on office work use. Using those, we recommend guidelines for VRISE amelioration intended for virtual environment creators and users. We identify five VRISE risks, focusing on short-term symptoms with their short-term effects. Three overall factor categories are considered: individual, hardware, and software. Over 90 factors may influence VRISE frequency and severity. We identify guidelines for each factor to help reduce VR side effects. To better reflect our confidence in those guidelines, we graded each with a level of evidence rating. Common factors occasionally influence different forms of VRISE. This can lead to confusion in the literature. General guidelines for using VR at work involve worker adaptation, such as limiting immersion times to between 20 and 30 min. These regimens involve taking regular breaks. Extra care is required for workers with special needs, neurodiversity, and gerontechnological concerns. In addition to following our guidelines, stakeholders should be aware that current head-mounted displays and virtual environments can continue to induce VRISE. While no single existing method fully alleviates VRISE, workers' health and safety must be monitored and safeguarded when VR is used at work.

Vision screening and vocational aptitude: A factor analysis approach

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

New insights into binocular rivalry from the reconstruction of evolving percepts using model network dynamics

When the two eyes are presented with highly distinct stimuli, the resulting visual percept generally switches every few seconds between the two monocular images in an irregular fashion, giving rise to a phenomenon known as binocular rivalry. While a host of theoretical studies have explored potential mechanisms for binocular rivalry in the context of evoked model dynamics in response to simple stimuli, here we investigate binocular rivalry directly through complex stimulus reconstructions based on the activity of a two-layer neuronal network model with competing downstream pools driven by disparate monocular stimuli composed of image pixels. To estimate the dynamic percept, we derive a linear input-output mapping rooted in the non-linear network dynamics and iteratively apply compressive sensing techniques for signal recovery. Utilizing a dominance metric, we are able to identify when percept alternations occur and use data collected during each dominance period to generate a sequence of percept reconstructions. We show that despite the approximate nature of the input-output mapping and the significant reduction in neurons downstream relative to stimulus pixels, the dominant monocular image is well-encoded in the network dynamics and improvements are garnered when realistic spatial receptive field structure is incorporated into the feedforward connectivity. Our model demonstrates gamma-distributed dominance durations and well obeys Levelt's four laws for how dominance durations change with stimulus strength, agreeing with key recurring experimental observations often used to benchmark rivalry models. In light of evidence that individuals with autism exhibit relatively slow percept switching in binocular rivalry, we corroborate the ubiquitous hypothesis that autism manifests from reduced inhibition in the brain by systematically probing our model alternation rate across choices of inhibition strength. We exhibit sufficient conditions for producing binocular rivalry in the context of natural scene stimuli, opening a clearer window into the dynamic brain computations that vary with the generated percept and a potential path toward further understanding neurological disorders.

InFoRM (Indicate-Follow-Replay-Me): A novel method to measure perceptual multistability dynamics using continuous data tracking and validated estimates of visual introspection

Perceptual multistability, e.g. Binocular Rivalry, has been intensively used as a tool to study visual consciousness. Current methods to assess multistability do not capture all potentially occurring perceptual states, provide no estimate of introspection, and lack continuous, high-temporal resolution to resolve perceptual changes between states and within mixed perceptual states. We introduce InFoRM (Indicate-Follow-Replay-Me), a four-phase method that (1) trains a participant to self-generate estimates of perceptual introspection-maps that are (2) validated during a physical mimic task, (3) gathers perceptual multistability data, and (4) confirms their validity during a physical replay. 28 condition-blinded adults performed InFoRM while experiencing binocular rivalry evoked with orthogonal sinusoidal gratings. A 60 Hz joystick (3600 data samples/minute) was used to indicate continuously changes across six perceptual states within each 1 min trial. A polarized monitor system was used to present the stimuli dichoptically. Three contrast conditions were investigated: low vs low, high vs high, and low vs high. InFoRM replicates standard outcome measures, i.e. alternation rate, mean and relative proportions of perception, and distribution of exclusive percepts that are well fitted with gamma functions. Furthermore, InFoRM generates novel outcomes that deliver new insights in visual cognition via estimates of introspection maps, in ocular dominance via perceptual-state-specific dominance scores, in transitory dynamics between and within perceptual states, via techniques adopted from eye-tracking, and in rivalry-zone-size estimates utilizing InFoRM's ability to simulate piecemeal perception. The replay phase (physical replay of perceptual rivalry) confirmed good overall agreement (73% ±5 standard deviation). InFoRM can be applied to other multistable paradigms and can be used to study visual consciousness in typical and neuro-atypical populations.

Differences in stereoacuity between crossed and uncrossed disparities reduce with practice

INTRODUCTION

Stereoacuity, like many forms of hyperacuity, improves with practice. We investigated the effects of repeated measurements over multiple visits on stereoacuity using two commonly utilised clinical stereotests, for both crossed and uncrossed disparity stimuli.

METHODS

Participants were adults with normal binocular vision (n = 17) aged between 18 and 50 years. Stereoacuity was measured using the Randot and TNO stereotests on five separate occasions over a six week period. We utilised both crossed and uncrossed stimuli to separately evaluate stereoacuity in both disparity directions. A subset of the subject group also completed a further five visits over an additional six week period. Threshold stereoacuity was determined by the lowest disparity level at which the subjects could correctly identify both the position and disparity direction (crossed or uncrossed) of the stimulus. Data were analysed by repeated measures analysis of variance.

RESULTS

Stereoacuity for crossed and uncrossed stimuli improved significantly across the first five visits (F_1,21  = 4.24, p = 0.05). The main effect of disparity direction on stereoacuity was not significant (F₁  = 0.02, p = 0.91). However, a significant interaction between disparity direction and stereotest was identified (F₁  = 7.92, p = 0.01).

CONCLUSIONS

Stereoacuity measured with both the TNO and Randot stereotests improved significantly over the course of five repetitions. Although differences between crossed and uncrossed stereoacuity were evident, they depended on the stereotest used and reduced or disappeared after repeated measurements. A single measure of stereoacuity is inadequate for properly evaluating adult stereopsis clinically.

Learning to see in depth

Stereopsis provides us with a vivid impression of the depth and distance of objects in our 3- dimensional world. Stereopsis is important for a number of everyday visual tasks, including (but not limited to) reaching and grasping, fine visuo-motor control, and navigating in our world. This review briefly discusses the neural substrate for normal binocular vision and stereopsis and its development in primates; outlines some of the issues and limitations of stereopsis tests and examines some of the factors that limit the typical development of stereopsis and the causes and consequences of stereo-deficiency and stereo-blindness. Finally, we review several approaches to improving or recovering stereopsis in both neurotypical individuals and those with stereo-deficiency and stereo-blindness and outline some emerging strategies for improving stereopsis.

Balanced Binocular Inputs Support Superior Stereopsis

Purpose

Our visual system compares the inputs received from the two eyes to estimate the relative depths of features in the retinal image. We investigated how an imbalance in the strength of the input received from the two eyes affects stereopsis. We also explored the level of agreement between different measurements of sensory eye imbalance.

Methods

We measured the sensory eye imbalance and stereoacuity of 30 normally sighted participants. We made our measurements using a modified amblyoscope. The sensory eye imbalance was assessed through three methods: the difference between monocular contrast thresholds, the difference in dichoptic masking weight, and the contribution of each eye to a fused binocular percept. We referred them as the “threshold imbalance,” “masking imbalance,” and “fusion imbalance,” respectively. The stereoacuity threshold was measured by having subjects discriminate which of four circles were displaced in depth. All of our tests were performed using stimuli of the same spatial frequency (2.5 cycles/degree).

Results

We found a relationship between stereoacuity and sensory eye imbalance. However, this was only the case for fusion imbalance measurement (ρ = 0.52; P = 0.003). Neither the threshold imbalance nor the masking imbalance was significantly correlated with stereoacuity. We also found the threshold imbalance was correlated with both the fusion and masking imbalances (r = 0.46, P = 0.011 and r = 0.49, P = 0.005, respectively). However, a nonsignificant correlation was found between the fusion and masking imbalances.

Conclusions

Our findings suggest that there exist multiple types of sensory eye dominance that can be assessed by different tasks. We find only imbalances in dominance that result in biases to fused percepts are correlated with stereoacuity.

Optics and neural adaptation jointly limit human stereovision

Stereovision is the ability to perceive fine depth variations from small differences in the two eyes' images. Using adaptive optics, we show that even minute optical aberrations that are not clinically correctable, and go unnoticed in everyday vision, can affect stereo acuity. Hence, the human binocular system is capable of using fine details that are not experienced in everyday vision. Interestingly, stereo acuity varied considerably across individuals even when they were provided identical perfect optics. We also found that individuals' stereo acuity is better when viewing with their habitual optics rather than someone else's (better) optics. Together, these findings suggest that the visual system compensates for habitual optical aberrations through neural adaptation and thereby optimizes stereovision uniquely for each individual. Thus, stereovision is limited by small optical aberrations and by neural adaptation to one's own optics.

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.

Comparison of three-dimensional (3D) endovision system versus ultra-high-definition 4K endovision system in minimally invasive surgical procedures: a randomized-open label pilot study

BACKGROUND

Experimental work comparing 3-Dimensional (3D) and 4K ultra-high-definition endovision system (4K) indicates that the latter with double the resolution of standard 2D high-definition systems may provide additional visual cues to compensate for the lack of stereoscopic vision. There is paucity of studies comparing 3D and 4K system in clinical settings. This randomized study compares 3D and 4K systems in three laparoscopic procedures of increasing complexity.

METHODS

139 patients undergoing laparoscopic cholecystectomy (60 patients), transabdominal preperitoneal (TAPP) repair (49 patients) and laparoscopic Heller's cardiomyotomy with anti- reflux procedure (30 patients) between May 2018 and February 2020 were randomized to undergo surgery using either 3D or 4K systems. Primary objective was to measure total operative time. Secondary objectives were to compare workload perceived by surgeons using SURG-TLX and surgeon satisfaction score. Timings of key surgical steps and peri-operative course of the patients was also recorded. Data were analyzed using Stata Corp. 2015.

RESULTS

Patients undergoing surgery with 3D and 4K systems were comparable in their clinical and demographic profiles. The mean total operative time in 3D and 4K groups was comparable in cholecystectomy (52.7 vs 56.2, p = 0.50), TAPP (63.8 vs 69.6, p = 0.25) and Heller's cardiomyotomy (124.7 vs 143.3, p = 0.14) with faster hiatal dissection in 3D group (8 min, p = 0.02). Operative time was better in patients undergoing Heller's myotomy with Angle of His accentuation with 3D by 28 min (p = 0.03). Total workload was similar in 3D and 4K groups in all the procedures but mental & physical demand was lower in 3D group in Heller's cardiomyotomy (p = 0.03, p = 0.01), Surgeon satisfaction score was comparable in all three procedures.

CONCLUSION

Overall, 3D HD and 4K systems are comparable in performing laparoscopic cholecystectomy, TAPP and Heller's Cardiomyotomy. Hiatal dissection time, mental and physical task load was better with 3D in Heller's Cardiomyotomy.

A new experimental phenomenological method to explore the subjective features of psychological phenomena: its application to binocular rivalry

The subjective features of psychological phenomena have been studied intensively in experimental science in recent years. Although various methods have been proposed to identify subjective features of psychological phenomena, there are elusive subjective features such as the spatiotemporal structure of experience, which are difficult to capture without some additional methodological tools. We propose a new experimental method to address this challenge, which we call the contrast-based experimental phenomenological method (CEP). CEP proceeds in four steps: (i) front-loading phenomenology, (ii) online second-personal interview, (iii) questionnaire survey, and (iv) hypotheses testing. It differs from other experimental phenomenological methods in that it takes advantage of phenomenal contrasts in collecting phenomenological data. In this paper, we verify the validity and productivity of this method by applying it to binocular rivalry (BR). The study contributes to empirical research on BR in three respects. First, it provides additional evidence for existing propositions about the subjective features of BR: e.g. the proposition that the temporal dynamics of the experience depend upon subject-dependent parameters such as attentional change. Second, it deepens our understanding of the spatiotemporal structures of the transition phase of BR. Third, it elicits new research questions about depth experience and individual differences in BR. The presence of such contributions demonstrates the validity and productivity of CEP.

A genome-wide association study reveals a substantial genetic basis underlying the Ebbinghaus illusion

The Ebbinghaus illusion (EI) is an optical illusion of relative size perception that reflects the contextual integration ability in the visual modality. The current study investigated the genetic basis of two subtypes of EI, EI overestimation, and EI underestimation in humans, using quantitative genomic analyses. A total of 2825 Chinese adults were tested on their magnitudes of EI overestimation and underestimation using the method of adjustment, a standard psychophysical protocol. Heritability estimation based on common single nucleotide polymorphisms (SNPs) revealed a moderate heritability (34.3%) of EI overestimation but a nonsignificant heritability of EI underestimation. A meta-analysis of two phases (phase 1: n = 1986, phase 2: n = 839) of genome-wide association study (GWAS) discovered 1969 and 58 SNPs reaching genome-wide significance for EI overestimation and EI underestimation, respectively. Among these SNPs, 55 linkage-disequilibrium-independent SNPs were associated with EI overestimation in phase 1 with genome-wide significance and their associations could be confirmed in phase 2 cohort. Gene-based analyses found seven genes to be associated with EI overestimation at the genome-wide level, two from meta-analysis, and five from classical two-stage analysis. Overall, this study provided consistent evidence for a substantial genetic basis of the Ebbinghaus illusion.

Three-dimensional (3D) visualization provides better outcome than two-dimensional (2D) visualization in single-port laparoscopic distal gastrectomy: a propensity-matched analysis

PURPOSE

There are currently no reports on the application of three-dimensional (3D) vision to single-incision laparoscopic surgery. This study compared 3D vision to the previous two-dimensional (2D) system in single-incision laparoscopic distal gastrectomy (SIDG).

METHODS

Medical charts of 179 gastric cancer patients who underwent SIDG from February 2014 to December 2017 were retrospectively reviewed. Patients were grouped into either a 2D group or 3D group depending on the type of camera that was used. All operations were performed using a flexible camera (Olympus, Japan). Operative data and postoperative outcome were analyzed.

RESULTS

There were 90 patients in the 2D group and 89 patients in the 3D group. No differences were found in terms of the age, body mass index, staging, and other demographics of the patients. Operative time was significantly faster in the 3D group (115.6 ± 34.0 vs. 129.4 ± 38.5 min, p = 0.012), and estimated blood loss (EBL) was less in the 3D group (20.7 ± 30.0 vs. 35.1 ± 56.0 ml, p = 0.034). Patients in the 3D group were able to start a small fluid diet earlier (2.5, range 1-6 vs. 3.0, range 2-8 postoperative days, p = 0.006) and were discharged faster (5.4, range 3-12 vs. 6.2, range 4-24 postoperative days, p = 0.024). There was no statistical difference between early and late complications.

CONCLUSION

The use of the 3D camera shortened operative time with possible clinical benefits for patients undergoing SIDG.

Factors limiting sensitivity to binocular disparity in human vision: Evidence from a noise-masking approach

Our visual system uses the disparity between the images received by the two eyes to judge three-dimensional distance to surfaces. We can measure this ability by having subjects discriminate the disparity of rendered surfaces. We wanted to know the basis of the individual differences in this ability. We tested 53 adults with normal vision using a relative disparity detection task. Targets were wedge-shaped surfaces formed from random dots. These were presented in either crossed or uncrossed disparity relative to a random dot background. The threshold disparity ranged from 24 arc seconds in the most-able subject to 275 arc seconds in the least-able subject. There was a small advantage for detecting crossed-disparity targets. We used the noise-masking paradigm to partition subject performance into two factors. These were the subject's equivalent internal noise and their processing efficiency. The parameters were estimated by fitting the linear amplifier model. We found both factors contributed to the individual differences in stereoacuity. Within subjects, those showing an advantage for one disparity direction had enhanced efficiency for that direction. Some subjects had a higher equivalent internal noise for one direction that was balanced out by an increased efficiency. Our approach provides a more thorough account of the stereo-ability of our subjects compared with measuring thresholds alone. We present a normative set of results that can be compared with clinical populations.

Three-dimensional imaging improved the laparoscopic performance of inexperienced operators: a prospective trial

BACKGROUND

Three-dimensional (3-D) high-definition (HD) stereovision and two-dimensional (2-D) ultra-high-resolution (4K) monitors have recently become available for laparoscopic surgery. The aim of this study was to compare laparoscopic performance between inexperienced participants using 3-D/HD and 2-D/4K monitors and those using conventional 2-D/HD monitors.

METHODS

The study enrolled 66 participants with no previous surgical experience or medical training. They were randomly divided into three equal groups, each using a different type of monitor (2-D/HD, 2-D/4K, or 3-D/HD), to perform three phantom tasks using a laparoscopic simulator: Task 1, touching markers on a non-flat surface; Task 2, bimanual peg transfer; and Task 3, passing a straight rod through a loop. Each task was performed three times. The performance scores (operative time, path length of the forceps, and technical errors) were compared for each monitor type and by age group (< 30 vs. > 30 years).

RESULTS

For all three tasks, scores using the 3-D monitor were significantly better than those using either 2-D monitor, with no difference between the 2-D/4K and 2-D/HD monitors. Using the 2-D monitors, the performance of Task 3 by the participants > 30 years was worse than that by the younger participants; however, there was no difference between the age groups when using the 3-D monitor.

CONCLUSION

Participants with no prior experience using a 3-D monitor showed better laparoscopic performance than those using 2-D monitors, even with 4K resolution. This improvement was more marked in older participants, suggesting a greater loss of depth perception in a 2-D environment.

Characterizing the Randot Preschool stereotest: Testability, norms, reliability, specificity and sensitivity in children aged 2-11 years

PURPOSE

To comprehensively assess the Randot Preschool stereo test in young children, including testability, normative values, test/retest reliability and sensitivity and specificity for detecting binocular vision disorders.

METHODS

We tested 1005 children aged 2-11 years with the Randot Preschool stereo test, plus a cover/uncover test to detect heterotropia. Monocular visual acuity was assessed in both eyes using Keeler Crowded LogMAR visual acuity test for children aged 4 and over.

RESULTS

Testability was very high: 65% in two-year-olds, 92% in three-year-olds and ~100% in older children. Normative values: In 389 children aged 2-5 with apparently normal vision, 6% of children scored nil (stereoblind). In those who obtained a threshold, the mean log threshold was 2.06 log10 arcsec, corresponding to 114 arcsec, and the median threshold was 100 arcsec. Most older children score 40 arcsec, the best available score. We found a small sex difference, with girls scoring slightly but significantly better. Test/retest reliability: ~99% for obtaining any score vs nil. Agreement between stereo thresholds is poor in children aged 2-5; 95% limit of agreement = 0.7 log10 arcsec: five-fold change in stereo threshold may occur without any change in vision. In children over 5, the test essentially acts only as a binary classifier since almost all non-stereoblind children score 40 arcsec. Specificity (true negative rate): >95%. Sensitivity (true positive rate): poor, <50%, i.e. around half of children with a demonstrable binocular vision abnormality score well on the Randot Preschool.

CONCLUSIONS

The Randot Preschool is extremely accessible for even very young children, and is very reliable at classifying children into those who have any stereo vision vs those who are stereoblind. However, its ability to quantify stereo vision is limited by poor repeatability in children aged 5 and under, and a very limited range of scores relevant to children aged over 5.

Vertical size disparity induces enhanced neural responses in good stereo observers

Stereoscopic three-dimensional vision requires cortical processing for horizontal binocular disparity between the two eyes' retinal images. Behavioral and theoretical studies suggest that vertical size disparity is used to recover the viewing geometry and to generate the slant of a large surface. However, unlike horizontal disparity, the relation between stereopsis and neural responses to vertical disparity remains controversial. To determine the role of cortical processing for vertical size disparity in stereopsis, we measured neuromagnetic responses to disparities in people with good and poor stereopsis, using magnetoencephalography (MEG). Healthy adult participants viewed stereograms with a horizontal or vertical size disparity, and judged the perceived slant of the pattern. We assessed neural activity in response to disparities in the visual cortex and the phase locking of oscillatory responses including the alpha frequency range using MEG. For participants with good stereopsis, activity in the visual areas was significantly higher in response to vertical size disparity than to horizontal size disparity. The time-frequency analysis revealed that early neural responses to vertical size disparity were more phase-locked in good stereo participants than in poor stereo participants. These results provide neuromagnetic evidence that vertical-size disparity processing plays a role in good stereo vision.

Individual variation in inter-ocular suppression and sensory eye dominance

The competitive and inhibitory interactions between the two eyes' images are a pervasive aspect of binocular vision. Over the last decade, our understanding of the neural processes underpinning binocular rivalry (BR) and continuous flash suppression (CFS) has increased substantially, but we still have little understanding of the relationship between these two effects and their variation in the general population. Studies that pool data across individuals and eyes risk masking substantial variations in binocular vision that exist in the general population. To investigate this issue we compared the depth of inter-ocular suppression evoked by BR with that elicited by CFS, in a group (N = 25) of visually normal individuals. A noise pattern (either static for BR or dynamic for CFS) was presented to one eye and its suppressive influence on a probe grating presented simultaneously to the other eye was measured. We found substantial individual differences in the magnitude of suppression (a 10-fold variation in probe detection threshold) evoked by each task, but performance on BR was a significant predictor of performance on the CFS task. However many individuals showed marked asymmetries between the two eyes' ability to detect a suppressed target, that were not necessarily the same for the two tasks. There was a tendency for the magnitude of the asymmetry to increase as the refresh rate of the dynamic noise increased. The results suggest a common underlying mechanism is likely to be responsible, at least in part, for driving inter-ocular suppression under BR and CFS. The marked asymmetries in inter-ocular suppression at higher noise refresh rates, may be indicative of a difference in temporal processing between the eyes.

Tagged MEG measures binocular rivalry in a cortical network that predicts alternation rate

Binocular rivalry (BR) is a dynamic visual illusion that provides insight into the cortical mechanisms of visual awareness, stimulus selection, and object identification. When dissimilar binocular images cannot be fused, perception switches every few seconds between the left and right eye images. The speed at which individuals switch between alternatives is a stable, partially heritable trait. In order to isolate the monocular and binocular processes that determine the speed of rivalry, we presented stimuli tagged with a different flicker frequency in each eye and applied stimulus-phase locked MEG source imaging. We hypothesized that the strength of the evoked fundamental or intermodulation frequencies would vary when comparing Fast and Slow Switchers. Ten subjects reported perceptual alternations, with mean dominance durations between 1.2–4.0 sec. During BR, event-related monocular input in V1, and broadly in higher-tier ventral temporal cortex, waxed and waned with the periods of left or right eye dominance/suppression. In addition, we show that Slow Switchers produce greater evoked intermodulation frequency responses in a cortical network composed of V1, lateral occipital, posterior STS, retrosplenial & superior parietal cortices. Importantly, these dominance durations were not predictable from the brain responses to either of the fundamental tagging frequencies in isolation, nor from any responses to a pattern rivalry control condition, or a non-rivalrous control. The novel cortical network isolated, which overlaps with the default-mode network, may contain neurons that compute the level of endogenous monocular difference, and monitor accumulation of this conflict over extended periods of time. These findings are the first to relate the speed of rivalry across observers to the ‘efficient coding’ theory of computing binocular differences that may apply to binocular vision generally.

Altered short-term neural plasticity related to schizotypal traits: Evidence from visual adaptation

Abnormalities in synaptic plasticity are argued to underlie the neural dysconnectivity observed in schizophrenia. One way to measure synaptic plasticity is through sensory adaptation, whereby sensory neurons exhibit reduced sensitivity after sustained stimulus exposure. Evidence for decreased adaptation in individuals with schizophrenia is currently inconclusive, possibly due to heterogeneity in clinical and medication status across samples. Here we circumvent these confounds by examining whether altered adaptation is represented sub-clinically in the general population. To test this we used three paradigms from visual perception research that provide a precise and non-invasive index of adaptation in the visual system. Two paradigms involve a class of illusory percepts termed visual aftereffects. The third relies on a visual phenomenon termed binocular rivalry, where incompatible stimuli are presented to the two eyes and observers alternate between perceiving exclusively one stimulus or a combination of the two (i.e. mixed perception). We analyzed the strength and dynamics of visual adaptation in these paradigms, in relation to schizotypy. Our results showed that increased schizotypal traits were related to reduced orientation, but not luminance, aftereffect strength (Exp. 1). Further, increased schizotypy was related to a greater proportion of mixed perception during binocular rivalry (Exp. 1 and 2). Given that visual adaption is well understood at cellular and computational levels, our data suggest that short-term plasticity in the visual system can provide important information about the disease mechanisms of schizophrenia.

Individual differences in continuous flash suppression: Potency and linkages to binocular rivalry dynamics

Binocular rivalry (BR) and continuous flash suppression (CFS) are compelling psychophysical phenomena involving interocular suppression. Using an individual differences approach we assessed whether interocular suppression induced by CFS is predictable in potency from characteristics of BR that are plausibly governed by interocular inhibition. We found large individual differences in BR dynamics and, in addition, in the strength of CFS as gauged by the incidence and durations of breakthroughs in CFS during an extended viewing periods. CFS's potency waned with repeated trials, but stable individual differences persisted despite these mean shifts. We also discovered large individual differences in the strength of the post-CFS shift in BR dominance produced by interocular suppression. While CFS breakthroughs were significantly negatively correlated with shifts in BR dominance after CFS, there were no significant associations between individual differences in alternation rate during pre-CFS binocular rivalry and either breakthroughs during CFS or post-CFS dominance shifts. Bayesian hypothesis tests and highest posterior density intervals confirmed the weak association between these two forms of interocular suppression. Thus, our findings suggest that the substantial individual differences in BR dynamics and CFS effectiveness are modestly related but not entirely mediated by one common neural substrate.

Binocular non-stereoscopic cues can deceive clinical tests of stereopsis

Stereoscopic vision plays a critical role in visual perception; however, it is difficult to assess. In clinical settings, stereoacuity is assessed with clinical stereotests. Observers can use monocular cues to deceive some of the most common stereotests, such as the Titmus test. The Randot test has been found free of monocular cues, and here we confirm that result by testing observers under monocular viewing. However, there is a common misconception that only monocular cues can be used to deceive stereotests. Here we demonstrate that binocular non-stereoscopic cues can also be used to pass the Randot, by testing participants with the test rotated, a condition that abolishes stereopsis, and comparing the performance to a monocular viewing condition. We also assessed the Random Dot Butterfly test and discovered considerable amounts of non-stereoscopic cues, including binocular cues in the Circles that can be used to deceive the test. Participants with amblyopia had more difficulty using non-stereoscopic cues than neurotypical observers. We gathered normal-viewing Randot stereoacuities for 110 participants (90 neurotypical and 20 with amblyopia) and compared them to psychophysical stereoacuities (our gold standard). The Randot test showed low positive normalized predictive values for detecting stereoblindness. It could perfectly detect stereo-impairment but with a low sensitivity.

The prevalence and diagnosis of 'stereoblindness' in adults less than 60 years of age: a best evidence synthesis

PURPOSE

Stereoscopic vision (or stereopsis) is the ability to perceive depth from binocular disparity - the difference of viewpoints between the two eyes. Interestingly, there are large individual differences as to how well one can appreciate depth from such a cue. The total absence of stereoscopic vision, called 'stereoblindness', has been associated with negative behavioural outcomes such as poor distance estimation. Surprisingly, the prevalence of stereoblindness remains unclear, as it appears highly dependent on the way in which stereopsis is measured.

RECENT FINDINGS

This review highlights the fact that stereopsis is not a unitary construct, but rather implies different systems. The optimal conditions for measuring these varieties of stereoscopic information processing are discussed given the goal of detecting stereoblindness, using either psychophysical or clinical stereotests. In that light, we then discuss the estimates of stereoblindness prevalence of past studies.

SUMMARY

We identify four different approaches that all converge toward a prevalence of stereoblindness of 7% (median approach: 7%; unambiguous-stereoblindness-criteria approach: 7%; visual-defect-included approach: 7%; multiple-criteria approach: 7%). We note that these estimates were derived considering adults of age <60 years old. Older adults may have a higher prevalence. Finally, we make recommendations for a new ecological definition of stereoblindness and for efficient clinical methods for determining stereoblindness by adapting existing tools.

ASTEROID: A New Clinical Stereotest on an Autostereo 3D Tablet

Purpose

To describe a new stereotest in the form of a game on an autostereoscopic tablet computer designed to be suitable for use in the eye clinic and present data on its reliability and the distribution of stereo thresholds in adults.

Methods

Test stimuli were four dynamic random-dot stereograms, one of which contained a disparate target. Feedback was given after each trial presentation. A Bayesian adaptive staircase adjusted target disparity. Threshold was estimated from the mean of the posterior distribution after 20 responses. Viewing distance was monitored via a forehead sticker viewed by the tablet's front camera, and screen parallax was adjusted dynamically so as to achieve the desired retinal disparity.

Results

The tablet must be viewed at a distance of greater than ∼35 cm to produce a good depth percept. Log thresholds were roughly normally distributed with a mean of 1.75 log₁₀ arcsec = 56 arcsec and SD of 0.34 log₁₀ arcsec = a factor of 2.2. The standard deviation agrees with previous studies, but ASTEROID thresholds are approximately 1.5 times higher than a similar stereotest on stereoscopic 3D TV or on Randot Preschool stereotests. Pearson correlation between successive tests in same observer was 0.80. Bland-Altman 95% limits of reliability were ±0.64 log₁₀ arcsec = a factor of 4.3, corresponding to an SD of 0.32 log₁₀ arcsec on individual threshold estimates. This is similar to other stereotests and close to the statistical limit for 20 responses.

Conclusions

ASTEROID is reliable, easy, and portable and thus well-suited for clinical stereoacuity measurements.

Translational Relevance

New 3D digital technology means that research-quality psychophysical measurement of stereoacuity is now feasible in the clinic.

The use of 3D laparoscopic imaging systems in surgery: EAES consensus development conference 2018

BACKGROUND

The use of 3D laparoscopic systems is expanding. The European Association of Endoscopic Surgery (EAES) initiated a consensus development conference with the aim of creating evidence-based statements and recommendations for the surgical community.

METHODS

Systematic reviews of the PubMed and Embase libraries were performed to identify evidence on potential benefits of 3D on clinical practice and patient outcomes. Statements and recommendations were prepared and unanimously agreed by an international surgical and engineering expert panel which were presented and voted at the EAES annual congress, London, May 2018.

RESULTS

9967 abstracts were screened with 138 articles included. 18 statements and two recommendations were generated and approved. 3D significantly shortened operative time (mean difference 11 min (8% [95% CI 20.29-1.72], I² 96%)). A significant reduction in complications was observed when 3D systems were used (RR 0.75, [95 CI% 0.60-0.94], I² 0%) particularly for cases involving laparoscopic suturing (RR 0.57 [95% CI 0.35-0.90], I² 0%). In 69 box trainer or simulator studies, 64% concluded trainees were significant faster and 62% performed fewer errors when using 3D.

CONCLUSION

We recommend the use of 3D vision in laparoscopy to reduce the operative time (grade of recommendation: low). Future robust clinical research is required to specifically investigate the potential benefit of 3D laparoscopy system on complication rates (grade of recommendation: high).

The use of 3D laparoscopic imaging systems in surgery: EAES consensus development conference 2018

BACKGROUND

The use of 3D laparoscopic systems is expanding. The European Association of Endoscopic Surgery (EAES) initiated a consensus development conference with the aim of creating evidence-based statements and recommendations for the surgical community.

METHODS

Systematic reviews of the PubMed and Embase libraries were performed to identify evidence on potential benefits of 3D on clinical practice and patient outcomes. Statements and recommendations were prepared and unanimously agreed by an international surgical and engineering expert panel which were presented and voted at the EAES annual congress, London, May 2018.

RESULTS

9967 abstracts were screened with 138 articles included. 18 statements and two recommendations were generated and approved. 3D significantly shortened operative time (mean difference 11 min (8% [95% CI 20.29-1.72], I² 96%)). A significant reduction in complications was observed when 3D systems were used (RR 0.75, [95 CI% 0.60-0.94], I² 0%) particularly for cases involving laparoscopic suturing (RR 0.57 [95% CI 0.35-0.90], I² 0%). In 69 box trainer or simulator studies, 64% concluded trainees were significant faster and 62% performed fewer errors when using 3D.

CONCLUSION

We recommend the use of 3D vision in laparoscopy to reduce the operative time (grade of recommendation: low). Future robust clinical research is required to specifically investigate the potential benefit of 3D laparoscopy system on complication rates (grade of recommendation: high).

Continuous flash suppression operates in local spatial zones: Effects of mask size and contrast

Continuous flash suppression (CFS) is a technique in which presenting one eye with a dynamic Mondrian sequence prevents a low-contrast target in the other eye from being perceived for many seconds. Frequently used to study unconscious visual processing, CFS bears many similarities with binocular rivalry (BR), another popular dichoptic stimulation technique. It is therefore puzzling that the effect of mask size and contrast seem to differ between CFS and BR. To resolve this discrepancy, we conducted a systematic investigation on the effects of mask size and contrast in CFS. Also, building on findings from BR, we asked if the collinearity of the contours in the Mondrian masker play a role in CFS suppression. Our results showed a robust effect of mask contrast on suppression durations, and an effect of mask size that depended on collinearity. Specifically, higher mask contrasts produced longer suppression regardless of collinearity and mask size. Mask size, on the other hand, had little effect on suppression when collinearity was low and it weakened suppression when collinearity is high. These observations parallel prior findings in BR, further substantiating the close link between the two paradigms and demonstrating the usefulness of a shared explanatory framework describing both phenomena.

Does stereopsis account for the link between motor and social skills in adults?

Background

Experimental and longitudinal evidence suggests that motor proficiency plays an important role in the development of social skills. However, stereopsis, or depth perception, may also play a fundamental role in social skill development either indirectly through its impact on motor skills or through a more direct route. To date, no systematic study has investigated the relationship between social skills and motor ability in the general adult population, and whether poor stereopsis may contribute to this association. This has implications for clinical populations since research has shown associations between motor abnormalities and social skills, as well as reduced depth perception in autism spectrum disorder and developmental coordination disorder.

Methods

Six hundred fifty adults completed three validated questionnaires, the stereopsis screening inventory, the Adult Developmental Coordination Disorder Checklist, and the Autism Spectrum Quotient.

Results

An exploratory factor analysis on pooled items across all measures revealed 10 factors that were largely composed of items from a single scale, indicating that any co-occurrence of poor stereopsis, reduced motor proficiency, and difficulties with social interaction cannot be attributed to a single underlying mechanism. Correlations between extracted factor scores found associations between motor skill and social skill.

Conclusions

Mediation analyses suggested that whilst fine motor skill and coordination explained the relationship between stereopsis and social skill to some extent, stereopsis nonetheless exerted a substantial direct effect upon social skill. This is the first study to demonstrate that the functional significance of stereopsis is not limited to motor ability and may directly impact upon social functioning.

A comparison of tests for quantifying sensory eye dominance

Clinicians rely heavily on stereoacuity to measure binocular visual function, but stereo-vision represents only one aspect of binocularity. Lab-based tests of sensory eye dominance (SED) are commonplace, but have not been translated to wider clinical practice. Here we compare several methods of quantifying SED in a format suitable for clinical use. We tested 30 participants with ostensibly normal vision on eight tests. Seven tests (#1-7) were designed to quantify SED in the form of an interocular balance-point (BP). In tests #1-6, we estimated a contrast-BP, the interocular difference in contrast required for observers to be equally likely to base their judgement on either eye, whereas in test #7 we measured binocular rivalry (interocular ratio of sensory dominance duration). We compare test-retest reliability (intra-observer consistency) and test-validity (inter-observer discriminatory power) and compare BP to stereoacuity (test #8). The test that best preserved inter-observer differences in contrast balance while maintaining good test-retest reliability was a polarity judgement using superimposed opposite-contrast polarity same-identity optotypes. A reliable and valid measure of SED can be obtained rapidly (20 trials) using a simple contrast-polarity judgement. Tests that use polarity-rivalrous stimuli elicit more reliable judgments than those that do not. SIGNIFICANCE STATEMENT: Although sensory eye dominance is central to understanding normal and disordered binocular vision, there is currently no consensus as to the best way to measure it. Here we compare several candidate measures of sensory eye dominance and conclude that a reliable measure of SED can be achieved rapidly using a judgement of stimulus contrast-polarity.

Genomic Analyses of Visual Cognition: Perceptual Rivalry and Top-Down Control

Visual cognition in humans has traditionally been studied with cognitive behavioral methods and brain imaging, but much less with genetic methods. Perceptual rivalry, an important phenomenon in visual cognition, is the spontaneous perceptual alternation that occurs between two distinct interpretations of a physically constant visual stimulus (e.g., binocular rivalry stimuli) or a perceptually ambiguous stimulus (e.g., the Necker cube). The switching rate varies dramatically across individuals and can be voluntarily modulated by observers. Here, we adopted a genomic approach to systematically investigate the genetics underlying binocular rivalry, Necker cube rivalry and voluntary modulation of Necker cube rivalry in young Chinese adults (Homo sapiens, 81% female, 20 ± 1 years old) at multiple levels, including common single nucleotide polymorphism (SNP)-based heritability estimation, SNP-based genome-wide association study (GWAS), gene-based analysis, and pathway analysis. We performed a pilot GWAS in 2441 individuals and replicated it in an independent cohort of 943 individuals. Common SNP-based heritability was estimated to be 25% for spontaneous perceptual rivalry. SNPs rs184765639 and rs75595941 were associated with voluntary modulation, and imaging data suggested genotypic difference of rs184765639 in the surface area of the left caudal-middle frontal cortex. Additionally, converging evidence from multilevel analyses associated genes such as PRMT1 with perceptual switching rate, and MIR1178 with voluntary modulation strength. In summary, this study discovered specific genetic contributions to perceptual rivalry and its voluntary modulation in human beings. These findings may promote our understanding of psychiatric disorders, as perceptual rivalry is a potential psychiatric biomarker.SIGNIFICANCE STATEMENT Perceptual rivalry is an important visual phenomenon in which our perception of a physically constant visual input spontaneously switches between two different states. There are individual variations in perceptual switching rate and voluntary modulation strength. Our genomic analyses reveal several loci associated with these two kinds of variation. Because perceptual rivalry is thought to be relevant to and potentially an endophenotype for psychiatric disorders, these results may help understand not only visual cognition, but also psychiatric disorders.

On the Relationship Between Sensory Eye Dominance and Stereopsis in the Normal-Sighted Adult Population: Normative Data

The extent of sensory eye dominance, a reflection of the interocular suppression in binocular visual processing, can be quantitatively measured using the binocular phase combination task. In this study, we aimed to provide a normative dataset for sensory eye dominance using this task. Based on that, we also assessed the relationship between perceptual eye dominance and stereopsis. One-hundred and forty-two adults (average age: 24.00 ± 1.74 years old) with normal or corrected to normal monocular visual acuity (logMAR < 0.00) participated. Observer's sensory eye dominance was quantified in two complementary ways: the interocular contrast ratio when the two eyes were balanced (i.e., the balance point) and the absolute value of the binocular perceived phase when each eye viewed maximum contrast stimuli in binocular phase combination task. Stereo acuities were measured with maximum contrast stimuli using an identical spatial frequency (0.30 cycles/degree) and stimulus arrangement to that used in the eye dominance assessment. The averaged balance point was 0.93 ± 0.06 (Mean ± SD), the averaged absolute value of the binocular perceived phase when both eyes viewed maximum contrast stimuli was 7.62 ± 5.91°, and the averaged stereo acuity was 2.19 ± 0.34 log arc seconds. Neither of these two sensory eye dominance measures were significantly correlated with stereo acuity (Balance point: ρ = 0.14, P = 0.10; Phase: ρ = -0.13, P = 0.13). The sensory eye dominance, as reflected using a phase combination task, and stereopsis are not significantly correlated in the normal-sighted population at low spatial frequencies.

Stereopsis: are we assessing it in enough depth?

The assessment of stereoacuity is an integral part of the ophthalmic assessment, with the responses used to inform clinical management decisions. Stereoacuity impacts on many aspects of life, but there are discrepancies reported where people without measurable stereoacuity report appreciating 3-D vision. This could be due, in part, to the presentation of the stimuli. A literature review was undertaken to evaluate current assessment techniques, how they relate to patient outcomes, identify the limitations of current tests and discuss how they could be improved. Recent evidence has been collated on currently available tests, used commonly within vision clinics, with normative data provided allowing responses to the tests to be interpreted. The relevance of the results is evaluated in relation to a range of outcomes, where a reduced level of stereopsis has a negative impact on the ability of an individual to perform many tasks, and can lead to an increase in difficulty interacting in the world. Current tests are limited in the aspects of stereoacuity they assess and their ability to precisely measure stereopsis. The world is not static, yet clinical tests are limited to measuring static stereoacuity, even though higher grades of depth perception can be identified in the presence of changing depth. Presentation methods of stereoacuity tests have remained similar over time, with a limited number of disparity levels assessed. New assessment methods are becoming available that include automated staircase testing to present multiple levels of disparity using digital technology. Current clinical tests are limited in their presentation, and are poor at detecting/measuring stereoacuity in those with limited stereopsis. Given the relevance of the stereoacuity measurement to management choices and functional outcomes, new testing methods would be beneficial to fully assess stereoacuity, both static and dynamic.

3D laparoscopic surgery: a prospective clinical trial

Since it's introduction, laparoscopic surgery represented a real revolution in clinical practice. The use of a new generation three-dimensional (3D) HD laparoscopic system can be considered a favorable "hybrid" made by combining two different elements: feasibility and diffusion of laparoscopy and improved quality of vision. In this study we report our clinical experience with use of three-dimensional (3D) HD vision system for laparoscopic surgery. Between 2013 and 2017 a prospective cohort study was conducted at the University Hospital of Palermo. We considered 163 patients underwent to laparoscopic three-dimensional (3D) HD surgery for various indications. This 3D-group was compared to a retrospective-prospective control group of patients who underwent the same surgical procedures. Considerating specific surgical procedures there is no significant difference in term of age and gender. The analysis of all the groups of diseases shows that the laparoscopic procedures performed with 3D technology have a shorter mean operative time than comparable 2D procedures when we consider surgery that require complex tasks. The use of 3D laparoscopic technology is an extraordinary innovation in clinical practice, but the instrumentation is still not widespread. Precisely for this reason the studies in literature are few and mainly limited to the evaluation of the surgical skills to the simulator. This study aims to evaluate the actual benefits of the 3D laparoscopic system integrating it in clinical practice. The three-dimensional view allows advanced performance in particular conditions, such as small and deep spaces and promotes performing complex surgical laparoscopic procedures.

Determinants of neural responses to disparity in natural scenes

We studied disparity-evoked responses in natural scenes using high-density electroencephalography (EEG) in an event-related design. Thirty natural scenes that mainly included outdoor settings with trees and buildings were used. Twenty-four subjects viewed a series of trials composed of sequential two-alternative temporal forced-choice presentation of two different versions (two-dimensional [2D] vs. three-dimensional [3D]) of the same scene interleaved by a scrambled image with the same power spectrum. Scenes were viewed orthostereoscopically at 3 m through a pair of shutter glasses. After each trial, participants indicated with a key press which version of the scene was 3D. Performance on the discrimination was >90%. Participants who were more accurate also tended to respond faster; scenes that were reported more accurately as 3D also led to faster reaction times. We compared visual evoked potentials elicited by scrambled, 2D, and 3D scenes using reliable component analysis to reduce dimensionality. The disparity-evoked response to natural scene stimuli, measured from the difference potential between 2D and 3D scenes, comprised a sustained relative negativity in the dominant response component. The magnitude of the disparity-specific response was correlated with the observer's stereoacuity. Scenes with more homogeneous depth maps also tended to elicit large disparity-specific responses. Finally, the magnitude of the disparity-specific response was correlated with the magnitude of the differential response between scrambled and 2D scenes, suggesting that monocular higher-order scene statistics modulate disparity-specific responses.

Is There a Common Summary Statistical Process for Representing the Mean and Variance? A Study Using Illustrations of Familiar Items

A number of studies revealed that our visual system can extract different types of summary statistics, such as the mean and variance, from sets of items. Although the extraction of such summary statistics has been studied well in isolation, the relationship between these statistics remains unclear. In this study, we explored this issue using an individual differences approach. Observers viewed illustrations of strawberries and lollypops varying in size or orientation and performed four tasks in a within-subject design, namely mean and variance discrimination tasks with size and orientation domains. We found that the performances in the mean and variance discrimination tasks were not correlated with each other and demonstrated that extractions of the mean and variance are mediated by different representation mechanisms. In addition, we tested the relationship between performances in size and orientation domains for each summary statistic (i.e. mean and variance) and examined whether each summary statistic has distinct processes across perceptual domains. The results illustrated that statistical summary representations of size and orientation may share a common mechanism for representing the mean and possibly for representing variance. Introspections for each observer performing the tasks were also examined and discussed.

50 Years of Stereoblindness: Reconciliation of a Continuum of Disparity Detectors With Blindness for Disparity in Near or Far Depth

Whitman Richards (1932–2016) discovered some 50 years ago that about 30% of observers from the normal population exhibit stereoblindness: the disability to process binocular disparities in either far or near depth. We review the literature on stereoblindness entailing two insights. First, contemporary scholars in stereopsis undervalue the comprehension that disparity processing studies require precise assessments of observers’ stereoblindness. We argue that this frequently leads to suboptimal interpretations. Second, there is still an open conundrum: How can the established finding that disparity is processed by a continuum of detectors be reconciled with the disability of many observers to process a whole class of far or near disparities? We propose, based upon integration of literature, that an asymmetry between far and near disparity detection at birth—being present for a variety of reasons—can suppress the typical formation of binocular correlation during the critical period for the development of stereopsis early in life, thereby disabling a whole class of far or near disparities.

Individual differences in sensory eye dominance reflected in the dynamics of binocular rivalry

Normal binocular vision emerges from the combination of neural signals arising within separate monocular pathways. It is natural to wonder whether both eyes contribute equally to the unified cyclopean impression we ordinarily experience. Binocular rivalry, which occurs when the inputs to the two eyes are markedly different, affords a useful means for quantifying the balance of influence exerted by the eyes (called sensory eye dominance, SED) and for relating that degree of balance to other aspects of binocular visual function. However, the precise ways in which binocular rivalry dynamics change when the eyes are unbalanced remain uncharted. Relying on widespread individual variability in the relative predominance of the two eyes as demonstrated in previous studies, we found that an observer's overall tendency to see one eye more than the other was driven both by differences in the relative duration and frequency of instances of that eye's perceptual dominance. Specifically, larger imbalances between the eyes were associated with longer and more frequent periods of exclusive dominance for the stronger eye. Increases in occurrences of dominant eye percepts were mediated in part by a tendency to experience "return transitions" to the predominant eye - that is, observers often experienced sequential exclusive percepts of the dominant eye's image with an intervening mixed percept. Together, these results indicate that the often-observed imbalances between the eyes during binocular rivalry reflect true differences in sensory processing, a finding that has implications for our understanding of the mechanisms underlying binocular vision in general.

Thresholds for sine-wave corrugations defined by binocular disparity in random dot stereograms: Factor analysis of individual differences reveals two stereoscopic mechanisms tuned for spatial frequency

Threshold functions for sinusoidal depth corrugations typically reach their minimum (highest sensitivity) at spatial frequencies of 0.2-0.4 cycles/degree (cpd), with lower thresholds for horizontal than vertical corrugations at low spatial frequencies. To elucidate spatial frequency and orientation tuning of stereoscopic mechanisms, we measured the disparity sensitivity functions, and used factor analytic techniques to estimate the existence of independent underlying stereo channels. The data set (N = 30 individuals) was for horizontal and vertical corrugations of spatial frequencies ranging from 0.1 to 1.6 cpd. A principal component analysis of disparity sensitivities (log-arcsec) revealed that two significant factors accounted for 70% of the variability. Following Varimax rotation to approximate "simple structure", one factor clearly loaded onto low spatial frequencies (≤0.4 cpd), and a second was tuned to higher spatial frequencies (≥0.8 cpd). Each factor had nearly identical tuning (loadings) for horizontal and vertical patterns. The finding of separate factors for low and high spatial frequencies is consistent with previous studies. The failure to find separate factors for horizontal and vertical corrugations is somewhat surprising because the neuronal mechanisms are believed to be different. Following an oblique rotation (Direct Oblimin), the two factors correlated significantly, suggesting some interdependence rather than full independence between the two factors.