Stereopsis and disparity vergence in monkeys with subnormal binocular vision

Screening for Stereopsis Using an Eye-Tracking Glasses-Free Display in Adults: A Pilot Study

Purpose:

To explore the feasibility and repeatability of a novel glasses-free display combined with random-dot stimulus and eye-tracking technology for screening stereopsis in adults.

Methods:

A total of 74 patients aged 18–44 years were recruited in this study (male: female, 32:42), including 33 patients with high myopia [≤ -6.0 diopters (D)] and 41 patients with moderate-to-low myopia (>-6.0 D). Stereopsis was measured using glasses-free, polarized, and Titmus stereotests. All patients completed a visual fatigue questionnaire after the polarized stereotest and glasses-free test. Kendall's W and Cohen's Kappa tests were used to evaluate repeatability and consistency of the glasses-free stereotest.

Results:

The stereotest results using the glasses-free monitor showed strong repeatability in the three consecutive tests (W = 0.968, P < 0.01) and good consistency with the polarized stereotest and Titmus test results (vs. polarization: Kappa = 0.910, P < 0.001; vs. Titmus: Kappa = 0.493, P < 0.001). Stereopsis levels of the high myopia group were significantly poorer than those of the moderate-to-low myopia group in three stereotest monitors (all P < 0.05). There was no significant difference in visual fatigue level between the polarized and the glasses-free display test (P = 0.72). Compared with the polarized test, 56.76% of patients preferred the glasses-free display and found it more comfortable, 20.27% reported both tests to be acceptable.

Conclusions:

In our adult patients, the new eye-tracking glasses-free display system feasibly screened stereopsis with good repeatability, consistency, and patient acceptance.

Multiple Short Daily Periods of Normal Binocular Vision Preserve Stereopsis in Strabismus

Purpose

Infantile strabismus impedes the development of stereopsis. In optically strabismic monkeys, 2 continuous hours of normal binocular vision per day has been shown to preserve near-normal stereopsis. In this study, we investigated whether, as in learning, multiple shorter periods of intervention would further boost performance.

Methods

To simulate infantile esotropia, infant monkeys were reared with 30 prism diopters base-in starting at 4 weeks of age. Daily periods of normal binocular vision were provided by replacing prisms with plano lenses. Altogether, 14 monkeys were prism reared: 2 with continuous prism, 2 with 2 continuous hours of normal binocular vision per day, 6 with 2 noncontinuous hours, and 4 with 1 noncontinuous hour of binocular vision each day. Seven normally reared monkeys provided control data. Behavioral methods were employed to measure spatial contrast sensitivity, eye alignment, and stereopsis.

Results

One monkey reared with continuous prism had poor stereopsis, and the other had no stereopsis. Ten of the 12 monkeys reared with periods of normal binocular vision had stereopsis, and those with longer and more continuous periods of binocular vision had stereopsis approaching that of normally reared monkeys.

Conclusions

During early development, multiple short periods of binocular vision were effective in preserving clinically significant stereopsis in monkeys. These results suggest that by providing relatively short multiple daily intervention periods, stereopsis may be preserved in strabismic human children.

Cortical correlates of amblyopia

There are many levels of disorder in amblyopic vision, from basic acuity and contrast sensitivity loss to abnormal binocular vision and global perception of motion and form. Amblyopia treatment via patching to restore acuity often leaves other aspects of vision deficient. The source for these additional deficits is unclear. Neural correlates of poor binocular function and acuity loss are found in V1 and V2. However, they are generally not sufficient to account for behaviorally measured vision loss. This review summarizes the known cortical correlates of visual deficits found in association with amblyopia, particularly those relevant to binocular vision and higher-order visual processing, in striate and extrastriate cortex. Recommendations for future research address open questions on the role of suppression and oculomotor abnormalities in amblyopic vision, and underexplored mechanisms such as top-down influences on information transmission in the amblyopic brain.

Congenitally Impaired Disparity Vergence in Children With Infantile Esotropia

Purpose

We examined whether congenital impairment of disparity vergence in infantile esotropia (ET) exists in children with short duration ET (≤3 months) compared with long-duration ET and healthy controls. A short duration of misalignment would allow for a substantial amount of balanced binocular input during the critical period of binocular disparity development.

Methods

A total of 19 children aged 5 to 12 years and treated for infantile ET with a short (≤3 months; n = 10) or long (≥5 months; n = 9) duration of constant misalignment before alignment were enrolled. A total of 22 healthy control children were enrolled as a comparison group. Eye movements during disparity vergence and accommodative vergence were recorded using an EyeLink 1000 binocular eye tracker. Mean response gain was compared between and within groups to determine the effect of duration of misalignment and viewing condition.

Results

Compared with controls, children with short (P = 0.002) and long (P < 0.001) duration infantile ET had reduced response gains for disparity vergence, but not for accommodative vergence (P = 0.19).

Conclusions

Regardless of duration of misalignment, children with infantile ET had reduced disparity vergence, consistent with a congenital impairment of disparity vergence in infantile ET. Although early correction of misalignment increases the likelihood that some level of binocular disparity sensitivity will be present, normal levels may never be achieved.

Observations on the relationship between anisometropia, amblyopia and strabismus

We investigated the potential causal relationships between anisometropia, amblyopia and strabismus, specifically to determine whether either amblyopia or strabismus interfered with emmetropization. We analyzed data from non-human primates that were relevant to the co-existence of anisometropia, amblyopia and strabismus in children. We relied on interocular comparisons of spatial vision and refractive development in animals reared with 1) monocular form deprivation; 2) anisometropia optically imposed by either contact lenses or spectacle lenses; 3) organic amblyopia produced by laser ablation of the fovea; and 4) strabismus that was either optically imposed with prisms or produced by either surgical or pharmacological manipulation of the extraocular muscles. Hyperopic anisometropia imposed early in life produced amblyopia in a dose-dependent manner. However, when potential methodological confounds were taken into account, there was no support for the hypothesis that the presence of amblyopia interferes with emmetropization or promotes hyperopia or that the degree of image degradation determines the direction of eye growth. To the contrary, there was strong evidence that amblyopic eyes were able to detect the presence of a refractive error and alter ocular growth to eliminate the ametropia. On the other hand, early onset strabismus, both optically and surgically imposed, disrupted the emmetropization process producing anisometropia. In surgical strabismus, the deviating eyes were typically more hyperopic than their fellow fixating eyes. The results show that early hyperopic anisometropia is a significant risk factor for amblyopia. Early esotropia can trigger the onset of both anisometropia and amblyopia. However, amblyopia, in isolation, does not pose a significant risk for the development of hyperopia or anisometropia.

Intermittent esotropia

Not even half the number of the patients included in this study (N = 46) had been noticed as intermittent. Diplopia (N = 5) is not a reliable criterium. They need surgery with comparatively large amounts, on which behalf we prefer bi-medial rectus recessions. The prevailing result is "subnormal binocular vision," not to be confused with microtropia. Only four patients reached a cure, which means that they could not be differentiated from unaffected individuals any more.

Mechanisms of perceptual learning of depth discrimination in random dot stereograms

Perceptual learning is a training induced improvement in performance. Mechanisms underlying the perceptual learning of depth discrimination in dynamic random dot stereograms were examined by assessing stereothresholds as a function of decorrelation. The inflection point of the decorrelation function was defined as the level of decorrelation corresponding to 1.4 times the threshold when decorrelation is 0%. In general, stereothresholds increased with increasing decorrelation. Following training, stereothresholds and standard errors of measurement decreased systematically for all tested decorrelation values. Post training decorrelation functions were reduced by a multiplicative constant (approximately 5), exhibiting changes in stereothresholds without changes in the inflection points. Disparity energy model simulations indicate that a post-training reduction in neuronal noise can sufficiently account for the perceptual learning effects. In two subjects, learning effects were retained over a period of six months, which may have application for training stereo deficient subjects.

Binocular depth perception and the cerebral cortex

Our ability to coordinate the use of our left and right eyes and to make use of subtle differences between the images received by each eye allows us to perceive stereoscopic depth, which is important for the visual perception of three-dimensional space. Binocular neurons in the visual cortex combine signals from the left and right eyes. Probing the roles of binocular neurons in different perceptual tasks has advanced our understanding of the stages within the visual cortex that lead to binocular depth perception.

Effects of perceptual learning on local stereopsis and neuronal responses of V1 and V2 in prism-reared monkeys

Visual performance improves with practice (perceptual learning). In this study, we sought to determine whether or not adult monkeys reared with early abnormal visual experience improve their stereoacuity by extensive psychophysical training and testing, and if so, whether alterations of neuronal responses in the primary visual cortex (V1) and/or visual area 2 (V2) are involved in such improvement. Strabismus was optically simulated in five macaque monkeys using a prism-rearing procedure between 4 and 14 wk of age. Around 2 yr of age, three of the prism-reared monkeys ("trained" monkeys) were tested for their spatial contrast sensitivity and stereoacuity. Two other prism-reared monkeys received no training or testing ("untrained" monkeys). Microelectrode experiments were conducted around 4 yr of age. All three prism-reared trained monkeys showed improvement in stereoacuity by a factor of 7 or better. However, final stereothresholds were still approximately 10-20 times worse than those in normal monkeys. In V1, disparity sensitivity was drastically reduced in both the trained and untrained prism-reared monkeys and behavioral training had no obvious effect. In V2, the disparity sensitivity in the trained monkeys was better by a factor of approximately 2.0 compared with that in the untrained monkeys. These data suggest that the observed improvement in stereoacuity of the trained prism-reared monkeys may have resulted from better retention of disparity sensitivity in V2 and/or from "learning" by upstream neurons to more efficiently attend to residual local disparity information in V1 and V2.

Binocular Deficits Associated With Early Alternating Monocular Defocus. I. Behavioral Observations

To study the binocular vision deficits associated with anisometropia, monkeys were reared with alternating monocular defocus, which allowed monocular mechanisms to develop normally while binocular mechanisms were selectively compromised. A defocusing contact lens of –1.5 D, –3 D, or –6 D was worn on alternate eyes on successive days ( n = 3 per lens power) from 3 wk to 9 mo of age. The control subjects were two normally reared monkeys and two human observers. Functional binocular vision was assessed through behavioral measurements of stereoscopic depth discrimination thresholds as a function of spatial frequency. To characterize the extent of the deficits in disparity processing at a given spatial frequency, the contrast required to support stereopsis was determined for a range of disparities that exceeded the subjects' measured stereoacuity. The lens-reared monkeys showed spatial-frequency-selective deficits in stereopsis that depended on the magnitude of the simulated anisometropia experienced during the rearing period. For a given spatial frequency, the treated monkeys generally required higher than normal contrasts to support stereopsis even for large disparities. Moreover, a given increase in contrast produced smaller than normal improvements in stereo discrimination in our treated subjects, which suggests that in addition to deficits in contrast sensitivity, disparity-sensitive mechanisms exhibited low contrast gains. The spatial-frequency selective nature of the binocular deficits produced by the imposed anisometropia indicate that disparity processing mechanisms are normally spatial-frequency selective and that mechanisms tuned to different spatial frequencies can be differentially affected by abnormal binocular visual experience.

Temporal integration for stereoscopic vision

With normal binocular vision, maximal stereoacuity requires an extended viewing duration, but the relationship between the critical viewing duration for stereopsis and other variables affecting stereoacuity is unknown. The purposes of the study were to investigate the properties of normal temporal integration for stereoscopic vision with respect to the effects of contrast and spatial frequency of the stimuli and to determine whether the temporal summation of disparity is affected in deficient stereopsis caused by abnormal binocular vision during infancy. Psychophysical methods were used to measure stereothresholds in human and monkey subjects with either normal binocular vision or abnormal binocular vision. The results showed that the critical viewing duration for stereoscopic depth discrimination was independent of variations in basic stimulus parameters and/or the subject's stereoacuity. A critical duration of approximately 100 ms was found for both local (narrowband Gabor and broadband line targets) and global (dynamic random dots) stimuli. Although stereothresholds increased with decreasing stimulus contrast, the properties of temporal integration did not. Stereothresholds were substantially elevated for monkeys and humans with abnormal binocular vision, but the critical durations for these subjects were not significantly different from those of subjects with normal binocular vision. Overall, the results demonstrate that the general properties of temporal integration for stereopsis are similar to other detection and discrimination tasks that do not require binocular processing. In addition, increased integration time does not account for the elevated stereothresholds of subjects with abnormal binocular vision.

Assessment of stereopsis in rhesus monkeys using visual evoked potentials

Rhesus monkeys can have deficiencies in stereo vision, making it necessary to screen monkey subjects intended for single cell studies of stereo-based depth processing. We measured VEPs in two monkeys using a dynamic random-dot display in which a stereo-defined checkerboard reversed in depth. Monkeys fixated upon a small dot during stimulus presentation. One monkey showed clear evoked potentials in response to changes in disparity that were similar to those obtained in human subjects, using an identical stimulus paradigm. Controls with presentations of the monocular stimulus sequences (in which no depth reversal can be perceived) yielded no or much weaker VEPs. In the other animal, however, there was no difference in evoked potential between the two conditions. These electrophysiological findings closely match the performance of these same two subjects in a disparity discrimination task in which they were previously trained. We conclude that VEPs using this type of stimulus display can be used to screen monkeys for single cell or behavioral studies of stereopsis.

Residual binocular interactions in the striate cortex of monkeys reared with abnormal binocular vision

We investigated the nature of residual binocular interactions in the striate cortex (V1) of monkey models for the two most common causes of visual dysfunction in young children, specifically anisometropia and strabismus. Infant rhesus monkeys were raised wearing either anisometropic spectacle lenses that optically defocused one eye or ophthalmic prisms that optically produced diplopia and binocular confusion. Earlier psychophysical investigations had demonstrated that all subjects exhibited permanent binocular vision deficits and, in some cases, amblyopia. When the monkeys were adults, the responses of individual V1 neurons were studied with the use of microelectrode recording techniques while the animals were anesthetized and paralyzed. The manner in which the signals from the two eyes were combined in individual cells was investigated by dichoptically stimulating both eyes simultaneously with drifting sine wave gratings. In both lens- and prism-reared monkeys, fewer neurons had balanced ocular dominances and greater numbers of neurons were excited by only one eye. However, many neurons that appeared to be monocular exhibited clear binocular interactions during dichoptic stimulation. For the surviving binocular neurons, the maximum binocular response amplitudes were lower than normal; fewer neurons, particularly complex cells, were sensitive to relative interocular spatial phase disparities; and the remaining disparity-sensitive neurons exhibited lower degrees of binocular interaction. In prism-reared monkeys, an unusually high proportion of complex cells exhibited binocular suppression during dichoptic stimulation. Binocular contrast summation experiments showed that for both cooperative and antagonistic binocular interactions, contrast signals from the two eyes were combined by individual neurons in a normal linear fashion in both lens- and prism-reared monkeys. The observed binocular deficits appear to reflect a reduction in functional inputs from one eye and/or spatial imprecision in the monocular receptive fields rather than an aberrant form of binocular interaction. In the prism-reared monkeys, the predominance of suppression suggests that inhibitory connections were, however, less susceptible to diplopia and confusion than excitatory connections. Overall, there were many parallels between V1 physiology in our monkey models and the residual vision of humans with anisometropia or strabismus.

Motor and sensory fusion in monkeys: psychophysical measurements

Motor and sensory fusion, the basic processes of binocularity, must be present for bifoveal fixation with true fusion and stereopsis during ordinary viewing. The characteristics of motor and sensory fusion have been established for patients with normal and subnormal binocular vision; the present report describes our psychophysical studies of these processes in the macaque monkey. Three recent investigations of motor and sensory fusion in monkeys are described. The studies involved: (1) the comparability of motor and sensory fusion in monkeys and humans with normal binocular vision, (2) the effects of an early period of abnormal binocular vision on motor and sensory fusion in monkeys, and (3) the contrast sensitivity for binocular disparity in monkeys with stereo-deficiencies. The results of these studies demonstrated an excellent homology between the normal binocular vision of monkeys and humans. We also found that a period of esotropia during infancy caused deficiencies in sensory fusion, but not motor fusion. In some monkeys, the sensory deficiency persisted over the entire range of binocular disparities that were compatible with stereopsis, while other subjects demonstrated normal stereo-sensitivity for the largest fusible binocular disparities. The stereo-deficiencies of these monkeys, along with other visual attributes, suggest that their binocular vision is a viable model for the binocularity of patients with subnormal binocular vision or the monofixation syndrome.